2011 HCPCS Code Status Indicator for Medicare Outpatient Prospective Payment System HCPCS Code (If Applicable)

Transcription

1 Surgical NOTE #1: For Medicare Outpatient Hospital procedures, C1776 [Joint device (implantable)] and C1713 [Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)] might be allowable for purposes of billing for Zimmer implantable devices and products. Please check with your Payer(s) for complete billing and reimbursement details. NOTE #2: For implantable devices and products in the Zimmer Catalog, there are no separately reportable HCPCS codes for billing Inpatient Hospital Medicare procedures on the UB-04 Claim Form. These implantable devices and products are considered integral to the procedure performed, and the Medicare MS-DRG payment includes their costs in the total facility payment. Revenue Code(s) in the 027X range could be appended on the UB-04 claim form to track facility charges for such implantable devices and products. Please check with your Payer(s) for complete billing and reimbursement details. # EDI Item # Item Header 1 Header 2 Type ATS 3000 TOURNIQUET W/HOSES AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A ATS 3000 TOURNIQUET W/HOSES & AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A CUFFS ATS 3000 TOURNIQUET W/HOSES, AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A CUFFS, STD, BSKT ATS 3000 TOURNIQUET W/HOSES, AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A STAND, BASKET MANUAL, ATS3000 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A ATS1200 TOURNIQUET W/HOSES AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A ATS1200 TOURNIQUET W/HOSES & AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A CUFFS ATS 1200 TOURNIQUET W/HOSES, AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A CUFFS, STD, BSKT ATS 1200 TOURNIQUET W/HOSES, AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A STAND, BASKET MANUAL, ATS1200 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A ATS 750 TOURNIQUET W/HOSE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 750 TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A ATS 750 TOURNIQUET W/HOSE & AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 750 TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A CUFFS ATS 750 TOURNIQUET W/HOSE, AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 750 TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A CUFFS, STD, BSKT ATS 750 TOURNIQUET W/HOSE, AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. 750 TOURNIQUET SYSTEM MACHINES Tourniquets Tourniquets (Extremity) N/A N/A N/A STAND, BASKET ATS 2000 CALIBRATION KIT AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S TOURNIQUET SYSTEM Tourniquets Tourniquets (Extremity) N/A N/A N/A ACCESSORIES ATS 2000 MANUAL W/CUFF ALERT AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S TOURNIQUET SYSTEM Tourniquets Tourniquets (Extremity) N/A N/A N/A ACCESSORIES DPSB STER DISP CUFF LUER LOCK W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) DPSB STER DISP CUFF LUER LOCK W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) DPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) DPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) DPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) DPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) DPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) DPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 1

2 # EDI Item # Item Header 1 Header SPSB STER DISP CUFF LUER LOCK W/SLEEVE Type AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF LUER LOCK W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF LUER LOCK W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF LUER LOCK W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF LUER LOCK W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) DPDB STER DISP CUFF PLC W/SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) DPDB STER DISP CUFF PLC WSLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS W/SLEEVES Tourniquets Tourniquets (Extremity) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 2

3 # EDI Item # Item Header 1 Header DPSB STER DISP CUFF LUER LOCK Type AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) DPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) DPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) DPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) DPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) DPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) DPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) DPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) DPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) DPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) DPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) DPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) DPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 3

4 # EDI Item # Item Header 1 Header 2 Type DPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 4

5 # EDI Item # Item Header 1 Header 2 Type SPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) SPSB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) DPDB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) DPDB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) DPDB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) DPDB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) DPDB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) DPDB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) SPDB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) SPDB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) SPDB STER DISP CUFF LUER LOCK AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) SPDB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) SPDB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 5

6 # EDI Item # Item Header 1 Header 2 Type SPDB STER DISP CUFF PLC AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) STERILE DISPOSABLE CUFFS Tourniquets Tourniquets (Extremity) DPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) DPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) DPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) DPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) DPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) DPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) DPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) DPDB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) DPDB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) DPDB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) SPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) SPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 6

7 # EDI Item # Item Header 1 Header SPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Type Tourniquets Tourniquets (Extremity) SPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) SPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) SPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) SPSB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) SPDB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) SPDB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) SPDB ATS CYLINDRICAL CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) REUSABLE CYLINDRICAL CUFFS (NON- STERILE) Tourniquets Tourniquets (Extremity) SPSB CONTOUR UPPER LIMB CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) SPSB CONTOUR THIGH CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) SPSB CONTOUR LOWER LEG CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) SPDB CONTOUR UPPPER LIMB IVRA CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) DPSB CONTOUR UPPER LIMB CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 7

8 # EDI Item # Item Header 1 Header DPSB CONTOUR THIGH CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Type Tourniquets Tourniquets (Extremity) DPSB CONTOUR LOWER LEG CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) DPDB CONTOUR UPPER LIMB IVRA CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) DPSB CONTOUR CUFF - XL (30 IN-39 IN) AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) XL CONTOUR CUFFS (REUSABLE, NON- STERILE) Tourniquets Tourniquets (Extremity) SPSB CONTOUR CUFF - XL (30 IN-39 IN) AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) XL CONTOUR CUFFS (REUSABLE, NON- STERILE) Tourniquets Tourniquets (Extremity) PROT.SLEEVE/CONT.ARM CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFF SLEEVES Tourniquets Tourniquets (Extremity) PROT.SLEEVE/CONT.THIGHCUF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFF SLEEVES Tourniquets Tourniquets (Extremity) PROT.SLEEVE/CONT.LEG CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CONTOUR CUFF SLEEVES Tourniquets Tourniquets (Extremity) SPSB EXTRA SMALL ADULT CUFF 3 IN AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) SMALL ADULT CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) SPSB SMALL ADULT CUFF 3.5 IN AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) SMALL ADULT CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) DPSB EXTRA SMALL ADULT CUFF 3 IN AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) SMALL ADULT CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) DPSB SMALL ADULT CUFF 3.5 IN AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) SMALL ADULT CUFFS W/SLEEVES (REUSABLE, NON-STERILE) Tourniquets Tourniquets (Extremity) PROT. SLEEVE/ X-SM ADULT AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) SMALL ADULT SLEEVES Tourniquets Tourniquets (Extremity) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 8

9 # EDI Item # Item Header 1 Header 2 Type PROT. SLEEVE/ SM ADULT 10 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) SMALL ADULT SLEEVES Tourniquets Tourniquets (Extremity) INCH CUFF SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF SLEEVES - STERILE Tourniquets Tourniquets (Extremity) INCH CUFF SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF SLEEVES - STERILE Tourniquets Tourniquets (Extremity) INCH CUFF SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF SLEEVES - STERILE Tourniquets Tourniquets (Extremity) INCH CUFF SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF SLEEVES - STERILE Tourniquets Tourniquets (Extremity) INCH CUFF SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF SLEEVES - STERILE Tourniquets Tourniquets (Extremity) INCH CUFF SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF SLEEVES - STERILE Tourniquets Tourniquets (Extremity) INCH CUFF SLEEVE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF SLEEVES - STERILE Tourniquets Tourniquets (Extremity) ESMARK BANDAGES, DISP, 3IN X 9FT AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) STER ESMARK BANDAGES, DISP 4INX 9FT STER AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) ESMARK BANDAGES, DISP, 6IN X 9FT AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) STER ESMARK BANDAGES, DISP, 3IN X 12FT STER AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) ESMARK BANDAGES, DISP, 4IN X 12FT STER AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 9

10 # EDI Item # Item Header 1 Header ESMARK BANDAGES, DISP, 6IN X 12FT STER Type AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) LATEX FREE ESMARK 3IN. X 9FT. AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) LATEX FREE ESMARK 4IN. X 9FT. AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) LATEX FREE ESMARK 5.5IN X 9FT AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) LATEX FREE ESMARK 3IN. X 12FT. AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) LATEX FREE ESMARK 4IN. X 12FT. AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) LATEX FREE ESMARK 5.5IN X 12FT AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) ESMARK BANDAGES - STERILE Tourniquets Tourniquets (Extremity) DUAL STERILE EXTENSION HOSE W/LUER LOCK CONNECTOR AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) DUAL STERILE EXTENSION HOSE W/PLC CONNECTOR AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) ATS 500/750/1200 HOSE, RED/WE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A ATS 500/750/1200 HOSE, BLUE/W AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A SINGLE STERILE EXTENSION HOSE AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) W/LUER LOCK CONNECTR SINGLE STERILE EXTENSION HOSE W/PLC CONNECTOR AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) ATS 1500/2000 DUAL HOSE, BLU/W AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A ATS 1500/2000 DUAL HOSE, RED/W AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A CPC-TO-LUER ADAPTORS AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A A.T.S. DUAL HOSE RETROFIT KIT AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A A.T.S. 500 HOSE RETROFIT KIT AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A RED UNIVERSAL HOSE ADAPTERS AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A BLUE UNIVERSAL HOSE ADAPTERS AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A O-RINGS FOR TOURNIQUET CUFF AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) CUFF HOSES Tourniquets Tourniquets (Extremity) N/A N/A N/A CALIBRATION HOSE ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A PLUMBING ASSY ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A CONTROL BOARD ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A BATTERY ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A MEMBRANE CONTROL PANEL ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 10

11 # EDI Item # Item Header 1 Header 2 Type VOLT PUMP ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A CASE BASE ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A CASE LID ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A ROTARY KNOB ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A BATTERY BRACKET ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A DEFLATE VALVE ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A POWER ENTRY MODULE ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A MAIN WIRE HARNESS ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A BATTERY HARNESS ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A OVERPRESSURE SWITCH HARNESS AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A OVERPRESSURE SWITCH ATS 750 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A PUMP W/O TUBING ATS2000 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A VALVE 24VOLT CLIPPARD SLOW AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A VALVE 24VOLT BURKERT:FAST AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A FUSE 1A 5X20MM AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A ALARM SILENCE SWITCH W/O LAMP AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A ALARM SILENCE LAMP AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A ALARM SILENCE LENS RED AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A FEET W/O SCREWS AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A FUSE DRAWER 1/4IN X 1 1/4IN AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A FUSE DRAWER 5X20 CM AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A ALARM SILENCE HARNESS AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A SPEAKER HARNESS AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A OHM SPEAKER AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A AMPTIME DELAY 1 1/4IN (3.2 CM) AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A GLASS FUSE PUMP GASKET AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A GRAY POWER CORD AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A MAINS WIRING HARNESS, ATS AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A CORD CLIP, ATS1200 AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. PARTS Tourniquets Tourniquets (Extremity) N/A N/A N/A TOURNIQUET ACCESSORY BASKET AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. ACCESSORIES Tourniquets Tourniquets (Extremity) N/A N/A N/A TOURNIQUET STAND, AUTOMATIC TOURNIQUET SYSTEMS (A.T.S.) A.T.S. ACCESSORIES Tourniquets Tourniquets (Extremity) N/A N/A N/A TELESCOPING, W/28 BASE PULSAVAC PLUS COMPONENT KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS Pulsavac ( Debridement Debridement) PULSAVAC PLUS FAN SPRAY KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS Pulsavac ( Debridement Debridement) PULSAVAC PLUS HIP KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS Pulsavac ( Debridement Debridement) PULSAVAC PLUS SHOWER SPRAY KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS Pulsavac ( Debridement Debridement) PULSAVAC PLUS COMPONENT KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS Pulsavac ( Debridement Debridement) PULSAVAC PLUS FAN KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS Pulsavac ( Debridement Debridement) PULSAVAC PLUS HIP KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS Pulsavac ( Debridement Debridement) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 11

12 Type # EDI Item # Item Header 1 Header PULSAVAC PLUS SHOWER KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS Pulsavac ( Debridement Debridement) PULSAVAC PLUS AC POWER SUPPLY WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS AC Pulsavac ( US Debridement Debridement) PULSAVAC PLUS A/C COMPONENT KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS AC Pulsavac ( Debridement Debridement) PULSAVAC PLUS AC FAN SPRAY KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS AC Pulsavac ( Debridement Debridement) PULSAVAC PLUS AC HIP KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS AC Pulsavac ( Debridement Debridement) PULSAVAC PLUS AC SHOWER SPRAY KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS AC Pulsavac ( Debridement Debridement) PULSAVAC PLUS (LOW PRESSURE) COMPONENT KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS LOW PRESSURE Pulsavac ( Debridement Debridement) PULSAVAC PLUS (LOW PRESSURE) FAN SPRAY KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS LOW PRESSURE Pulsavac ( Debridement Debridement) PULSAVAC PLUS (LOW PRESSURE) SHOWER SPRAY KIT WOUND DEBRIDEMENT PRODUCTS PULSAVAC PLUS LOW PRESSURE Pulsavac ( Debridement Debridement) ADJUSTABLE LENGTH IM TIP HI-CAP WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) SINGLE STREAM TIP W/SPLASH SHIELD HI-CAP WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) FAN SPRAY TIP HI-CAP WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) FAN SPRAY TIP W/FILTER HI-CAP WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) FOUR ORIFICES IM TIP HI-CAP 20.32CM X 1.27CM WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 12

13 # EDI Item # Item Header 1 Header RADIAL SPRAY IM TIP HI-CAP 22.86CM X.89 CM Type WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) FEMORAL BRUSH TIP HI-CAP WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) HIP REVISION TIP HI-CAP WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) FOUR ORIFICES IM TIP HI-CAP 30.48CM X 1.27CM WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) TIBIAL PLATEAU BRUSH TIP HI-CAP WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) SHOWER SPRAY TIP HI-CAP WOUND DEBRIDEMENT PRODUCTS HIGH CAPACITY TIPS Pulsavac ( Debridement Debridement) IN SPLASH SHIELD WOUND DEBRIDEMENT PRODUCTS SPLASH SHIELDS Pulsavac ( Debridement Debridement) N/A N/A N/A IN SPLASH SHIELD WOUND DEBRIDEMENT PRODUCTS SPLASH SHIELDS Pulsavac ( Debridement Debridement) N/A N/A N/A SHIELDLESS FAN SPRAY TIP HI-CAP WOUND DEBRIDEMENT PRODUCTS SHIELDLESS TIPS Pulsavac ( Debridement Debridement) SHIELDLESS SHOWER SPRAY TIP HI- WOUND DEBRIDEMENT PRODUCTS SHIELDLESS TIPS Pulsavac ( CAP Debridement Debridement) WIDE SINGLE STREAM IM TIP WOUND DEBRIDEMENT PRODUCTS MISCELLANEOUS TIPS Pulsavac ( Debridement Debridement) FLEXIBLE TIP WOUND DEBRIDEMENT PRODUCTS MISCELLANEOUS TIPS Pulsavac ( Debridement Debridement) DUAL SPIKE Y-CONNECTOR WOUND DEBRIDEMENT PRODUCTS MISCELLANEOUS Pulsavac ( Debridement Debridement) HEMOVAC INFECTION CONTROL BAG PVC CLOSED WOUND DRAINAGE HEMOVAC INFECTION CONTROL KITS Closed PVC HEMOVAC INFECTION CONTROLKIT, 3/32 PVC DRAIN PVC CLOSED WOUND DRAINAGE HEMOVAC INFECTION CONTROL KITS Closed PVC 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 13

14 # EDI Item # Item Header 1 Header HEMOVAC INFECTION CONTROLKIT, 1/8 PVC DRAIN Type PVC CLOSED WOUND DRAINAGE HEMOVAC INFECTION CONTROL KITS Closed PVC HEMOVAC INFECTION CONTROLKIT, 3/16 PVC DRAIN PVC CLOSED WOUND DRAINAGE HEMOVAC INFECTION CONTROL KITS Closed PVC HEMOVAC INFECTION CONTROLKIT, 1/4 PVC DRAIN PVC CLOSED WOUND DRAINAGE HEMOVAC INFECTION CONTROL KITS Closed PVC ML HEMOVAC INFECTION CONTROL COMPONENT KIT PVC CLOSED WOUND DRAINAGE HEMOVAC INFECTION CONTROL KITS Closed PVC BONDED HEMOVAC INF CTRL, 1/8 PVC W/TROCAR DRN CLMP PVC CLOSED WOUND DRAINAGE HEMOVAC INFECTION CONTROL KITS Closed PVC BONDED HEMOVAC INF CTRL, 3/16 PVC W/TROCR DRN CLMP PVC CLOSED WOUND DRAINAGE HEMOVAC INFECTION CONTROL KITS Closed PVC BONDED HEMOVAC INF CTRL, 1/4 PVC W/TROCAR DRN CLMP PVC CLOSED WOUND DRAINAGE HEMOVAC INFECTION CONTROL KITS Closed PVC ML HEMOVAC KIT 1/8 IN PVC CLOSED WOUND DRAINAGE HEMOVAC KITS Closed PVC ML HEMOVAC KIT 3/16 IN PVC CLOSED WOUND DRAINAGE HEMOVAC KITS Closed PVC ML HEMOVAC KIT 1/4 IN PVC CLOSED WOUND DRAINAGE HEMOVAC KITS Closed PVC ML HEMOVAC KIT, 1/8 PVC DRAIN PVC CLOSED WOUND DRAINAGE HEMOVAC KITS Closed PVC ML HEMOVAC COMPONENT KIT PVC CLOSED WOUND DRAINAGE HEMOVAC KITS Closed PVC ML HEMOVAC KIT, 3/16 SOFT PVC PVC CLOSED WOUND DRAINAGE HEMOVAC KITS Closed DRAIN PVC ML HEMOVAC KIT, 1/4 PVC DRAIN, PVC CLOSED WOUND DRAINAGE HEMOVAC KITS Closed 4 IN TROCAR PVC 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 14

15 # EDI Item # Item Header 1 Header ML HEMOVAC KIT, 1/4 PVC DRAIN, PVC CLOSED WOUND DRAINAGE HEMOVAC KITS Closed 5 IN TROCAR Type PVC ML HEMOVAC KIT, 3/32 IN PVC DRAIN PVC CLOSED WOUND DRAINAGE HEMOVAC KITS Closed PVC HYDROCOAT PVC KIT, 1/8 PVC DRAIN PVC CLOSED WOUND DRAINAGE HEMOVAC KITS - HYDROCOAT Closed PVC HYDROCOAT PVC KIT, 3/16 PVC DRAIN PVC CLOSED WOUND DRAINAGE HEMOVAC KITS - HYDROCOAT Closed PVC HYDROCOAT PVC KIT, 1/4 PVC DRAIN PVC CLOSED WOUND DRAINAGE HEMOVAC KITS - HYDROCOAT Closed PVC ML SURGIVAC KIT, 1/8 IN PVC DRAIN PVC CLOSED WOUND DRAINAGE SURGIVAC KITS Closed PVC ML SURGIVAC COMPONENT KIT PVC CLOSED WOUND DRAINAGE SURGIVAC KITS Closed PVC ML SURGIVAC KIT, 3/16 IN PVC DRAIN PVC CLOSED WOUND DRAINAGE SURGIVAC KITS Closed PVC ML SURGIVAC KIT, 1/4 PVC DRAIN PVC CLOSED WOUND DRAINAGE SURGIVAC KITS Closed W/TROCAR, LARGE PVC /32 IN PVC DRAIN, 5 IN TROCAR PVC CLOSED WOUND DRAINAGE MIDDLE PERFORATED PVC DRAINS Closed PVC /8 IN PVC DRAIN, 5 IN TROCAR PVC CLOSED WOUND DRAINAGE MIDDLE PERFORATED PVC DRAINS Closed PVC /16 IN SOFT PVC DRAIN, 5 IN TROCAR PVC CLOSED WOUND DRAINAGE MIDDLE PERFORATED PVC DRAINS Closed PVC /16 IN FIRM PVC DRAIN, 5 IN TROCAR PVC CLOSED WOUND DRAINAGE MIDDLE PERFORATED PVC DRAINS Closed PVC /4 IN PVC DRAIN, 5 IN TROCAR PVC CLOSED WOUND DRAINAGE MIDDLE PERFORATED PVC DRAINS Closed PVC 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 15

16 # EDI Item # Item Header 1 Header /8 IN PVC DRAIN, DUAL TROCARS PVC CLOSED WOUND DRAINAGE MIDDLE PERFORATED PVC DRAINS Closed Type PVC /16 IN PVC DRAIN, DUAL TROCARS PVC CLOSED WOUND DRAINAGE MIDDLE PERFORATED PVC DRAINS Closed PVC /4 PVC DRAIN, DUAL TROCARS PVC CLOSED WOUND DRAINAGE MIDDLE PERFORATED PVC DRAINS Closed PVC /8 IN PVC DRAIN, END- PERFORATED PVC CLOSED WOUND DRAINAGE END PERFORATED PVC DRAINS Closed PVC IN TROCARS, 1/8 IN PVC CLOSED WOUND DRAINAGE TROCARS Closed PVC IN TROCARS, 3/32 IN PVC CLOSED WOUND DRAINAGE TROCARS Closed PVC IN TROCARS, 1/4 IN PVC CLOSED WOUND DRAINAGE TROCARS Closed PVC IN TROCARS, 1/4 IN PVC CLOSED WOUND DRAINAGE TROCARS Closed PVC IN TROCARS, 3/16 IN PVC CLOSED WOUND DRAINAGE TROCARS Closed PVC EVACUATOR TUBING PVC CLOSED WOUND DRAINAGE ACCESSORIES Closed PVC UNIVERSAL Y-CONNECTOR PVC CLOSED WOUND DRAINAGE ACCESSORIES Closed PVC SUCTION ADAPTER PVC CLOSED WOUND DRAINAGE ACCESSORIES Closed PVC DIRECTIONAL FLOW CONTROL PVC CLOSED WOUND DRAINAGE ACCESSORIES Closed PVC ML HEMOVAC,1/8 SILICONE ROUND DRAIN W/TROCAR SILICONE CLOSED WOUND DRAINAGE HEMOVAC KITS Closed Silicone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 16

17 # EDI Item # Item Header 1 Header ML HEMOVAC 3/16 SILICONE ROUND DRAIN W/TROCAR Type SILICONE CLOSED WOUND DRAINAGE HEMOVAC KITS Closed Silicone ML HEMOVAC, 1/4 SILICONE ROUND DRAIN W/TROCAR SILICONE CLOSED WOUND DRAINAGE HEMOVAC KITS Closed Silicone ML HEMOVAC 3/32 ROUND W/TROCAR, SMALL STER SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone ML HEMOVAC, 1/8 ROUND W/TROCAR, MEDIUM STER SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone ML HEMOVAC 3/16 ROUND W/TROCAR, SOFT STER SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone ML MINI-BULB, 1/4 SILICONE ROUND W/TROCAR SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone ML HEMOVAC FULL PERF FLAT W/TROC 7MMX20CM STER SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone ML HEMOVAC FULL PERF FLT W/TROC 10MMX20CM STER SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone ML HEMOVAC 3/4 PERF FLAT W/TROC 7MMX20CM STER SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone ML HEMOVAC 3/4 PERF FLAT W/TROC 10MMX20CM STR SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone ML HEMOVAC FULL PERF W/O TROCAR 7MM X 20CM STER SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone ML HEMOVAC FULL PERF FLT W/OTROC 10MMX20CM STR SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone ML HEMOVAC 3/4 PERF FLT W/O TROC 7MMX20CM STR SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone ML HEMOVAC 3/4 PERF FLT W/OTROC 10MMX20CM STR SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Silicone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 17

18 # EDI Item # Item Header 1 Header ML MINI-HEMOVAC BULB SILICONE CLOSED WOUND DRAINAGE MINI-BULB KITS Closed Type Silicone ML MINI-HEMOVAC INFECTION CONTROL KIT SILICONE CLOSED WOUND DRAINAGE MINI-HEMOVAC INFECTION CONTROL KITS Closed Silicone ML COLLECTION BAG FOR MINI- HEMOVAC BULB SILICONE CLOSED WOUND DRAINAGE MINI-HEMOVAC INFECTION CONTROL KITS Closed Silicone ML SURGIVAC 1/8 DRAIN ROUND W/TROCAR SILICONE CLOSED WOUND DRAINAGE SURGIVAC KITS Closed Silicone ML SURGIVAC 3/16 DRAINROUND SILICONE CLOSED WOUND DRAINAGE SURGIVAC KITS Closed W/TROCAR, SOFT Silicone ML SURGIVAC 1/4 DRAIN ROUND W/TROCAR SILICONE CLOSED WOUND DRAINAGE SURGIVAC KITS Closed Silicone SILICONE FLAT DRAIN W/TROCAR, FULL PERF, 7MMX20CM SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed Silicone SILICONE FLAT DRAIN W/TROCAR, FULL PERF, 10MMX20CM SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed Silicone SILICONE FLAT DRAIN W/TROCAR, 3/4 PERF, 7MM X 20CM SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed Silicone SILICONE FLAT DRAIN W/TROCAR, 3/4 PERF, 10MMX20CM SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed Silicone MM X 20CM SILICONE FLAT DRAIN, FULL-PERFORATED SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed Silicone MM X 20CM SILICONE FLAT DRAIN, SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed FULL-PERFORATED Silicone MM X 20CM SILICONE FLAT DRAIN, 3/4-PERFORATED SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed Silicone MM X 20CM 3/4-PERFORATED SILICONE FLAT DRAIN SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed Silicone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 18

19 # EDI Item # Item Header 1 Header MMX 30CM FULL PERF SILICONE FLAT DRAIN Type SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed Silicone MM X 30CM SILICONE FLATDRAIN, FULL-PERFORATED SILICONE CLOSED WOUND DRAINAGE FLAT SILICONE DRAINS Closed Silicone /32 IN SILICONE ROUND DRAIN, END-PERFORATED SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone /8 IN SILICONE ROUND DRAIN, END- SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed PERFORATED Silicone /8 IN SILICONE ROUND DRAIN, MIDDLE-PERFORATED SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone /16 IN SILICONE ROUND DRAIN, MIDDLE-PERFORATED SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone /16 IN SILICONE ROUND DRAIN, END-PERFORATED SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone /4 IN SILICONE ROUND DRAIN, END- SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed PERFORATED Silicone /32 IN SILICONE ROUND DRAIN, MIDDLE-PERFORATED SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone /4 IN SILICIONE ROUND DRAIN, MIDDLE-PERFORATED SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone /32 IN SILICONE ROUND DRAIN, END-PERFORATED W/TRO SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone /8 IN SLICONE ROUND DRAIN, END- PERFORATED W/TROCA SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone /16 IN SILICONE ROUND DRAIN, END-PERFORATED W/TRO SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone /4 IN SILICONE ROUND DRAIN, END- SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed PERFORATED W/TROC Silicone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 19

20 # EDI Item # Item Header 1 Header SILICONE DRAIN, 3/32 DRAIN W/TROCAR MIDDLE PERF Type SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone SILICONE DRAIN, 1/8 DRAIN W/TROCAR, MIDDLE PERF SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone SILICONE DRAIN, 3/16 DRAIN W/TROCAR, MIDDLE PERF SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone SILICONE DRAIN, 1/4 DRAIN W/TROCAR, MIDDLE PERF SILICONE CLOSED WOUND DRAINAGE SILICONE DRAINS Closed Silicone HEMOVAC HYDROCOAT, 1/8 RND, END PERF W/TROCAR STER SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone HEMOVAC HYDROCOAT, 3/16 ROUND, END PERF W/TROCAR SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone HEMOVAC HYDROCOAT, 1/4 ROUND, END PERF W/TROCAR SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone HEMOVAC HYDROCOAT, 1/8 ROUND, MIDDLE PERF W/TROCAR SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone HEMOVAC HYDROCOAT, 3/16 RND, MDL PERF W/TROCR STER SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone HEMOVAC HYDROCOAT, 1/4 ROUND, MIDDLE PERF W/TROCAR SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone HEMOVAC HYDROCOAT FLAT DRAIN FULL PERF 7MM X 20CM SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone MM X 20CM FULLY PERF HEMOVAC HYROCOAT FLT DRN SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone MM X 20CM 3/4 PERF HEMOVAC HYDROCOAT FLT DRN SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone MM X 20CM 3/4 PERF HEMOVAC HYDROCOAT FLT DRN SILICONE CLOSED WOUND DRAINAGE HYDROCOAT SILICONE DRAINS Closed Silicone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 20

21 # EDI Item # Item Header 1 Header /8 IN HYDROCOAT QUAD-LUMEN DRAIN W/TROCAR Type SILICONE CLOSED WOUND DRAINAGE HYDROCOAT QUAD-LUMEN DRAINS Closed Silicone /16 IN HYDROCOAT QUAD-LUMEN DRAIN W/TROCAR SILICONE CLOSED WOUND DRAINAGE HYDROCOAT QUAD-LUMEN DRAINS Closed Silicone /4 IN HYDROCOAT QUAD-LUMEN DRAIN W/TROCAR SILICONE CLOSED WOUND DRAINAGE HYDROCOAT QUAD-LUMEN DRAINS Closed Silicone Y-CONNECTOR (FOR 3/32 AND 1/8 ROUND DRAINS) SILICONE CLOSED WOUND DRAINAGE ACCESSORIES Closed Silicone Y-CONNECTORS (FOR 3/16 & 1/4 ROUND & FLAT DRAINS) SILICONE CLOSED WOUND DRAINAGE ACCESSORIES Closed Silicone BIFURCATED DRAIN EXTENSIONS SILICONE CLOSED WOUND DRAINAGE ACCESSORIES Closed Silicone SUCTION ADAPTER SILICONE CLOSED WOUND DRAINAGE ACCESSORIES Closed Silicone HEMOVAC AUTOTRANSFUSION AUTOTRANSFUSION PRODUCTS HEMOVAC AUTOTRANSFUSION SYSTEMS Autotransfusi Autotransfusion HAS N/A N/A N/A SYSTEM, 1/8 PVC DRAIN (H.A.S.) on HEMOVAC AUTOTRANSFUSION AUTOTRANSFUSION PRODUCTS HEMOVAC AUTOTRANSFUSION SYSTEMS Autotransfusi Autotransfusion HAS N/A N/A N/A SYSTEMS, 3/16 PVC DRAIN (H.A.S.) on HEMOVAC AUTOTRANSFUSION AUTOTRANSFUSION PRODUCTS HEMOVAC AUTOTRANSFUSION SYSTEMS Autotransfusi Autotransfusion HAS N/A N/A N/A SYSTEMS, 1/4 PVC DRAIN (H.A.S.) on HAS COLLECTION BOTTLE AUTOTRANSFUSION PRODUCTS HEMOVAC AUTOTRANSFUSION SYSTEMS Autotransfusi Autotransfusion HAS N/A N/A N/A REPLACEMENT (H.A.S.) on HEMOVAC AUTOTRANSFUSION AUTOTRANSFUSION PRODUCTS HEMOVAC AUTOTRANSFUSION SYSTEMS Autotransfusi Autotransfusion HAS N/A N/A N/A SYSTEM, NO DRAIN (H.A.S.) on ZIMMER BLOOD REINFUSION AUTOTRANSFUSION PRODUCTS ZIMMER BLOOD REINFUSION SYSTEM Autotransfusi Zimmer Blood Reinfusion N/A N/A N/A SYSTEM 1/8 (Z.B.R.S.) on System ZIMMER BLOOD REINFUSION AUTOTRANSFUSION PRODUCTS ZIMMER BLOOD REINFUSION SYSTEM Autotransfusi Zimmer Blood Reinfusion N/A N/A N/A SYSTEM 3/16 (Z.B.R.S.) on System ZIMMER BLOOD REINFUSION AUTOTRANSFUSION PRODUCTS ZIMMER BLOOD REINFUSION SYSTEM Autotransfusi Zimmer Blood Reinfusion N/A N/A N/A SYSTEM 1/4 (Z.B.R.S.) on System ZIMMER BLOOD REINFUSION AUTOTRANSFUSION PRODUCTS ZIMMER BLOOD REINFUSION SYSTEM Autotransfusi Zimmer Blood Reinfusion N/A N/A N/A SYSTEM, NO DRAIN (Z.B.R.S.) on System ADVANCE 1115 STRAIGHT TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A ADVANCE 1115 OFFSET TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A ADVANCE POSTER OFFSET TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A ADVANCE 1115 STRAIGHT STL TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A ADVANCE 1115 OFFSET 4POSTER ST TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A STRYKER MPS STRAIGHT ABL TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A STRYKER MPS OFFSET ABS TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A STRYKER MPS OFFSET ABS TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A 4POSTER STRYKER MPS STRAIGHT STL TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A STRYKER MPS OFFSET STS TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A STRYKER MPS 4POSTER STS TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A HILL-ROM 840 4POSTER TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A TOTALCARE FRAME-BALKAN KIT- TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A COMPLETE CAREASSIST FRAME -BALKAN KIT- TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A COMPLETE VERSACARE FRAME-BALKAN KIT- TRACTION OVERHEAD FRAME KITS Traction Traction N/A N/A N/A COMPLETE SWIVEL BAR W/PULLEY, 9 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A DOUBLE PULLEY BAR, 18 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 21

22 # EDI Item # Item Header 1 Header 2 Type PLAIN BAR, 96 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A SWIVEL CLAMP BAR, 66 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A SINGLE CLAMP BAR, 9 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A SINGLE CLAMP BAR, 18 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A SINGLE CLAMP BAR, 27 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A SINGLE CLAMP BAR, 36 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A CENTER CLAMP BAR, 36 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A IV BAR TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A CURVED DOUBLE CLAMP BAR, 24 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A PLAIN BAR, 85 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A REINFORCED OVERHEAD BAR TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A OFFSET SWIVEL CLAMP BAR TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A HEAVY DUTY PLAIN BAR, 96 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A ZIMCO TRACTION PULLEY ASSY TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A PLASTISOL PLUG TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A SWIVEL CLAMP ASSEMBLY W/KNOB TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A KNOB-LOCK SCREW ASSY TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A TRAPEZE TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A CAP TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A LOCKING SLEEVE TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A S HOOK ONLY TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A SPREADER BAR, 22 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A DOUBLE CLAMP BAR, 27 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A IV POST W/CLAMP, 4 1/2 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A OFFSET DOUBLE CLAMP BAR, 27 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A PLAIN BAR, 36 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A SWIVEL CLAMP BAR, 48 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A ADJUSTABLE BAR, OVERHEAD, TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A LONG SMOOTH-TRAC TRACTION BAR, TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A LONG ADJUSTABLE BAR, TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A OVERHEAD,SHORT SMOOTH TRAC TRACTION TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A BAR,SHORT IV POST W/CLAMP, 9 3/4 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A IV POST W/CLAMP, 13 3/4 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A IV POST W/CLAMP, 18 3/4 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A DOUBLE CLAMP BAR, 35 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A OFFSET DOUBLE CLAMP BAR, 35 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A SINGLE CLAMP BAR, 5 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A IV POST W/CLAMP, 3 3/4 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A IV POST W/CLAMP, 24 5/8 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A IV POST W/CLAMP, 13 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A IV POST W/CLAMP, 19 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A IV POST W/CLAMP, 10 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A DOUBLE CLAMP BAR, 31 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A OFFSET DOUBLE CLAMP, 31 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A ANGLED IV POST W/CLAMP, 19 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A IV POST W/CLAMP 22 3/4 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A ANGLED IV POST W/CLAMP, 23 3/4 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A IV POST W/CLAMP, 16 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A IV POST W/CLAMP, 24 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A IV POST W/CLAMP, 28 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A PLAIN BAR, 44 TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A ANGLED IV POST W/CLAMP, 13 3/4 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A ANGLED IV POST W/CLAMP, 18 3/4 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A IV POST W/CLAMP, 5 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A IV POST W/CLAMP, 20 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A IV POST W/CLAMP, 12 1/2 IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A TOTALCARE-VERTICAL POST-61IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A VERSACARE VERTICAL POST- 69IN TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A TOTALCARE IV POST BRACKETHEAD TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A TOTALCARE IV POST BRACKETFOOT TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A CAREASSIST BRACKET HEAD TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A CAREASSIST BRACKET FOOT TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A VERSACARE BRACKET, FOOT TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A TOTAL CARE 40 IN PLAIN BAR TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A VERSACARE 42 IN PLAIN BAR TRACTION TRACTION BARS & IV POSTS Traction Traction N/A N/A N/A 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 22

23 # EDI Item # Item Header 1 Header 2 Type VINYL PAD HALF-RING CHILD TRACTION TRACTION ACCESSORIES Traction Traction E0870 Y TRACTION FRAME, ATTACHED TO FOOTBOARD, EXTREMITY TRACTION, (E.G. BUCKS) Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment VINYL PAD HALF-RING YOUTH TRACTION TRACTION ACCESSORIES Traction Traction E0870 Y TRACTION FRAME, ATTACHED TO FOOTBOARD, EXTREMITY TRACTION, (E.G. BUCKS) Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment VINYL PAD HALF-RING ADULT TRACTION TRACTION ACCESSORIES Traction Traction E0870 Y TRACTION FRAME, ATTACHED TO FOOTBOARD, EXTREMITY TRACTION, (E.G. BUCKS) Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment SLING, FULL LENGTH TRACTION TRACTION ACCESSORIES Traction Traction A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment PEARSON ATTACHMENT CHILD 48CM TRACTION TRACTION ACCESSORIES Traction Traction PEARSON ATTACHMENT YOUTH 53CM TRACTION TRACTION ACCESSORIES Traction Traction PEARSON ATTACHMENT ADULT 64CM TRACTION TRACTION ACCESSORIES Traction Traction 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 23

24 # EDI Item # Item Header 1 Header 2 Type FOOT SUPPORT, 26 CM TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE STRAP, EACH, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC HEEL REST, 13 CM TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE STRAP, EACH, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC CANVAS KNEE SLING TRACTION TRACTION ACCESSORIES Traction Traction A4565 N SLINGS BUNKER FT PIECE W/PULLEY TRACTION TRACTION ACCESSORIES Traction Traction E0941 Y Gravity assisted traction device, any type, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC POLYESTER PILE KNEE SLING TRACTION TRACTION ACCESSORIES Traction Traction A4565 N SLINGS POLYESTER PILE KNEE SLING TRACTION TRACTION ACCESSORIES Traction Traction A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment SERRATED CLIPS TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A ZIM CLIP TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A MINI-CLIPS TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A FOLDING BED CRADLE TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A BOHLER BRAUN LEG SPLINT TRACTION TRACTION ACCESSORIES Traction Traction A4570 E Splint 0270 Medical surgical supplies general; See Also Q4051 Splint supplies misc 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 24

25 # EDI Item # Item Header 1 Header 2 Type CANVAS SLINGS TRACTION TRACTION ACCESSORIES Traction Traction A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment BOHLER-STEINMANN PIN HOLDER, 9 TRACTION TRACTION ACCESSORIES Traction Traction X 8CM BOHLER-STEINMANN PIN HOLDER, 16 X 11CM TRACTION TRACTION ACCESSORIES Traction Traction BOHLER-STEINMANN PIN HOLDER, 21 X 11CM TRACTION TRACTION ACCESSORIES Traction Traction REPLACEMENT THUMB SCREW TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A KIRSCHNER WIRE TRACTOR TRACTION TRACTION ACCESSORIES Traction Traction 14X10CM KIRSCHNER WIRE TRACTOR 19X17CM TRACTION TRACTION ACCESSORIES Traction Traction KIRSCHNER WIRE TRACTOR 24X 17CM TRACTION TRACTION ACCESSORIES Traction Traction WEIGHT CARRIER, 15 CM TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A WEIGHT CARRIER, 22 CM TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A WEIGHT CARRIER, 30 CM TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A CAST IRON TRACTION WEIGHT, 1 LB TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A CAST IRON TRACTION WEIGHT, 2 LB TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A CAST IRON TRACTION WEIGHT, 5 LB TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A NYLON CORD, 100 FEET TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A DICOSOLA ROPE HOLDER TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A S-HOOK TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A ST. JOSEPH BED CRADLE TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A TRACTION FINGER APPARATUS, ADULT TRACTION TRACTION ACCESSORIES Traction Traction FINGER GRIP, SMALL TRACTION TRACTION ACCESSORIES Traction Traction FINGER GRIP, MEDIUM TRACTION TRACTION ACCESSORIES Traction Traction FINGER GRIP, LARGE TRACTION TRACTION ACCESSORIES Traction Traction 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 25

26 # EDI Item # Item Header 1 Header 2 Type FINGER GRIP, PEDIATRIC TRACTION TRACTION ACCESSORIES Traction Traction TRACTION FINGER APPARATUS,PEDIATRIC TRACTION TRACTION ACCESSORIES Traction Traction PANEL CLAMP - BUCK'S TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A TRAPEZE, HEAVY DUTY TRACTION TRACTION ACCESSORIES Traction Traction E0911 Y TRAPEZE BAR, HEAVY DUTY, FOR PATIENT WEIGHT CAPACITY GREATER THAN 250 POUNDS, ATTACHED TO BED, WITH GRAB BAR, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC PULLEY TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A WALL BUMPER HORNS TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A PANEL CLAMP, UPPER TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A PANEL CLAMP, LOWER TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A WALL BUMPER ROLLER TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A SPREADER BAR, 6 TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A SPREADER BAR, 8 TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A SPREADER BAR, 9 TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A SPREADER BAR, 12 TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A SPREADER BAR, STEPHAN, 8 TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A MINIMUM TO 16 MAXIMUM NELSON FINGER EXERCISER TRACTION TRACTION ACCESSORIES Traction Traction SPREADER BLOCK, 2 TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A SPREADER BLOCK, 3 TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A SPREADER BLOCK, 4 TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A TRACTION CORD, 33 YDS TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A TRACTION CORD, 100 YDS TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A TRACTION CORD, 250 YDS TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A TRACTION CART HOOK KIT TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A MOBILE TRACTION UNIT-COMPACT TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A MOBILE TRACTION UNIT, X-LONG TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A CROSS CLAMP TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A BRADY SPLINT ASSEMBLY TRACTION TRACTION ACCESSORIES Traction Traction 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 26

27 # EDI Item # Item Header 1 Header 2 Type FOOT EXERCISER PAD TRACTION TRACTION ACCESSORIES Traction Traction E1399 Y Unlisted device Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment BRADY BALANCED SUSPENSION SYSTEM TRACTION TRACTION ACCESSORIES Traction Traction PEARSON ATTACHMENT, BRADY TRACTION TRACTION ACCESSORIES Traction Traction FOOT EXERCISER ASSEMBLY TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A BILATERAL CLAMP ASSEMBLY TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A SPLINT PAD RING TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A THOMAS LEG SPLINT SET, PEDIATRIC TRACTION TRACTION ACCESSORIES Traction Traction THOMAS LEG SPLINT, PEDIATRIC TRACTION TRACTION ACCESSORIES Traction Traction THOMAS LEG SPLINT, SMALL TRACTION TRACTION ACCESSORIES Traction Traction THOMAS LEG SPLINT, MEDIUM TRACTION TRACTION ACCESSORIES Traction Traction THOMAS LEG SPLINT, LARGE TRACTION TRACTION ACCESSORIES Traction Traction THOMAS LEG SPLINT SET, SMALL TRACTION TRACTION ACCESSORIES Traction Traction THOMAS LEG SPLINT SET, MEDIUM TRACTION TRACTION ACCESSORIES Traction Traction SLINGS TRACTION TRACTION ACCESSORIES Traction Traction A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 27

28 # EDI Item # Item Header 1 Header 2 Type THOMAS LEG SPLINT SET, LARGE TRACTION TRACTION ACCESSORIES Traction Traction FOOT SUPPORT SLING TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC STRAP CLAMPS TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A THOMAS LEG SPLINT SET, X-WIDE TRACTION TRACTION ACCESSORIES Traction Traction PEARSON ATTACHMENT, SMALL TRACTION TRACTION ACCESSORIES Traction Traction PEARSON ATTACHMENT, MEDIUM TRACTION TRACTION ACCESSORIES Traction Traction PEARSON ATTACHMENT, LARGE TRACTION TRACTION ACCESSORIES Traction Traction PEARSON ATTACHMENT, X-WIDE TRACTION TRACTION ACCESSORIES Traction Traction SLINGS, EXTRA WIDE TRACTION TRACTION ACCESSORIES Traction Traction A4565 N SLINGS FOOT SUPPORT, SMALL TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 28

29 # EDI Item # Item Header 1 Header 2 Type FOOT SUPPORT, MEDIUM TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC FOOT SUPPORT, LARGE TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC FOOT SUPPORT, X-WIDE TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC HEEL REST, SMALL TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC HEEL REST, MEDIUM TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC HEEL REST, LARGE TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 29

30 # EDI Item # Item Header 1 Header 2 Type HEEL REST, X-LARGE TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC RING PAD, SMALL TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC RING PAD, MEDIUM TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC RING PAD, LARGE TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC RING PAD, X-LARGE TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC RING STRAP, SMALL TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 30

31 # EDI Item # Item Header 1 Header 2 Type RING STRAP, MEDIUM TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC RING STRAP, LARGE TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC RING STRAP, X-LARGE TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC PEARSON ATTACHMENT, PEDIATRIC TRACTION TRACTION ACCESSORIES Traction Traction FULL LENGTH SLING TRACTION TRACTION ACCESSORIES Traction Traction A4565 N SLINGS SLINGS, PEDIATRIC TRACTION TRACTION ACCESSORIES Traction Traction A4565 N SLINGS RADIOLUCENT SPLINT X-WIDE TRACTION TRACTION ACCESSORIES Traction Traction Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment KODEL RING PAD, SMALL TRACTION TRACTION ACCESSORIES Traction Traction E1399 Y Unlisted device Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 31

32 # EDI Item # Item Header 1 Header 2 Type KODEL RING PAD, MEDIUM TRACTION TRACTION ACCESSORIES Traction Traction E1399 Y Unlisted device Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment KODEL RING PAD, LARGE TRACTION TRACTION ACCESSORIES Traction Traction E1399 Y Unlisted device Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment KODEL THOMAS RING PAD TRACTION TRACTION ACCESSORIES Traction Traction E1399 Y Unlisted device Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment FOOT SUPPORT TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC HEEL REST TRACTION TRACTION ACCESSORIES Traction Traction E0951 OR E1399 Y E0951 HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE, 0290 Durable Medical STRAP, EACH E1399 UNLISTED DEVICE Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC TRACTION BAR END GUARDS TRACTION TRACTION ACCESSORIES Traction Traction HEAVY DUTY PULLEY TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A SINGLE BAG HOOK TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A MULTIPLE BAG HOOK TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 32

33 # EDI Item # Item Header 1 Header ZIMCODE TRACTION WEIGHT BAG, 10 LBS Type TRACTION TRACTION ACCESSORIES Traction Traction SAND WEIGHT BAG, 1 LB TRACTION TRACTION ACCESSORIES Traction Traction SAND WEIGHT BAG, 2 LBS TRACTION TRACTION ACCESSORIES Traction Traction SAND WEIGHT BAG, 5 LBS TRACTION TRACTION ACCESSORIES Traction Traction SAND WEIGHT BAG, 10 LBS TRACTION TRACTION ACCESSORIES Traction Traction FLEX-FOAM TRACTION STRIPS, 2 X 42 TRACTION TRACTION ACCESSORIES Traction Traction FLEX-FOAM TRACTION STRIPS 3X 42 TRACTION TRACTION ACCESSORIES Traction Traction FLEX-FOAM TRACTION STRIPS 4 X 42 TRACTION TRACTION ACCESSORIES Traction Traction FLEX-FOAM TRACTION STRIPS 2 IN X 25 YDS TRACTION TRACTION ACCESSORIES Traction Traction FLEX-FOAM TRACTION STRIPS 3 IN X 25 YDS TRACTION TRACTION ACCESSORIES Traction Traction FLEX-FOAM TRACTON STRIPS 4 IN X TRACTION TRACTION ACCESSORIES Traction Traction 25 YDS SKIN-TRAC TRACTION STRIP, 2 X 24 TRACTION TRACTION ACCESSORIES Traction Traction SKIN-TRAC TRACTION STRIP, 2-1/2 X 30 TRACTION TRACTION ACCESSORIES Traction Traction 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 33

34 # EDI Item # Item Header 1 Header 2 Type SKIN-TRAC TRACTION STRIP, 3 X 40 TRACTION TRACTION ACCESSORIES Traction Traction SKIN-TRAC TRACTION STRIP, 3 X 56 TRACTION TRACTION ACCESSORIES Traction Traction SKIN-TRAC TRACTION STRIP, 4 X 60 TRACTION TRACTION ACCESSORIES Traction Traction SKIN-TRAC DISPENSER CARTON, TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A SMALL SKIN-TRAC DISPENSER CARTON, TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A MEDIUM SKIN-TRAC DISPENSER CARTON, TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A LARGE SKIN-TRAC DISPENSER CARTON, TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A ADULT-LONG SKIN-TRAC DISPENSER CARTON, TRACTION TRACTION ACCESSORIES Traction Traction N/A N/A N/A LGE, X-LONG X-WIDE WILSON CONVEX FRAME TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction N/A N/A N/A TRACTION SET W/912 HALTER TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0942 N/A CERVICAL HEAD HARNESS/HALTER ZIMCODE BUCK'S EXTENSION SYSTEM EXO-STATIC TRACTION KIT W/WATER WEIGHT TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0870 Y TRACTION FRAME, ATTACHED TO FOOTBOARD, EXTREMITY TRACTION, (E.G. BUCKS) TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0942 Y CERVICAL HEAD HARNESS/HALTER HILL-ROM PATIENT HELPER TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0910 Y Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 34

35 # EDI Item # Item Header 1 Header PATIENT HELPER REINFORCED OVERHEAD BAR PAT HELPER ADAPTER(HEIGHT ADJ) SLEEVE Type TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0910 Y Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0910 Y Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar PATIENT HELPER, TOTAL CARE BED TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0910 Y Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar PATIENT HELPER STAND, TOTAL CARE TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0910 Y Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar PAT HELPER VERSACARE COMP TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0910 Y Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar BED FRAME ADAPTER VERSACARE TRACTION MISCELLANEOUS TRACTION FRAMES Traction Traction E0910 Y Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment ANKLE DISTRACTOR HARDWARE TRACTION SURGICAL TRACTION PRODUCTS Traction Traction Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 35

36 # EDI Item # Item Header 1 Header 2 Type ANKLE DISTRACTOR STRAP KIT TRACTION SURGICAL TRACTION PRODUCTS Traction Traction ANKLE DISTRACTOR EXTENSION BAR TRACTION SURGICAL TRACTION PRODUCTS Traction Traction ANKLE DISTRACTOR FORCE SCALE TRACTION SURGICAL TRACTION PRODUCTS Traction Traction ANKLE DISTRACTOR TENSION BAR TRACTION SURGICAL TRACTION PRODUCTS Traction Traction ALVARADO KNEE SUPPORT ASSEMBLY TRACTION SURGICAL TRACTION PRODUCTS Traction Traction ALVARADO KNEE SUPPORT, BASE PLATE TRACTION SURGICAL TRACTION PRODUCTS Traction Traction ALVARADO KNEE SUPPORT, TABLE BUTTRESS RIGHT FOOT TRACTION SURGICAL TRACTION PRODUCTS Traction Traction ALVARADO KNEE SUPPORT, TABLE BUTTRESS LEFT FOOT TRACTION SURGICAL TRACTION PRODUCTS Traction Traction ALVARADO SURGICAL KNEE HOLDER STABILIZING PLATE TRACTION SURGICAL TRACTION PRODUCTS Traction Traction ALVARADO DISPOSABLE LINER TRACTION SURGICAL TRACTION PRODUCTS Traction Traction ALVARADO II KNEE SUPPORT ASSEMBLY TRACTION SURGICAL TRACTION PRODUCTS Traction Traction ALVARADO II FOOT PIECE TRACTION SURGICAL TRACTION PRODUCTS Traction Traction ALVARADO II BASE PLATE TRACTION SURGICAL TRACTION PRODUCTS Traction Traction 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 36

37 # EDI Item # Item Header 1 Header 2 Type DELUXE DISKARD HEAD HALTERS TRACTION TRACTION REPAIRS & WARRANTIES Traction Traction E0942 Y CERVICAL HEAD HARNESS/HALTER MISC TRACTION REPAIR TRACTION TRACTION REPAIRS & WARRANTIES Traction Traction N/A N/A N/A BOHLER BRAUN FRAME REPAIR TRACTION TRACTION REPAIRS & WARRANTIES Traction Traction N/A N/A N/A STEINMANN PIN HOLDER REPAIR TRACTION TRACTION REPAIRS & WARRANTIES Traction Traction N/A N/A N/A KIRSCHNER WIRE TRACTOR REPAIR TRACTION TRACTION REPAIRS & WARRANTIES Traction Traction N/A N/A N/A Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment WILSON FRAME REPAIR CHG TRACTION TRACTION REPAIRS & WARRANTIES Traction Traction N/A N/A N/A TRACTION KNOB REPAIR CHG TRACTION TRACTION REPAIRS & WARRANTIES Traction Traction N/A N/A N/A BALANCED SUSP REPAIR CHG TRACTION TRACTION REPAIRS & WARRANTIES Traction Traction N/A N/A N/A TRACTION CLAMP REPAIR CHG TRACTION TRACTION REPAIRS & WARRANTIES Traction Traction N/A N/A N/A DELUXE PADDED HEAD HALTER, SMALL TRACTION HEAD HALTERS Traction Traction E0942 Y CERVICAL HEAD HARNESS/HALTER Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment DELUXE PADDED HEAD HALTER, MEDIUM TRACTION HEAD HALTERS Traction Traction E0942 Y CERVICAL HEAD HARNESS/HALTER Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment DELUXE PADDED HEAD HALTER, LARGE TRACTION HEAD HALTERS Traction Traction E0942 Y CERVICAL HEAD HARNESS/HALTER Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment ZIMMER PRO HEAD HALTER TRACTION HEAD HALTERS Traction Traction E0942 Y CERVICAL HEAD HARNESS/HALTER Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 37

38 # EDI Item # Item Header 1 Header 2 Type NO.7 HEAD HALTER TRACTION HEAD HALTERS Traction Traction E0942 Y CERVICAL HEAD HARNESS/HALTER Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment COMFORT PANEL TRACTION BELT 30-TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under 45, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment COMFORT PANEL TRACTION BELT 30-TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under 52, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment COMFORT PANEL TRACTION BELT SIZE DELUXE FOAM PADDED PELVICBELT+C143, SMALL TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment DELUXE FOAM PADDED PELVICBELT, TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under MEDIUM 34-42, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 38

39 # EDI Item # Item Header 1 Header 2 Type DELUXE FOAM PADDED PELVICBELT, TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under LARGE 42-50, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment DELUXE FOAM PADDED PELVICBELT, TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under X-LARGE 50-58, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment ZIMCODE PELVIC BELT, DOUBLE STRAP VELCR, ZIMCODE PELVIC BELT, DOUBLE STRAP VELCR, ZIMCODE PELVIC BELT, DOUBLE STRAP VELCR, ZIMCODE PELVIC BELT, DOUBLE STRAP VELCR,38-42 TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 39

40 # EDI Item # Item Header 1 Header ZIMCODE PELVIC BELT, DOUBLE STRAP VELCR,42-46 Type TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment ZIMCODE PELVIC BELT, -DBL STRAP,VELCRO, TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment UNIVERSAL DOUBLE-STRAP PELVIC TRACTION BELT UNIVERSAL DOUBLE-STRAP PELVIC TRACTION BELT TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment TRACTION STRAP KIT TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment UNIVERSAL SINGLE STRAP PELVIC TRACTION BELT TRACTION PELVIC BELTS Traction Traction E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 40

41 # EDI Item # Item Header 1 Header 2 Type UNIVERSAL TRACTION BOOT TRACTION TRACTION BOOTS Traction Traction DELUXE ZIM-TRAC CONV TRACTION SPLINT, PED DELUXE ZIM-TRAC CONV TRACTION SPLINT, X-SMALL DELUXE ZIM-TRAC CONV TRACTION SPLINT, SMALL DELUXE ZIM-TRAC CONV TRACTION SPLINT, MEDIUM DELUXE ZIM-TRAC CONV TRACTION SPLINT, LARGE DELUXE ZIM-TRAC CONV TRACTION SPLINT, X-LARGE ECONOMY LEG TRACTION SPLINT, SMALL TRACTION TRACTION BOOTS Traction Traction E0870 Y Traction frame, attached to footboard, extremity traction, (e.g. buck's) TRACTION TRACTION BOOTS Traction Traction E0870 Y Traction frame, attached to footboard, extremity traction, (e.g. buck's) TRACTION TRACTION BOOTS Traction Traction E0870 Y Traction frame, attached to footboard, extremity traction, (e.g. buck's) TRACTION TRACTION BOOTS Traction Traction E0870 Y Traction frame, attached to footboard, extremity traction, (e.g. buck's) TRACTION TRACTION BOOTS Traction Traction E0870 Y Traction frame, attached to footboard, extremity traction, (e.g. buck's) TRACTION TRACTION BOOTS Traction Traction E0870 Y Traction frame, attached to footboard, extremity traction, (e.g. buck's), 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment TRACTION TRACTION BOOTS Traction Traction Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 41

42 # EDI Item # Item Header 1 Header ECONOMY LEG TRACTION SPLINT, MEDIUM Type TRACTION TRACTION BOOTS Traction Traction ECONOMY LEG TRACTION SPLINT, LARGE TRACTION TRACTION BOOTS Traction Traction ECONOMY LEG TRACTION SPLINT, X- TRACTION TRACTION BOOTS Traction Traction LARGE SERPENTINE FOAM COLLAR, SM, X- WIDE, 4 X 18 ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) SERPENTINE FOAM COLLAR, SMALL, ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic 3 X 16-1/2 L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) SERPENTINE FOAM COLLAR, MEDIUM, 4 X 20-1/2 ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) SERPENTINE FOAM COLLAR, LARGE, 5 X 21-1/2 ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) SERPENTINE FOAM COLLAR, UNIVERSAL, 3 1/2X23-1/2 ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) SERPENTINE FOAM COLLAR, SM, X- LONG, 3 X 21 ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) SERPENTINE FOAM COLLAR, SM, 2-1/2 X 16-1/2 ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) SERPENTINE FOAM COLLAR, SMALL, ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic X-WIDE L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) SERPENTINE FOAM COLLAR, SMALL ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) SERPENTINE FOAM COLLAR, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) SERPENTINE FOAM COLLAR, LARGE ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) SERPENTINE FOAM COLLAR, MEDIUM, X-LONG ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) FOAM CERVICAL COLLAR, SMALL X- WIDE ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) FOAM CERVICAL COLLAR, SMALL ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) FOAM CERVICAL COLLAR, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 42

43 # EDI Item # Item Header 1 Header 2 Type FOAM CERVICAL COLLAR, LARGE ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) FOAM CERVICAL COLLAR, MEDIUM, X-LONG ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) FOAM CERVICAL COLLAR, SMALL, X- ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic WIDE L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) FOAM CERVICAL COLLAR, SMALL ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) FOAM CERVICAL COLLAR, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) FOAM CERVICAL COLLAR, LARGE ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) FOAM CERVICAL COLLAR, MEDIUM, X-LONG ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) PEDIATRIC CERVICAL COLLAR ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) FOAM CERVICAL COLLAR, UNIVERSAL ORTHOPAEDIC BRACES & SUPPORTS SOFT CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) EMS EXTRICATION COLLAR, PEDIATRIC ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) EMS EXTRICATION COLLAR, X- SMALL ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) EMS EXTRICATION COLLAR, SHORT ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) EMS EXTRICATION COLLAR, REGULAR ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) EMS EXTRICATION COLLAR, TALL ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) EMS EXTRICATION COLLAR, PED, SHORT ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0120 A CERVICAL, FLEXIBLE, NON- ADJUSTABLE (FOAM COLLAR) PHILADELPHIA CERVICAL COLLAR, SMALL, 3-1/4 ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE PHILADELPHIA CERVICAL COLLAR, MEDIUM, 3-1/4 ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE PHILADELPHIA CERVICAL COLLAR, LARGE, 3-1/4 ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE PHILADELPHIA CERVICAL COLLAR, SMALL, 4-1/4 ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 43

44 # EDI Item # Item Header 1 Header PHILADELPHIA CERVICAL COLLAR, MEDIUM, 4-1/4 Type ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE PHILADELPHIA CERVICAL COLLAR, LARGE, 4-1/4 ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE PHILADELPHIA CERVICAL COLLAR, SMALL, 5-1/4 ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE PHILADELPHIA CERVICAL COLLAR, MEDIUM, 5-1/4 ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE PHILADELPHIA CERVICAL COLLAR, LARGE, 5-1/4 ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE PADDED CERVICAL COLLAR, S ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE PADDED CERVICAL COLLAR, MED ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE PADDED CERVICAL COLLAR, STAND ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE PADDED CERVICAL COLLAR, T ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE REPLACEMENT PAD SET ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE Philly Patriot Collar, Pe ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE PHILLY PATRIOT ADJUSTABLE EXTRICATION COLLAR ADULT ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE PHILLY ONE-PIECE EXTRICATION COLLAR, INFANT ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE PHILLY ONE-PIECE EXTRICATION COLLAR, PED ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE PHILLY ONE-PIECE EXTRICATION COLLAR, LOW ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE PHILLY ONE-PIECE EXTRICATION COLLAR, SHORT ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE PHILLY ONE-PIECE EXTRICATION COLLAR, REG ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE PHILLY ONE-PIECE EXTRICATION COLLAR, TALL ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE COOLBRACE COLLAR, SMALL ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 44

45 # EDI Item # Item Header 1 Header 2 Type COOLBRACE COLLAR, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE COOLBRACE COLLAR, LARGE ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE PHILADELPHIA CERVICAL COLLAR, PED, 2-1/2 ORTHOPAEDIC BRACES & SUPPORTS EMS, RIGID CERVICAL COLLARS Orthopaedic L0172 A CERVICAL, COLLAR, SEMI-RIGID THERMOPLASTIC FOAM, TWO PIECE ZIMMER ARM SLING MULTI-PAK ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment ZIMMER ARM SLING MULTI-PAK ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment ZIMMER ARM SLING MULTI-PAK ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment ZIMMER ARM SLING MULTI-PAK ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment PEDIATRIC ARM SLING, XX-SMALL ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment PEDIATRIC ARM SLING, X-SMALL ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment FASHION ARM SLING, SMALL ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment FASHION ARM SLING SMALL, BOX 10 ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment FASHION ARM SLING, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment FASHION ARM SLING, MEDIUM, BOX 10 ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment FASHION ARM SLING, LARGE ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment FASHION ARM SLING, LARGE, BOX 10 ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 45

46 # EDI Item # Item Header 1 Header 2 Type FASHION ARM SLING, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment FASHION ARM SLING, X-LARGE, BOX ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic 10 A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment UNIVERSAL MULTI-SLING ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment PADDED STRAP ARM SLING, SMALL ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment PADDED STRAP ARM SLING, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment PADDED STRAP ARM SLING, LARGE ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment PADDED STRAP ARM SLING, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment American Way Arm Sling ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment UNIVERSAL ARM ELEVATOR/SLING ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment GARDNER ARM ELEVATOR, PEDIATRIC ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment GARDNER ARM ELEVATOR, YOUTH ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment PEDIATRIC FASHION ARM SLING, NAVY ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment PEDIATRIC FASHION ARM SLING, CHILD PRINT ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment STRAP ARM SLING W/PAD, SMALL ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 46

47 # EDI Item # Item Header 1 Header 2 Type STRAP ARM SLING W/PAD, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment STRAP ARM SLING W/PAD, LARGE ORTHOPAEDIC BRACES & SUPPORTS ARM SLINGS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment SHOULDER IMMOBILIZER/VELPEAU DRESSING, SMALL ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that SHOULDER IMMOBILIZER/VELPEAU DRESSING, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that SHOULDER IMMOBILIZER/VELPEAU DRESSING, LARGE ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that SHOULDER IMMOBILIZER/VELPEAU DRESSING, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that SHOULDER IMMOBILIZER/VELPEAU DRESSING, PED ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 47

48 # EDI Item # Item Header 1 Header MEN ELASTIC SHOULDER IMOBILIZER, CHEST, Type ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that MEN ELASTIC SHOULDER IMOBILIZER, CHEST, ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that MEN ELASTIC SHOULDER IMOBILIZER, CHEST ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that MEN ELASTIC SHOULDER IMOBILIZER, CHEST, ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that WOMEN ELASTIC SHOULDER IMOBILIZER, CHEST ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that WOMEN ELASTIC SHOULDER IMOBILIZER, CHEST ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 48

49 # EDI Item # Item Header 1 Header WOMEN ELASTIC SHOULDER IMOBILIZER, CHEST Type ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that WOMEN ELASTIC SHOULDER IMOBILIZER, CHEST ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ELASTIC SHOULDER IMMOBILIZER XX-LARGE ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that UNIVERSAL SHOULDER IMMOBILIZER PADDED ARM/SHOULDER IMMOBILIZER, SMALL ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE L3670 A SHOULDER ORTHOSIS, supplies prosthetic/orthotic devices; medical ACROMIO/CLAVICULAR (CANVAS surgical supplies other supplies/devices AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that PADDED ARM/SHOULDER IMMOBILIZER, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, General Medical Surgical Supplies 0270, Non- ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that PADDED ARM/SHOULDER IMMOBILIZER, LARGE ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 49

50 # EDI Item # Item Header 1 Header PADDED ARM/SHOULDER IMMOBILIZER, X-LARGE Type ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic L3670 A SHOULDER ORTHOSIS, ACROMIO/CLAVICULAR (CANVAS AND WEBBING TYPE), When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that DELUXE SLING AND SWATHE, SMALL ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment DELUXE SLING AND SWATHE, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment DELUXE SLING AND SWATHE, LARGE ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment DELUXE SLING AND SWATHE, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment UNIVERSAL SLING AND SWATHE ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment DELUXE SLING AND SWATHE, X- SMALL ORTHOPAEDIC BRACES & SUPPORTS SHOULDER IMMOBILIZERS Orthopaedic A4565 N SLINGS Packaged Item or Service. Items and Services Packaged into APC Rates. Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment MCLEOD CLAVICLE SPLINT, BUCKLE, ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic X-SMALL MCLEOD CLAVICLE SPLINT, BUCKLE, ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic SMALL L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 50

51 # EDI Item # Item Header 1 Header 2 Type MCLEOD CLAVICLE SPLINT, BUCKLE, ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic MEDIUM L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that MCLEOD CLAVICLE SPLINT, BUCKLE, ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic LARGE MCLEOD CLAVICLE SPLINT, BUCKLE, ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic X-LARGE L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that MCLEOD CLAVICLE SPLINT, CONTACT CLOSURE, X-SMALL ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that MCLEOD CLAVICLE SPLINT, CONTACT CLOSURE, SMALL ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that MCLEOD CLAVICLE SPLINT, CONTACT CLOSURE, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 51

52 # EDI Item # Item Header 1 Header MCLEOD CLAVICLE SPLINT, CONTACT CLOSURE, LARGE Type ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that MCLEOD CLAVICLE SPLINT, CONTACT CLOSURE, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that MCCLEOD CLAVICLE STRAP, X- SMALL ORTHOPAEDIC BRACES & SUPPORTS CLAVICLE SPLINTS Orthopaedic L3650 A SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that WRIST SPLINT, SMALL, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non WRIST SPLINT, SMALL, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non WRIST SPLINT, MEDIUM, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non WRIST SPLINT, MEDIUM, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non WRIST SPLINT, LARGE, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non WRIST SPLINT, LARGE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non WRIST SPLINT, X-LARGE, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 52

53 # EDI Item # Item Header 1 Header 2 Type WRIST SPLINT, X-LARGE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non ZIMMER PREMIUM WRIST BRACE, X- ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic SMALL, LEFT L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER PREMIUM WRIST BRACE, X- ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic SMALL, RIGHT L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER PREMIUM WRIST BRACE, SMALL, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER PREMIUM WRIST BRACE, SMALL, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER PREMIUM WRIST BRACE, MEDIUM, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 53

54 # EDI Item # Item Header 1 Header ZIMMER PREMIUM WRIST BRACE, MEDIUM, RIGHT Type ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER PREMIUM WRIST BRACE, LARGE, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER PREMIUM WRIST BRACE, LARGE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER PREMIUM WRIST BRACE, X- ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic LARGE, LEFT L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER PREMIUM WRIST BRACE, X- ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic LARGE, RIGHT L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER PREMIUM THUMB SPICA, X- SMALL, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 54

55 # EDI Item # Item Header 1 Header ZIMMER PREMIUM THUMB SPICA, X- SMALL, RIGHT Type ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER PREMIUM THUMB SPICA, SMALL, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER PREMIUM THUMB SPICA, SMALL, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER PREMIUM THUMB SPICA, MEDIUM, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER PREMIUM THUMB SPICA, MEDIUM, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER PREMIUM THUMB SPICA, LARGE, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 55

56 # EDI Item # Item Header 1 Header ZIMMER PREMIUM THUMB SPICA, LARGE, RIGHT Type ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER PREMIUM THUMB SPICA, X- LARGE, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER PREMIUM THUMB SPICA, X- LARGE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3931 A WRIST HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S), TURNBUCKLES, ELASTIC BANDS/SPRINGS, MAY INCLUDE SOFT INTERFACE MATERIAL, STRAPS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that Exo-Wrist Brace, Small, L ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that Exo-Wrist Brace, Small, R ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that EXO-WRIST BRACE, MEDIUM, L ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 56

57 # EDI Item # Item Header 1 Header 2 Type EXO-WRIST BRACE, MEDIUM, R ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that EXO-WRIST BRACE, LARGE, L ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that EXO-WRIST BRACE, LARGE, R ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that DELUXE COCKUP WRIST SPLINT, SMALL, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that DELUXE COCKUP WRIST SPLINT, SMALL, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that DELUXE COCKUP WRIST SPLINT, MEDIUM, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 57

58 # EDI Item # Item Header 1 Header DELUXE COCKUP WRIST SPLINT, MEDIUM, RIGHT Type ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that DELUXE COCKUP WRIST SPLINT, LARGE, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that DELUXE COCKUP WRIST SPLINT, LARGE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that DELUXE COCKUP WRIST SPLINT, X- LARGE, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that DELUXE COCKUP WRIST SPLINT, X- LARGE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that UNIVERSAL COCK-UP WRIST SPLINT, ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic RIGHT L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 58

59 # EDI Item # Item Header 1 Header UNIVERSAL COCK-UP WRIST, SPLINT, LEFT Type ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ADJUSTABLE WRIST BRACE, X- SMALL, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ADJUSTABLE WRIST BRACE, X- SMALL, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ADJUSTABLE WRIST BRACE, SMALL, ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic LEFT L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ADJUSTABLE WRIST BRACE, SMALL, ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic RIGHT L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ADJUSTABLE WRIST BRACE, MEDIUM, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 59

60 # EDI Item # Item Header 1 Header ADJUSTABLE WRIST BRACE, MEDIUM, RIGHT Type ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ADJUSTABLE WRIST BRACE, LARGE, ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic LEFT L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ADJUSTABLE WRIST BRACE, LARGE, ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic RIGHT L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ADJUSTABLE WRIST BRACE, X- LARGE, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ADJUSTABLE WRIST BRACE, X- LARGE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3807 A WRIST HAND FINGER ORTHOSIS, WITHOUT JOINT(S), S, ANY TYPE When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that WRISTLET WITH STRAP, SMALL RIGHT WRISTLET WITH STRAP, MEDIUM RIGHT WRISTLET WITH STRAP, LARGE RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 60

61 # EDI Item # Item Header 1 Header WRISTLET WITH STRAP, X-LARGE RIGHT Type ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic WRISTLET WITH STRAP, SMALL LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic WRISTLET WITH STRAP, MEDIUM LEFT WRISTLET WITH STRAP, LARGE LEFT WRISTLET WITH STRAP, X-LARGE LEFT DELUXE COCKUP WRIST SPLINT, X- SMALL, LEFT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that DELUXE COCKUP WRIST SPLINT, X- SMALL, RIGHT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that UNIVERSAL COCK-UP WRIST SPLINT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic 6 RIGHT UNIVERSAL COCK-UP WRIST SPLINT ORTHOPAEDIC BRACES & SUPPORTS WRIST SPLINTS Orthopaedic 6 LEFT L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, L3908 A WRIST HAND ORTHOSIS, WRIST EXTENSION CONTROL COCK- UP, NON MOLDED, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 61

62 # EDI Item # Item Header 1 Header ZIMMER AIRFORM BACK SUPPORT SMALL Type ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER AIRFORM BACK SUPPORT MEDIUM ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER AIRFORM BACK SUPPORT LARGE ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER AIRFORM BACK SUPPORT X-ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic LARGE L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER AIRFORM BACK SUPPORT XX-LARGE ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that UNIVERSAL SACROLUMBAR SUPPORT ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0626 or L0627 A Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l- 5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 62

63 # EDI Item # Item Header 1 Header 2 Type SPS III, LUMBAR SUPPORT, X-SMALL, ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic SPS III, LUMBAR SUPPORT, SMALL, ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic SPS III, LUMBAR SUPPORT, MEDIUM, ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic SPS III, LUMBAR SUPPORT, LARGE, SPS III, LUMBAR SUPPORT, X- LARGE, ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic ELASTIC BACK SUPPORT, SMALL ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0627 A Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment L0627 A Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment L0627 A Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment L0627 A Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment L0627 A Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, includes fitting and adjustment L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 63

64 # EDI Item # Item Header 1 Header 2 Type ELASTIC BACK SUPPORT, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ELASTIC BACK SUPPORT, LARGE ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic ELASTIC BACK SUPPORT, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that UNIVERSAL LUMBAR SUPPORT, SMALL/MEDIUM ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that UNIVERSAL LUMBAR SUPPORT, LARGE/X-LARGE ORTHOPAEDIC BRACES & SUPPORTS BACK SUPPORTS Orthopaedic L0625 A Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that COMFORT PANEL RIB BELT, MALE ORTHOPAEDIC BRACES & SUPPORTS RIB BELTS Orthopaedic COMFORT PANEL RIB BELT, FEMALE ORTHOPAEDIC BRACES & SUPPORTS RIB BELTS Orthopaedic UNIVERSAL RIB BELT, MALE, 6 IN ORTHOPAEDIC BRACES & SUPPORTS RIB BELTS Orthopaedic UNIVERSAL RIB BELT, MALE, 8 IN ORTHOPAEDIC BRACES & SUPPORTS RIB BELTS Orthopaedic A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 64

65 # EDI Item # Item Header 1 Header 2 Type UNIVERSAL RIB BELT, FEMALE, 6 IN ORTHOPAEDIC BRACES & SUPPORTS RIB BELTS Orthopaedic UNIVERSAL RIB BELT, FEMALE, 8 IN ORTHOPAEDIC BRACES & SUPPORTS RIB BELTS Orthopaedic COMFORT PANEL 9 IN ABDOMINAL BINDER ORTHOPAEDIC BRACES & SUPPORTS ABDOMINAL SUPPORTS Orthopaedic A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE COMFORT PANEL 9 IN ABDOMINAL BINDER ORTHOPAEDIC BRACES & SUPPORTS ABDOMINAL SUPPORTS Orthopaedic COMFORT PANEL 12 IN ABDOMINAL BINDER ORTHOPAEDIC BRACES & SUPPORTS ABDOMINAL SUPPORTS Orthopaedic COMFORT PANEL 12 IN ABDOMINAL BINDER ORTHOPAEDIC BRACES & SUPPORTS ABDOMINAL SUPPORTS Orthopaedic COMFORT PANEL ABDOMINAL S ORTHOPAEDIC BRACES & SUPPORTS ABDOMINAL SUPPORTS Orthopaedic COMFORT PANEL ABDOMINAL S ORTHOPAEDIC BRACES & SUPPORTS ABDOMINAL SUPPORTS Orthopaedic UNIVERSAL ABDOMINAL SUPPORT, 10 IN ORTHOPAEDIC BRACES & SUPPORTS ABDOMINAL SUPPORTS Orthopaedic UNIVERSAL ABDOMINAL SUPPORT, 12 IN ORTHOPAEDIC BRACES & SUPPORTS ABDOMINAL SUPPORTS Orthopaedic KNEE IMMOBILIZER FOAM CONTOURED, SMALL, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM CONTOURED, SMALL, 16 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 65

66 # EDI Item # Item Header 1 Header KNEE IMMOBILIZER FOAM CONTOURED, SMALL, 19 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM CONTOURED, SMALL, 22 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM CONTOURED, SMALL, 24 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM CONTOURED, MEDIUM, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM CONTOURED, MEDIUM, 16 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM CONTOURED, MEDIUM, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 66

67 # EDI Item # Item Header 1 Header KNEE IMMOBILIZER FOAM CONTOURED, MEDIUM, 22 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM CONTOURED, MEDIUM, 24 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM CONTOURED, LARGE, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM CONTOURED, LARGE, 16 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM CONTOURED, LARGE, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM CONTOURED, LARGE, 22 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 67

68 # EDI Item # Item Header 1 Header KNEE IMMOBILIZER FOAM CONTOURED, LARGE, 24 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM CONTOURED, X-LARGE, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM CONTOURED, X-LARGE, 16 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM CONTOURED, X-LARGE, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM CONTOURED, X-LARGE, 22 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM CONTOURED, X-LARGE, 24 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 68

69 # EDI Item # Item Header 1 Header KNEE IMMOBILIZER FOAM CONTOURED, XX-LARGE, 19 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM CONTOURED, XX-LARGE, 22 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM STRAIGHT, SMALL, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM STRAIGHT, SMALL, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM STRAIGHT, SMALL, 22 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM STRAIGHT, SMALL, 24 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 69

70 # EDI Item # Item Header 1 Header KNEE IMMOBILIZER FOAM STRAIGHT, MEDIUM, 12 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM STRAIGHT, MEDIUM, 16 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM STRAIGHT, MEDIUM, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM STRAIGHT, MEDIUM, 22 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM STRAIGHT, MEDIUM, 24 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM STRAIGHT, LARGE, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 70

71 # EDI Item # Item Header 1 Header KNEE IMMOBILIZER FOAM STRAIGHT, LARGE, 16 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM STRAIGHT, LARGE, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM STRAIGHT, LARGE, 22 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM STRAIGHT, LARGE, 24 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM STRAIGHT, X-LARGE, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM STRAIGHT, X-LARGE, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 71

72 # EDI Item # Item Header 1 Header KNEE IMMOBILIZER FOAM STRAIGHT, X-LARGE, 22 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM STRAIGHT, X-LARGE, 24 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM STRAIGHT, XX-LARGE, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM/TRICOT, SMALL, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM/TRICOT, SMALL, 16 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM/TRICOT, SMALL, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 72

73 # EDI Item # Item Header 1 Header KNEE IMMOBILIZER FOAM/TRICOT, SMALL, 22 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM/TRICOT, SMALL, 24 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM/TRICOT, MEDIUM, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM/TRICOT, MEDIUM, 16 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM/TRICOT, MEDIUM, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM/TRICOT, MEDIUM, 22 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 73

74 # EDI Item # Item Header 1 Header KNEE IMMOBILIZER FOAM/TRICOT, MEDIUM, 24 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM/TRICOT, LARGE, 12 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM/TRICOT, LARGE, 16 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM/TRICOT, LARGE, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM/TRICOT, LARGE, 22 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM/TRICOT, LARGE, 24 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 74

75 # EDI Item # Item Header 1 Header 2 Type KNEE IMMOBILIZER FOAM/TRICOT, X- ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, LARGE, 12 When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM/TRICOT, X- ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, LARGE, KNEE IMMOBILIZER FOAM/TRICOT, X- ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, LARGE, KNEE IMMOBILIZER FOAM/TRICOT, X- ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, LARGE, KNEE IMMOBILIZER FOAM/TRICOT, X- ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, LARGE, 24 When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER FOAM/TRICOT, XX-LARGE, 19 ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 75

76 # EDI Item # Item Header 1 Header KNEE IMMOBILIZER FOAM/TRICOT, XX-LARGE, 22 Type ORTHOPAEDIC BRACES & SUPPORTS SIZED KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER WITH MEDIAL/LATERAL STAYS, 12 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER WITH MEDIAL/LATERAL STAYS, 16 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER WITH MEDIAL/LATERAL STAYS, 19 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER WITH MEDIAL/LATERAL STAYS, 22 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER WITH MEDIAL/LATERAL STAYS, 24 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 76

77 # EDI Item # Item Header 1 Header KNEE IMMOBILIZER WITH MEDIAL/LATERAL STAYS, 26 Type ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER WITH MEDIAL/LATERAL STAYS, 28 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER TRIM FOAM, CONTOURED STAYS, 12 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER TRIM FOAM,CONTOURED STAYS 16 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER TRIM FOAM, CONTOURED STAYS, 19 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER TRIM FOAM, CONTOURED STAYS, 22 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 77

78 # EDI Item # Item Header 1 Header KNEE IMMOBILIZER TRIM FOAM, CONTOURED STAYS, 24 Type ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER TRIM FOAM, CONTOURED STAYS, 26 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER TRIM FOAM, CONTOURED STAYS, 28 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER TRIM FOAM, STRAIGHT STAYS, 12 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER TRIM FOAM, STRAIGHT STAYS, 16 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER TRIM FOAM, STRAIGHT STAYS, 19 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 78

79 # EDI Item # Item Header 1 Header KNEE IMMOBILIZER TRIM FOAM, STRAIGHT STAYS, 22 Type ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER TRIM FOAM, STRAIGHT STAYS, 24 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER TRI-PANEL, CONTOURED STAYS, 12 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER TRI-PANEL, CONTOURED STAYS, 16 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER TRI-PANEL, CONTOURED STAYS, 19 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER TRI-PANEL, CONTOURED STAYS, 22 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 79

80 # EDI Item # Item Header 1 Header KNEE IMMOBILIZER TRI-PANEL, CONTOURED STAYS, 24 Type ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER TRI-PANEL, CONTOURED STAYS, 26 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER TRI-PANEL, CONTOURED STAYS, 28 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER, UNIV W/PATELLA STRAP, 12 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER, UNIV W/PATELLA STRAP, 16 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER, UNIV W/PATELLA STRAP, 19 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 80

81 # EDI Item # Item Header 1 Header KNEE IMMOBILIZER, UNIV W/PATELLA STRAP, 22 Type ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER, UNIV W/PATELLA STRAP, 24 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER, UNIV W/PATELLA STRAP, 26 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that KNEE IMMOBILIZER, UNIV W/PATELLA STRAP, 28 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that UNIV ELASTIC STRAP KNEE IMMOBILIZER, 12 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that UNIV ELASTIC STRAP KNEE IMMOBILIZER, 16 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 81

82 # EDI Item # Item Header 1 Header UNIV ELASTIC STRAP KNEE IMMOBILIZER, 19 Type ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that UNIV ELASTIC STRAP KNEE IMMOBILIZER, 22 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that UNIV ELASTIC STRAP KNEE IMMOBILIZER, 24 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that UNIV ELASTIC STRAP KNEE IMMOBILIZER, 26 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that UNIV ELASTIC STRAP KNEE IMMOBILIZER, 28 ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support L1830 A KNEE ORTHOSIS, IMMOBILIZER, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that POPLITEAL FOAM INSERT ORTHOPAEDIC BRACES & SUPPORTS UNIVERSAL KNEE IMMOBILIZERS Knee Knee Support FORMFIT NIGHT SPLINT, SMALL ORTHOPAEDIC BRACES & SUPPORTS NIGHT SPLINTS Orthopaedic L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 82

83 # EDI Item # Item Header 1 Header 2 Type FORMFIT NIGHT SPLINT, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS NIGHT SPLINTS Orthopaedic L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that FORMFIT NIGHT SPLINT, LARGE ORTHOPAEDIC BRACES & SUPPORTS NIGHT SPLINTS Orthopaedic L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that PAVLIK HARNESS, SMALL ORTHOPAEDIC BRACES & SUPPORTS PAVLIK HARNESSES Orthopaedic PAVLIK HARNESS, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS PAVLIK HARNESSES Orthopaedic PAVLIK HARNESS, LARGE ORTHOPAEDIC BRACES & SUPPORTS PAVLIK HARNESSES Orthopaedic PAVLIK HARNESS, X-SMALL ORTHOPAEDIC BRACES & SUPPORTS PAVLIK HARNESSES Orthopaedic E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment E0944 Y Pelvic belt/harness/boot Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 83

84 # EDI Item # Item Header 1 Header ANKLE BR W/ELASTIC STRAP,X- SMALL LEFT Type ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ANKLE BR W/ELASTIC STRAP,X- SMALL, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ANKLE BR W/ELASTIC STRAP, SMALL, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ANKLE BR W/ELASTIC STRAP,SMALL, ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic RIGHT L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ANKLE BR W/ELASTIC STRAP, MEDIUM, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ANKLE BR W/ELASTIC STRAP, MEDIUM, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 84

85 # EDI Item # Item Header 1 Header ANKLE BR W/ELASTIC STRAP, LARGE, LEFT Type ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ANKLE BR W/ELASTIC STRAP, LARGE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ANKLE BR W/ELASTIC STRAP, X- LARGE, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ANKLE BR W/ELASTIC STRAP, X- LARGE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that /50 GEL ANKLE BRACE, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic /50 GEL ANKLE BRACE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 85

86 # EDI Item # Item Header 1 Header 2 Type /20 GEL ANKLE BRACE, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that /20 GEL ANKLE BRACE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic /50 PONY GEL ANKLE, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic /50 PONY GEL ANKLE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic LACE LOCK ANKLE BRACE, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic LACE LOCK ANKLE BRACE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 86

87 # EDI Item # Item Header 1 Header 2 Type PONY LACE LOCK ANKLE, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that PONY LACE LOCK ANKLE, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1930 A ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER HONEYCONE ANKLE STIRRUP, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER HONEYCOMB ANKLE STIRRUP, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER AIR ANKLE STIRRUP, LEFT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic ZIMMER AIR ANKLE STIRRUP, RIGHT ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 87

88 # EDI Item # Item Header 1 Header ZIMMER LACE ANKLE W/O STRAPS, SMALL Type ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER LACE ANKLE W/O STRAPS, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER LACE ANKLE W/O STRAPS, LARGE ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER LACE ANKLE W/O STRAPS, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER LACE ANKLE W/ STRAPS, SMALL ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER LACE ANKLE W/ STRAPS, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 88

89 # EDI Item # Item Header 1 Header ZIMMER LACE ANKLE W/STRAPS, LARGE Type ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER LACE ANKLE W/ STRAPS, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic DELUXE ANKLE BRACE, SMALL ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic DELUXE ANKLE BRACE, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic DELUXE ANKLE BRACE, LARGE ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic DELUXE ANKLE BRACE, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 89

90 # EDI Item # Item Header 1 Header ANKLE SUPPORT W/CONTACT CLOSURE, SMALL Type ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ANKLE SUPPORT W/CONTACT CLOSURE, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ANKLE SUPPORT W/CONTACT CLOSURE, LARGE ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ANKLE SUPPORT W/CONTACT CLOSURE, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS ANKLE BRACES Orthopaedic L1902 A Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that DH PRESSURE RELIEF WALKER, SMALL ORTHOPAEDIC BRACES & SUPPORTS PRESSURE RELIEF WALKERS Orthopaedic L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that DH PRESSURE RELIEF WALKER, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS PRESSURE RELIEF WALKERS Orthopaedic L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 90

91 # EDI Item # Item Header 1 Header DH PRESSURE RELIEF WALKER, LARGE Type ORTHOPAEDIC BRACES & SUPPORTS PRESSURE RELIEF WALKERS Orthopaedic L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that FIXED HINGE LEG WALKER, SMALL ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic REPLACEMENT LINER FOR ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic FIXED HINGE LEG WALKER, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic REPLACEMENT LINER FOR ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic FIXED HINGE LEG WALKER, LARGE ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that REPLACMENT LINER FOR ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 91

92 # EDI Item # Item Header 1 Header 2 Type REPLACEMENT LINER FOR ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic REPLACEMENT LINER FOR ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic REPLACEMENT LINER FOR ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic LOWER LEG ORTHOSIS II, SMALL ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic LOWER LEG ORTHOSIS II, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic LOWER LEG ORTHOSIS II, LARGE ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic ZIMMER AIR WALKER, SMALL ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic ZIMMER AIR WALKER, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 92

93 # EDI Item # Item Header 1 Header 2 Type ZIMMER AIR WALKER, LARGE ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER ANKLE TOP WALKER, SMALL ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER ANKLE TOP WALKER, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ZIMMER ANKLE TOP WALKER, LARGE ORTHOPAEDIC BRACES & SUPPORTS LOWER LEG WALKERS Orthopaedic L2116 A ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE ORTHOSIS, RIGID, When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that CUSHION ROCKER CAST SHOE,PED ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each CUSHION ROCKER CAST SHOE, XX- SMALL ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each CUSHION ROCKER CAST SHOE, X- SMALL ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each CUSHION ROCKER CAST SHOE, SMALL ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each CUSHION ROCKER CAST SHOE, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each CUSHION ROCKER CAST SHOE, LARGE ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each CUSHION ROCKER CAST SHOE, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 93

94 # EDI Item # Item Header 1 Header CUSHION ROCKER CAST BOOT, X- SMALL Type ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each CUSHION ROCKER CAST BOOT, SMALL ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each CUSHION ROCKER CAST BOOT, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each CUSHION ROCKER CAST BOOT, LARGE ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each CUSHION ROCKER CAST BOOT, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each DARCO CAST SHOE NAVY, X-SMALL ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each DARCO CAST SHOE NAVY, SMALL ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each DARCO CAST SHOE NAVY, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each DARCO CAST SHOE NAVY, LARGE ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each DARCO CAST SHOE NAVY, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each ROCKER SOLE CAST SHOE, X- SMALL ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each ROCKER SOLE CAST SHOE, SMALL ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each ROCKER SOLE CAST SHOE, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each ROCKER SOLE CAST SHOE, LARGE ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each ROCKER SOLE CAST SHOE, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS CAST SHOES & BOOTS Orthopaedic L3260 A Surgical boot/shoe, each DARCO ORTHOWEDGE HEALING SHOE, X-SMALL ORTHOPAEDIC BRACES & SUPPORTS HEALING SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH DARCO ORTHOWEDGE HEALING SHOE, SMALL ORTHOPAEDIC BRACES & SUPPORTS HEALING SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH DARCO ORTHOWEDGE HEALING SHOE, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS HEALING SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH DARCO ORTHOWEDGE HEALING SHOE, LARGE ORTHOPAEDIC BRACES & SUPPORTS HEALING SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 94

95 # EDI Item # Item Header 1 Header DARCO ORTHOWEDGE SHOE, X- LARGE Type ORTHOPAEDIC BRACES & SUPPORTS HEALING SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH DH PRESSURE RELIEF SHOE SMALL ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A Surgical boot/shoe, each DH PRESSURE RELIEF SHOE MEDIUM ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A Surgical boot/shoe, each DH PRESSURE RELIEF SHOE LARGE ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A Surgical boot/shoe, each DH PRESSURE RELIEF SHOE, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A Surgical boot/shoe, each PADDED POST-OP SHOE, MEN, SMALL, W/VELCRO ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH PADDED POST-OP SHOE, MEN, MEDIUM, W/VELCRO ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH PADDED POST-OP SHOE, MEN, LARGE, W/VELCRO ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH PADDED POST-OP SHOE, WOMEN, SMALL W/VELCRO ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH PADDED POST-OP SHOE, WOMEN, MEDIUM W/VELCRO ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH PADDED POST-OP SHOE, WOMEN, LARGE, W/VELCRO ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH DARCO POST-OP SHOE, WOMEN, SMALL ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH DARCO POST-OP SHOE, WOMEN, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH DARCO POST-OP SHOE, WOMEN, LARGE ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH DARCO POST-OP SHOE, MEN, SMALL ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH DARCO POST-OP SHOE, MEN, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH DARCO POST-OP SHOE, MEN, LARGE ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH DARCO POST-OP SHOE, MEN, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH DARCO MED/SURG BLACK VELCRO, XS ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A Surgical boot/shoe, each 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 95

96 # EDI Item # Item Header 1 Header DARCO MED/SURG BLACK VELCRO, SM Type ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A Surgical boot/shoe, each DARCO MED/SURG BLACK VELCRO, MD ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A Surgical boot/shoe, each DARCO MED/SURG BLACK VELCRO, LG ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A Surgical boot/shoe, each DARCO MED/SURG BLACK VELCRO, XL ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A Surgical boot/shoe, each POST-OPERATIVE SHOE, MEN'S, SMALL ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH POST-OPERATIVE SHOE, MEN'S, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH POST-OPERATIVE SHOE, MEN'S, LARGE ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH POST-OPERATIVE SHOE, WOMEN'S, SMALL ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH POST-OPERATIVE SHOE, WOMEN'S, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH POST-OPERATIVE SHOE, WOMEN'S, LARGE ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH PADDED POST-OP SHOE, PEDIATRIC, LACE-UP ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH PADDED POST-OP SHOE, YOUTH, W/VELCRO ORTHOPAEDIC BRACES & SUPPORTS POST-OP SHOES Orthopaedic L3260 A SURGICAL BOOT/SHOE, EACH FROIMSON TENNIS ELBOW SUPPORT, UNIVERSAL ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified ZIMMER FOREARM SUPPORT, SMALL ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified ZIMMER FOREARM SUPPORT, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified ZIMMER FOREARM SUPPORT, LARGE ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified ZIMMER FOREARM SUPPORT, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified ZIMMER FOREARM SUPPORT, SMALL ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified ZIMMER FOREARM SUPPORT, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 96

97 # EDI Item # Item Header 1 Header ZIMMER FOREARM SUPPORT, LARGE Type ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified ZIMMER FOREARM SUPPORT, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified TENNIS ELBOW SPT W/GEL ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified NEOPRENE ELBOW SUPPORT, SMALL ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified NEOPRENE ELBOW SUPPORT, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified NEOPRENE ELBOW SUPPORT, LARGE ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified NEOPRENE ELBOW SUPPORT, X- LARGE ORTHOPAEDIC BRACES & SUPPORTS FOREARM & ELBOW SUPPORTS Orthopaedic L3999 A Upper limb orthosis, not otherwise specified ELASTIC KNEE SUPPORT, SMALL ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ELASTIC KNEE SUPPORT, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ELASTIC KNEE SUPPORT, LARGE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ELASTIC KNEE SUPPORT, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE KNEE SLEEVE W/CLOSED PATELLA, BEIGE, SMALL KNEE SLEEVE W/CLOSED PATELLA, BEIGE, MEDIUM KNEE SLEEVE W/CLOSED PATELLA, BEIGE, LARGE KNEE SLEEVE W/CLOSED PATELLA, BEIGE, X-LARGE KNEE SLEEVE W/CLOSED PATELLA, BEIGE, XX-LARGE KNEE SLEEVE W/CLOSED PATELLA, BLUE, SMALL ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 97

98 # EDI Item # Item Header 1 Header KNEE SLEEVE W/CLOSED PATELLA, BLUE, MEDIUM KNEE SLEEVE W/CLOSED PATELLA, BLUE, LARGE KNEE SLEEVE W/CLOSED PATELLA, BLUE, X-LARGE KNEE SLEEVE W/CLOSED PATELLA, BLUE, XX-LARGE KNEE SLEEVE W/OPEN PATELLA, BEIGE, SMALL KNEE SLEEVE W/OPEN PATELLA, BEIGE, MEDIUM KNEE SLEEVE W/OPEN PATELLA, BEIGE, LARGE KNEE SLEEVE W/OPEN PATELLA, BEIGE, X-LARGE KNEE SLEEVE W/OPEN PATELLA, BEIGE, XX-LARGE KNEE SLEEVE W/OPEN PATELLA, BLUE, SMALL KNEE SLEEVE W/OPEN PATELLA, BLUE, MEDIUM KNEE SLEEVE W/OPEN PATELLA, BLUE, LARGE KNEE SLEEVE W/OPEN PATELLA, BLUE, X-LARGE KNEE SLEEVE W/OPEN PATELLA, BLUE, XX-LARGE NEOPRENE UNIVERSAL KNEE SUPPORT, BEIGE NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BEIGE, SML Type ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 98

99 # EDI Item # Item Header 1 Header NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BEIGE, MED NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BEIGE, LGE NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BEIGE, X-LGE NEOPRENE KNEE SPRT INFERIOR BUTTRESS BEIGE, XX-LGE NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BEIGE, XXXLG NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BEIGE, XXXXL NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BLUE, SML NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BLUE, MED NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BLUE, LGE NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BLUE, X-LGE NEOPRENE KNEE SPRT INFERIOR BUTTRESS, BLUE, XX-LGE NEOPRENE KNEE SPRT SUPERIOR BUTTRESS, BEIGE, SML NEOPRENE KNEE SPRT SUPERIOR BUTTRESS, BEIGE, MED NEOPRENE KNEE SPRT SUPERIOR BUTTRESS, BEIGE, LGE NEOPRENE KNEE SPRT SUPERIOR BUTTRESS, BEIGE, X-LGE NEOPRENE KNEE SPRT SUPERIOR BUTTRESS BEIGE, XX-LGE Type ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 99

100 # EDI Item # Item Header 1 Header NEOPRENE KNEE SPRT SUPERIOR BTRSS BGE XXX-L NEOPRENE KNEE SPRT SUPERIOR BTRSS BG XXXXLGE NEOPRENE KNEE SPRT SUPERIOR BUTTRESS, BLUE, SML NEOPRENE KNEE SPRT SUPERIOR BUTTRESS, BLUE, MED NEOPRENE KNEE SPRT SUPERIOR BUTTRESS, BLUE, LGE NEOPRENE KNEE SPRT SUPERIOR BUTTRESS, BLUE, X-LGE NEOPRENE KNEE SPRT SUPERIOR BUTTRESS, BLUE, XX-LGE NEOPRENE KNEE SPRT RIGHT BUTTRESS, BEIGE, SML NEOPRENE KNEE SPRT RIGHT BUTTRESS, BEIGE, MED NEOPRENE KNEE SPRT RIGHT BUTTRESS, BEIGE, LGE NEOPRENE KNEE SPRT RIGHT BUTTRESS, BEIGE, X-LGE NEOPRENE KNEE SPRT RIGHT BUTTRESS, BEIGE, XX-LGE NEOPRENE KNEE SPRT RIGHT BUTTRESS, BLUE, SML NEOPRENE KNEE SPRT RIGHT BUTTRESS, BLUE, MED NEOPRENE KNEE SPRT RIGHT BUTTRESS, BLUE, LGE NEOPRENE KNEE SPRT RIGHT BUTTRESS, BLUE, X-LGE Type ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 100

101 # EDI Item # Item Header 1 Header NEOPRENE KNEE SPRT RIGHT BUTTRESS, BLUE, XX-LGE NEOPRENE KNEE SPRT LEFT BUTTRESS, BEIGE, SML NEOPRENE KNEE SPRT LEFT BUTTRESS, BEIGE, MED NEOPRENE KNEE SPRT LEFT BUTTRESS, BEIGE, LGE NEOPRENE KNEE SPRT LEFT BUTTRESS, BEIGE, X-LGE NEOPRENE KNEE SPRT LEFT BUTTRESS, BEIGE, XX-LGE NEOPRENE KNEE SPRT LEFT BUTTRESS, BLUE, SML NEOPRENE KNEE SPRT LEFT BUTTRESS, BLUE, MED NEOPRENE KNEE SPRT LEFT BUTTRESS, BLUE, LGE NEOPRENE KNEE SPRT LEFT BUTTRESS, BLUE, X-LGE NEOPRENE KNEE SPRT LEFT BUTTRESS, BLUE, XX-LGE NEOPRENE PATELLAR STABILIZER, BEIGE, SMALL NEOPRENE PATELLAR STABILIZER, BEIGE, MEDIUM NEOPRENE PATELLAR STABILIZER, BEIGE, LARGE NEOPRENE PATELLAR STABILIZER, BEIGE, X-LARGE NEOPRENE PATELLAR STABILIZER, BEIGE, XX-LARGE Type ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 101

102 # EDI Item # Item Header 1 Header NEOPRENE PATELLAR STABILIZER, BLUE, SMALL NEOPRENE PATELLAR STABILIZER, BLUE, MEDIUM NEOPRENE PATELLAR STABILIZER, BLUE, LARGE NEOPRENE PATELLAR STABILIZER, BLUE, X-LARGE NEOPRENE PATELLAR STABILIZER, BLUE, XX-LARGE NEOPRENE HINGED KNEE SUPPORT, BEIGE, SMALL Type ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that NEOPRENE HINGED KNEE SUPPORT, BEIGE, MEDIUM NEOPRENE HINGED KNEE SUPPORT, BEIGE, LARGE NEOPRENE HINGED KNEE SUPPORT, BEIGE, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 102

103 # EDI Item # Item Header 1 Header NEOPRENE HINGED KNEE SUPPORT, BEIGE, XX-LARGE Type ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that NEOPRENE HINGED KNEE SUPPORT, BLUE, SMALL NEOPRENE HINGED KNEE SUPPORT, BLUE, MEDIUM NEOPRENE HINGED KNEE SUPPORT, BLUE, LARGE NEOPRENE HINGED KNEE SUPPORT, BLUE, X-LARGE NEOPRENE HINGED KNEE SUPPORT, BLUE, XX-LARGE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that NEOPRENE POST-ARTHROSCOPY KNEE SUPPORT, BEIGE, SML NEOPRENE POST-ARTHROSCOPY KNEE SUPPORT, BEIGE, MED ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 103

104 # EDI Item # Item Header 1 Header NEOPRENE POST-ARTHROSCOPY KNEE SUPPORT, BEIGE, LGE NEOPRENE POST-ARTHROSCOPY KNEE SUPPORT, BEIGE, XLG NEOPRENE POST-ARTHROSCOPY KNEE SUPPORT, BEIGE, XXL FLEXION/EXTENSION KNEE BRACE, REGULAR FLEXION/EXTENSION KNEE BRACE, SHORT Type ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support E1812 Y DYNAMIC KNEE, EXTENSION/FLEXION DEVICE WITH ACTIVE RESISTANCE CONTROL ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support E1812 Y DYNAMIC KNEE, EXTENSION/FLEXION DEVICE WITH ACTIVE RESISTANCE CONTROL DROP-LOK KNEE BRACE, X-SMALL ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1832 A Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment, 0290 Durable Medical Equipment (other than renal) - General Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC. When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that DROP-LOK KNEE BRACE, SMALL ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1832 A Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 104

105 # EDI Item # Item Header 1 Header 2 Type DROP-LOK KNEE BRACE, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1832 A Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that DROP-LOK KNEE BRACE, LARGE ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1832 A Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that DROP-LOK KNEE BRACE, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1832 A Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that CARTILAGE KNEE BRACE, X-SMALL ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE CARTILAGE KNEE BRACE, SMALL ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE CARTILAGE KNEE BRACE, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE CARTILAGE KNEE BRACE, LARGE ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE CARTILAGE KNEE BRACE, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support A4466 E GARMENT, BELT, SLEEVE OR 0270 Medical surgical supplies general; OTHER COVERING, ELASTIC OR SIMILAR STRETCHABLE 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 105

106 # EDI Item # Item Header 1 Header 2 Type HINGED KNEE SUPPORT, SMALL ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that HINGED KNEE SUPPORT, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that HINGED KNEE SUPPORT, LARGE ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that HINGED KNEE SUPPORT, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that NEOPRENE HINGED KNEE SUPPORT, SMALL ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 106

107 # EDI Item # Item Header 1 Header NEOPRENE HINGED KNEE SUPPPORT, MEDIUM Type ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that NEOPRENE HINGED KNEE SUPPORT, LARGE ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that NEOPRENE HINGED KNEE SUPPORT, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that NEOPRENE HINGED KNEE SPT, XXL ORTHOPAEDIC BRACES & SUPPORTS HINGED KNEE SUPPORTS Knee Knee Support L1810 A Knee orthosis, elastic with joints, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that STANDARD ORTHOPAEDIC WRAP, 2IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STANDARD ORTHOPAEDIC WRAP, 3IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STANDARD ORTHOPAEDIC WRAP, 4IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 107

108 # EDI Item # Item Header 1 Header STANDARD ORTHOPAEDIC WRAP, 6IN X 5YD Type ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STANDARD ORTHOPAEDIC WRAP, 2IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STANDARD ORTHOPAEDIC WRAP, 3IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STANDARD ORTHOPAEDIC WRAP, 4IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STANDARD ORTHOPAEDIC WRAP, 6IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STANDARD ORTHOPAEDIC WRAP, 4IN X 10YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STANDARD ORTHOPAEDIC WRAP, 6IN X 10YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non PREMIUM ORTHOPAEDIC WRAP, 2IN X 5.5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non PREMIUM ORTHOPAEDIC WRAP, 3IN X 5.5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non PREMIUM ORTHOPAEDIC WRAP, 4IN X 5.5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non PREMIUM ORTHOPAEDIC WRAP, 6IN X 5.5 YDS ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non PREMIUM ORTHOPAEDIC WRAP, 4IN X 10YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non PREMIUM ORTHOPAEDIC WRAP, 6IN X 11YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 108

109 # EDI Item # Item Header 1 Header STERILE PREMIUM ORTHOPAEDIC WRAP, 2IN X 5.5YD Type ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STERILE PREMIUM ORTHOPAEDIC WRAP, 3IN X 5.5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STERILE PREMIUM ORTHOPAEDIC WRAP, 4IN X 5.5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STERILE PREMIUM ORTHOPAEDIC WRAP, 6IN X 5.5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STERILE PREMIUM ORTHOPAEDIC WRAP, 4IN X 11YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STERILE PREMIUM ORTHOPAEDIC WRAP, 6IN X 11YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STANDARD ORTHOPAEDIC WRAP NON-LATEK 2IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STANDARD ORTHOPAEDIC WRAP NON-LATEKX 3IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STANDARD ORTHOPAEDIC WRAP NON-LATEX 4IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STANDARD ORTHOPAEDIC WRAP NON-LATEX 6IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STANDARD ORTHOPAEDIC WRAP NON-LATEX 2IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STANDARD ORTHOPAEDIC WRAP NON-LATEX 3IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STANDARD ORTHOPAEDIC WRAP NON-LATEX 4IN X 5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 109

110 # EDI Item # Item Header 1 Header STANDARD ORTHOPAEDIC WRAP NON-LATEX 6IN X 5YD Type ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STANDARD ORTHOPAEDIC WRAP NON-LATEX 4IN X 10YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STANDARD ORTHOPAEDIC WRAP NON-LATEX 6IN X 10YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non PREMIUM ORTHOPAEDIC WRAP NON-LATEX 2IN X 5.5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non PREMIUM ORTHOPAEDIC WRAP NON-LATEX 3IN X 5.5 YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non PREMIUM ORTHOPAEDIC WRAP NON-LATEX 4IN X 5.5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non PREMIUM ORTHOPAEDIC WRAP NON-LATEX 6IN X 5.5YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non PREMIUM ORTHOPAEDIC WRAP NON-LATEX 4IN X 11YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non PREMIUM ORTHOPAEDIC WRAP NON-LATEX 6IN X 11YD ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STERILE PREMIUM ORTHO WRAP ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STERILE PREMIUM ORTHO WRAP ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STERILE PREMIUM ORTHO WRAP ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STERILE PREMIUM ORTHO WRAP ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 110

111 # EDI Item # Item Header 1 Header 2 Type STERILE PREMIUM ORTHO WRAP ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non STERILE PREMIUM ORTHO WRAP ORTHOPAEDIC BRACES & SUPPORTS ELASTIC BANDAGES - NON-LATEX Orthopaedic S8431 N/A Compression bandage, roll General Medical Surgical Supplies 0270, Non INSTANT COLD PACK, SMALL ORTHOPAEDIC BRACES & SUPPORTS COLD PACKS Orthopaedic INSTANT COLD PACK, LARGE ORTHOPAEDIC BRACES & SUPPORTS COLD PACKS Orthopaedic COLD THERAPY WRAP, X-SMALL ORTHOPAEDIC BRACES & SUPPORTS COLD THERAPY WRAPS Orthopaedic COLD THERAPY WRAP, SMALL ORTHOPAEDIC BRACES & SUPPORTS COLD THERAPY WRAPS Orthopaedic COLD THERAPY WRAP, MEDIUM ORTHOPAEDIC BRACES & SUPPORTS COLD THERAPY WRAPS Orthopaedic COLD THERAPY WRAP, LARGE ORTHOPAEDIC BRACES & SUPPORTS COLD THERAPY WRAPS Orthopaedic COLD THERAPY WRAP, X-LARGE ORTHOPAEDIC BRACES & SUPPORTS COLD THERAPY WRAPS Orthopaedic COLD THERAPY WRAP, SHOULDER ORTHOPAEDIC BRACES & SUPPORTS COLD THERAPY WRAPS Orthopaedic COLD THERAPY WRAP, X-LONG ORTHOPAEDIC BRACES & SUPPORTS COLD THERAPY WRAPS Orthopaedic PLASTIC FOREARM SPLINT, CHILD, LEFT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non PLASTIC FOREARM SPLINT, CHILD, RIGHT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 111

112 # EDI Item # Item Header 1 Header PLASTIC FOREARM SPLINT, YOUTH, LEFT Type SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non PLASTIC FOREARM SPLINT, YOUTH, RIGHT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non PLASTIC FOREARM SPLINT, ADULT, LEFT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non PLASTIC FOREARM SPLINT, ADULT, RIGHT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non PLASTIC COLLES SPLINT, SMALL CHILD, LEFT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non PLASTIC COLLES SPLINT, SMALL CHILD, RIGHT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non PLASTIC COLLES SPLINT, CHILD, LEFT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non PLASTIC COLLES SPLINT, CHILD, RIGHT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non PLASTIC COLLES SPLINT, YOUTH/SMALL ADULT, LEFT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non- Service not separately priced by part B PLASTIC COLLES SPLINT, YOUTH/SMALL ADULT, RIGHT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non PLASTIC COLLES SPLINT, ADULT, LEFT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non PLASTIC COLLES SPLINT, ADULT, RIGHT SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non FOREARM SPLINT, LEFT, CHILD, PADDED, 7-1/2 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 112

113 # EDI Item # Item Header 1 Header FOREARM SPLINT, RIGHT, CHILD, PADDED, 7-1/2 Type SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non FOREARM SPLINT, LEFT, YOUTH, PADDED, 10 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non FOREARM SPLINT, RIGHT, YOUTH, PADDED, 10 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non FOREARM SPLINT, LEFT, ADULT, PADDED, 11-1/2 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non FOREARM SPLINT, RIGHT, ADULT, PADDED, 11-1/2 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non COLLES SPLINT PADDED LEFTSMALL CHILD SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non COLLES SPLINT, PADDED, RIGHT, SMALL CHILD SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non COLLES SPLINT, PADDED, LEFT, CHILD, 8 1/4 X 2 3/4 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non COLLES SPLINT, PADDED, RIGHT, CHILD, 8 1/4 X 2 3/4 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non COLLES SPLINT, PADDED, LEFT, YOUTH, 10 X 3 1/4 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non COLLES SPLINT, PADDED, RIGHT, YOUTH, 10 X 3 1/4 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non COLLES SPLINT, PADDED, LEFT, ADULT, 11 X 4 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non COLLES SPLINT, PADDED, RIGHT, ADULT, 11 X 4 SPLINTS FOREARM SPLINTS Splints Splint S8451 N/A Splint, prefabricated, wrist or ankle General Medical Surgical Supplies 0270, Non Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 113

114 # EDI Item # Item Header 1 Header METACARPAL SPLINT, LEFT, YOUTH, ANTERIOR 9 X 8CM METACARPAL SPLINT, RIGHT, YOUTH, ANTERIOR 9 X 8CM METACARPAL SPLINT, LEFT, ADULT, ANTERIOR 10 X 9CM METACARPAL SPLINT, RIGHT,ADULT, ANTERIOR 10 X 9CM FINGER PROTECTORS NONPADDED 4 CM Type SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc See Also Q4051 Splint supplies misc See Also Q4051 Splint supplies misc See Also Q4051 Splint supplies misc See Also Q4051 Splint supplies misc FINGER PROTECTORS NONPADDED 8 CM SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc FINGER PROTECTORS NONPADDED 9 CM SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc MASON-ALLEN SPLINT SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; MASON-ALLEN SPLINT SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; ZIMFOAM FINGER SPLINTS, 46 X 2 CM ZIMFOAM FINGER SPLINTS, 46 X 3 CM ZIMFOAM FINGER SPLINTS, 23 X 1 CM SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; ZIMFOAM BASEBALL SPLINTS, 2-3/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; ZIMFOAM BASEBALL SPLINTS, 2-13/16 SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; ZIMFOAM BASEBALL SPLINTS, 2-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; ZIMFOAM FINGER SPLINT KIT SPLINTS WRIST & FINGER SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; FINGER SPLINT KITS, ASSORTED SIZES SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc See Also Q4051 Splint supplies misc See Also Q4051 Splint supplies misc See Also Q4049 Finger splint, static; Q4051 Splint supplies misc See Also Q4049 Finger splint, static; Q4051 Splint supplies misc See Also Q4049 Finger splint, static; Q4051 Splint supplies misc See Also Q4051 Splint supplies misc See Also Q4051 Splint supplies misc See Also Q4051 Splint supplies misc See Also Q4049 Finger splint, static; Q4051 Splint supplies misc FINGER SPLINT KITS, 1-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc FINGER SPLINT KITS, 2-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc FINGER SPLINT KITS, 3-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc FINGER SPLINT KITS, 4-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 114

115 # EDI Item # Item Header 1 Header 2 Type FINGER SPLINT KIT, W/BULB, 3-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc FINGER SPLINT KIT, W/BULB, 4-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc FINGER SPLINT KIT, W/BULB, 5-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc FINGER SPLINT KIT, W/BULB, 6-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc FINGER SPLINT KIT, W/BULB, 7-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc STAX FINGER SPLINT KIT SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc REPLACEMENT SPLINTS, 1 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) REPLACEMENT SPLINTS, 2 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) REPLACEMENT SPLINTS, 3 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) REPLACEMENT SPLINTS, 4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) REPLACEMENT SPLINTS, 5 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) REPLACEMENT SPLINTS, 5-1/2 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) REPLACEMENT SPLINTS, 6 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) REPLACEMENT SPLINTS, 7 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) PADDED FINGER SPLINTS, 1-5/8 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc PADDED FINGER SPLINTS, 2-5/8 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc PADDED FINGER SPLINTS, 6 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 115

116 # EDI Item # Item Header 1 Header 2 Type FINGER COTS, PADDED, 1-1/4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc FINGER COTS, PADDED, 2 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc FINGER COTS, PADDED, 3 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc FINGER COTS, PADDED, 3-1/2 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc ZIMFOAM FINGER SPLINTS, PADDED, 3-5/8 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc ZIMFOAM FINGER SPLINTS, PADDED, 4-5/8 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc NARROW FINGER SPLINTS, PADDED, 6 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc FINGER PROTECTORS, PADDED, 1-1/2 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc FINGER PROTECTORS, PADDED, 3 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc FINGER PROTECTORS, PADDED, 3-1/2 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc LEWIN STERN THUMB SPLINT,6 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) LEWIN STERN FINGER SPLINT8-7/16 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) LEWIN BASEBALL SPLINTS, 3 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) LEWIN BASEBALL SPLINTS, 4 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) LEWIN BASEBALL SPLINTS, 5 SPLINTS WRIST & FINGER SPLINTS Splints Splint S8450 N/A lint, prefabricated, digit (specify digit General Medical Surgical Supplies 0270, Nonby use of modifier) See Also Q4049 Finger splint, static; Q4051 Splint supplies misc UNIVERSAL PLASTER SPLINTING, 7.2 YD SPLINTS UNIVERSAL SPLINTS Splints Splint A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; UNIVERSAL PLASTER SPLINTING, 7.2 YD SPLINTS UNIVERSAL SPLINTS Splints Splint A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; UNIVERSAL PLASTER SPLINTING, 7.2 YD SPLINTS UNIVERSAL SPLINTS Splints Splint A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 116

117 # EDI Item # Item Header 1 Header UNIVERSAL PLASTER SPLINTING, 7.2 YD Type SPLINTS UNIVERSAL SPLINTS Splints Splint A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; UNIVERSAL PLASTER SPLINTING, 7.2 YD SPLINTS UNIVERSAL SPLINTS Splints Splint A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; FIBERGLASS SPLINTING, 3 X 12 SPLINTS UNIVERSAL SPLINTS Splints Splint A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; FIBERGLASS SPLINTING, 4 X 15 SPLINTS UNIVERSAL SPLINTS Splints Splint A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; FIBERGLASS SPLINTING, 4 X 30 SPLINTS UNIVERSAL SPLINTS Splints Splint A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; PLASTIC TIBIA/FIBULA SPLINT SML CHILD, KNEE LENGTH SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; See Also Q4051 Splint supplies misc PLASTIC TIBIA/FIBULA SPLINT, CHILD, KNEE LENGTH SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; See Also Q4051 Splint supplies misc PLASTIC TIBIA/FIBULA SPLINT, YOUTH, KNEE LENGTH SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; See Also Q4051 Splint supplies misc PLASTIC TIBIA/FIBULA SPLINT, ADULT, KNEE LENGTH SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; See Also Q4051 Splint supplies misc PLASTIC TIBIA/FIBULA SPLINT SML CHILD, HIP LENGTH SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; See Also Q4051 Splint supplies misc PLASTIC TIBIA/FIBULA SPLINT, CHILD, HIP LENGTH SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; See Also Q4051 Splint supplies misc PLASTIC TIBIA/FIBULA SPLINT, YOUTH, HIP LENGTH SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; See Also Q4051 Splint supplies misc PLASTIC TIBIA/FIBULA SPLINT, ADULT, HIP LENGTH SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; See Also Q4051 Splint supplies misc TIBIA/FIBULA SPLINT, PAD,SMALL CHILD, 8-3/4 SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; See Also Q4051 Splint supplies misc TIBIA/FIBULA SPLINT, PAD,CHILD, 11-3/4 SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; See Also Q4051 Splint supplies misc TIBIA/FIBULA SPLINT, PAD,YOUTH/SMALL ADULT, 14 SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; See Also Q4051 Splint supplies misc 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 117

118 # EDI Item # Item Header 1 Header 2 Type TIBIA/FIBULA SPLINT, PAD,ADULT, 15- SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; /4 See Also Q4051 Splint supplies misc TIBIA/FIBULA SPLINT, PAD,HIP, SMALL CHILD, 14 SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; See Also Q4051 Splint supplies misc TIBIA/FIBULA SPLINT, PAD,HIP, CHILD, 19-1/2 SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; See Also Q4051 Splint supplies misc TIBIA/FIBULA SPLINT, PAD, HIP, Y/SML ADULT SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; See Also Q4051 Splint supplies misc TIBIA/FIBULA SPLINT, PAD,HIP, ADULT, 31 SPLINTS LEG SPLINTS Splints Splint A4570 E Splint 0270 Medical surgical supplies general; See Also Q4051 Splint supplies misc HUMERAL FRACTURE BRACE, SMALL SPLINTS FRACTURE BRACES Cast Cast L3980 A Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that HUMERAL FRACTURE BRACE, LARGE SPLINTS FRACTURE BRACES Cast Cast L3980 A Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that THUMB/WRIST IMMOBILIZER, SMALL, SPLINTS FRACTURE BRACES Cast LEFT THUMB/WRIST IMMOBILIZER, SMALL, SPLINTS FRACTURE BRACES Cast RIGHT Cast L3807 A Wrist hand finger orthosis, without joint(s), prefabricated, includes fitting and adjustments, any type Cast L3807 A Wrist hand finger orthosis, without joint(s), prefabricated, includes fitting and adjustments, any type When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 118

119 # EDI Item # Item Header 1 Header THUMB/WRIST IMMOBILIZER, MEDIUM, LEFT Type SPLINTS FRACTURE BRACES Cast Cast L3807 A Wrist hand finger orthosis, without joint(s), prefabricated, includes fitting and adjustments, any type When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that THUMB/WRIST IMMOBILIZER, MEDIUM, RIGHT SPLINTS FRACTURE BRACES Cast Cast L3807 A Wrist hand finger orthosis, without joint(s), prefabricated, includes fitting and adjustments, any type When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that THUMB/WRIST IMMOBILIZER, LARGE, LEFT SPLINTS FRACTURE BRACES Cast Cast L3807 A Wrist hand finger orthosis, without joint(s), prefabricated, includes fitting and adjustments, any type When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that THUMB/WRIST IMMOBILIZER, LARGE, RIGHT SPLINTS FRACTURE BRACES Cast Cast L3807 A Wrist hand finger orthosis, without joint(s), prefabricated, includes fitting and adjustments, any type When hospital outpatient staff provide a prosthetic or orthotic device, and the HCPCS code that ABDUCTION PILLOW SET, SMALL FOAM PRODUCTS ABDUCTION PILLOWS Foam ABDUCTION PILLOW SET, MEDIUM FOAM PRODUCTS ABDUCTION PILLOWS Foam ABDUCTION PILLOW SET, LARGE FOAM PRODUCTS ABDUCTION PILLOWS Foam ABDUCTION PILLOW BAND, SMALL FOAM PRODUCTS ABDUCTION PILLOWS Foam ABDUCTION PILLOW BAND, MEDIUM FOAM PRODUCTS ABDUCTION PILLOWS Foam Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES 0270 Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 119

120 # EDI Item # Item Header 1 Header ABDUCTION PILLOW BAND, LARGE FOAM PRODUCTS ABDUCTION PILLOWS Foam TUBULAR ZIMFOAM PADS, SMALL FOAM PRODUCTS ABDUCTION PILLOWS Foam TUBULAR ZIMFOAM PADS, MEDIUM FOAM PRODUCTS ABDUCTION PILLOWS Foam TUBULAR ZIMFOAM PADS, LARGE FOAM PRODUCTS ABDUCTION PILLOWS Foam ABDUCTION PILLOW STRAPS, SMALL ABDUCTION PILLOW STRAPS, MEDIUM ABDUCTION PILLOW STRAPS, LARGE Type FOAM PRODUCTS ABDUCTION PILLOWS Foam FOAM PRODUCTS ABDUCTION PILLOWS Foam FOAM PRODUCTS ABDUCTION PILLOWS Foam ABDUCTION PILLOWS FOAM PRODUCTS ABDUCTION PILLOWS Foam ABDUCTION PILLOWS FOAM PRODUCTS ABDUCTION PILLOWS Foam ABDUCTION PILLOWS FOAM PRODUCTS ABDUCTION PILLOWS Foam HEEL PROTECTORS, ZIMMER FOAM PRODUCTS HEEL & ELBOW PROTECTORS Foam Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0191 Y HEEL OR ELBOW PROTECTOR, EACH 0270 Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 120

121 # EDI Item # Item Header 1 Header HEEL PROTECTOR, ECONOMY FOAM PRODUCTS HEEL & ELBOW PROTECTORS Foam Type Foam E0191 Y HEEL OR ELBOW PROTECTOR, EACH Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment HEEL/ELBOW PROTECTORS, ULTRA- FOAM PRODUCTS HEEL & ELBOW PROTECTORS Foam CARE Foam E0191 Y HEEL OR ELBOW PROTECTOR, EACH Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment HEEL/ELBOW PROTECTORS, SLEEVE KNIT FOAM PRODUCTS HEEL & ELBOW PROTECTORS Foam Foam E0191 Y HEEL OR ELBOW PROTECTOR, EACH Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment HEEL/ELBOW PROTECTORS FOAM PRODUCTS HEEL & ELBOW PROTECTORS Foam OR DONUTS FOAM PRODUCTS POSITIONERS Foam MULTI-CRADLE POSITIONER FOAM PRODUCTS POSITIONERS Foam LAMINECTOMY ARM CRADLES FOAM PRODUCTS POSITIONERS Foam ULNAR NERVE PROTECTORS FOAM PRODUCTS POSITIONERS Foam Foam E0191 Y HEEL OR ELBOW PROTECTOR, EACH Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Non-Implantable Durable Medical Equipment Not paid under, 0290 Durable Medical OPPS. All institutional providers other than home health Equipment (other than renal) - General agencies bill to DMERC. Classification, 0291 Durable Medical Equipment (other than renal) - Rental, 0292 Durable Medical Equipment (other than renal) - Purchase of New DME, 0293 Durable Medical Equipment (other than renal) - Purchase of Used DME, 0294 Durable Medical Equipment (other than renal) - Supplies/Drugs for DME,0299 Durable Medical Equipment (other than renal) - Other Equipment 0270 Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 121

122 # EDI Item # Item Header 1 Header BODY ALIGNERS FOAM PRODUCTS POSITIONERS Foam CAST ELEVATORS FOAM PRODUCTS POSITIONERS Foam FOOT DROP STOPS FOAM PRODUCTS POSITIONERS Foam CRADLE BOOTS FOAM PRODUCTS POSITIONERS Foam SHOULDER ABDUCTION POSITIONER Type FOAM PRODUCTS POSITIONERS Foam L-P ULNAR NERVE PROTECTORS FOAM PRODUCTS POSITIONERS Foam OR HEAD POSITIONER FOAM PRODUCTS POSITIONERS Foam DEROTATION BOOT, COMPLETE FOAM PRODUCTS POSITIONERS Foam DEROTATION BOOT LINER FOAM PRODUCTS POSITIONERS Foam PCS KNEE ANTI-EMBOLISM STOCKINGS, SMALL, SHORT ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Foam E0190 E POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND ACCESSORIES Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; Medical surgical supplies general; PCS KNEE ANTI-EMBOLISM STOCKINGS, MEDIUM, SHORT ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; PCS KNEE ANTI-EMBOLISM STOCKINGS, LARGE, SHORT ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; PCS KNEE ANTI-EMBOLISM STOCKINGS, SMALL, REGULAR ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; PCS KNEE ANTI-EMBOLISM STOCKINGS, MEDIUM, REGULAR ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; PCS KNEE ANTI-EMBOLISM STOCKINGS, LARGE, REGULAR ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 122

123 # EDI Item # Item Header 1 Header PCS KNEE ANTI-EMBOLISM STOCKINGS, X-LARGE, REGULAR Type ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; PCS KNEE ANTI-EMBOLISM STOCKINGS, SMALL, LONG ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; PCS KNEE ANTI-EMBOLISM STOCKINGS, MEDIUM, LONG ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; PCS KNEE ANTI-EMBOLISM STOCKINGS, LARGE, LONG ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; PCS KNEE ANTI-EMBOLISM STOCKINGS, X-LARGE, LONG ANTI-EMBOLISM STOCKINGS KNEE-HIGH Compressio n Compression A4500 E Surgical stockings below knee length, each 0270 Medical surgical supplies general; PCS THIGH ANTI-EMBOLISM STOCKINGS, SMALL, SHORT ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; PCS THIGH ANTI-EMBOLISM STOCKINGS, MEDIUM, SHORT ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; PCS THIGH ANTI-EMBOLISM STOCKINGS, LARGE, SHORT ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; PCS THIGH ANTI-EMBOLISM STOCKINGS, SMALL, REGULAR ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; PCS THIGH ANTI-EMBOLISM STOCKINGS, MEDIUM, REGULAR ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; PCS THIGH ANTI-EMBOLISM STOCKINGS, LARGE, REGULAR ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; PCS THIGH ANTI-EMBOLISM STOCKINGS, X-LGE, REGULAR ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; PCS THIGH ANTI-EMBOLISM STOCKINGS, SMALL, LONG ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; PCS THIGH ANTI-EMBOLISM STOCKINGS, MEDIUM, LONG ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; PCS THIGH ANTI-EMBOLISM STOCKINGS, LARGE, LONG ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; PCS THIGH ANTI-EMBOLISM STOCKINGS, X-LARGE, LONG ANTI-EMBOLISM STOCKINGS THIGH-HIGH Compressio n Compression A4495 E Surgical stockings thigh length, each 0270 Medical surgical supplies general; WHITE FELT PADDING, 3/8 X 36 X 21 CASTING PRODUCTS CAST PADDING Cast Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 123

124 # EDI Item # Item Header 1 Header WHITE FELT PADDING, 1/8 X 36 X 21 CASTING PRODUCTS CAST PADDING Cast Type Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; WHITE FELT PADDING, 1/4 X 36 X 21 CASTING PRODUCTS CAST PADDING Cast WHITE FELT PADDING, 1/2 X 36 X 21 CASTING PRODUCTS CAST PADDING Cast ORTHO CAST PADDING, 2 CASTING PRODUCTS CAST PADDING Cast ORTHO CAST PADDING, 3 CASTING PRODUCTS CAST PADDING Cast ORTHO CAST PADDING, 4 CASTING PRODUCTS CAST PADDING Cast ORTHO CAST PADDING, 5 CASTING PRODUCTS CAST PADDING Cast Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; CAST VACUUM CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast BAGS FILTER REPLACEMENT CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast Cast N/A N/A N/A Cast CAST VAC WIREFORM CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast ZIMMER CAST SAW CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast ZIMMER CAST REMOVAL SYSTEM CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast SUPER UNIVERSAL SAW BLADE CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast Cast N/A N/A N/A Cast N/A N/A N/A Cast N/A N/A N/A Cast UNIVERSAL CAST SAW BLADE,2-1/2 CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast Cast CUTTER II SHROUD ASSEMBLY, 90 DEG CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast CUTTER II SHROUD ASSEMBLY, CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast STRAIGHT VACUUM CONNECTOR KIT, 90 DEG CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast VACUUM CONNECTOR KIT, CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast STRAIGHT CAST CUTTER REPAIR CASTING PRODUCTS CAST REMOVAL PRODUCTS Cast CASTING SPLINTS, 3 X 15 CASTING PRODUCTS CAST TAPE Cast Cast N/A N/A N/A Cast N/A N/A N/A Cast N/A N/A N/A Cast N/A N/A N/A Cast N/A N/A N/A Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; CASTING SPLINTS, 4 X 15 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 124

125 # EDI Item # Item Header 1 Header CASTING SPLINTS, 3 X 24 CASTING PRODUCTS CAST TAPE Cast Type Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; CASTING SPLINTS, 4 X 24 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; CASTING SPLINTS, 4 X 30 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; ZIM-FLEX CAST TAPE 2 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; ZIM-FLEX CAST TAPE, RED 2 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; ZIM-FLEX CAST TAPE, PINK,2 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; ZIM-FLEX CAST TAPE, LIGHTBLUE, 2 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; ZIM-FLEX CAST TAPE, BLUE,2 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; ZIM-FLEX CAST TAPE, GREEN, 2 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; ZIM-FLEX CAST TAPE, 3 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; ZIM-FLEX CAST TAPE, RED, 3 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; ZIM-FLEX CAST TAPE, PINK,3 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; ZIM-FLEX CAST TAPE, LIGHTBLUE, 3 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; ZIM-FLEX CAST TAPE, BLUE,3 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; ZIM-FLEX CAST TAPE, GREEN, 3 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; ZIM-FLEX CAST TAPE, 4 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; ZIM-FLEX CAST TAPE, RED, 4 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 125

126 # EDI Item # Item Header 1 Header ZIM-FLEX CAST TAPE, PINK,4 CASTING PRODUCTS CAST TAPE Cast Type Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; ZIM-FLEX CAST TAPE, LT BLU, 4 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; ZIM-FLEX CAST TAPE, BLUE,4 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; ZIM-FLEX CAST TAPE, GREEN, 4 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; ZIM-FLEX CAST TAPE, 5 CASTING PRODUCTS CAST TAPE Cast Cast A4590 E Special casting material (e.g. fiberglass) 0270 Medical surgical supplies general; ESMARCH PLASTER SHEARS CASTING PRODUCTS CAST INSTRUMENTS Cast UNIVERSAL SCISSORS, 18CM CASTING PRODUCTS CAST INSTRUMENTS Cast UTILITY FELT SHEARS CASTING PRODUCTS CAST INSTRUMENTS Cast BRUN PLASTER SHEARS CASTING PRODUCTS CAST INSTRUMENTS Cast CAST CART CASTING PRODUCTS CAST INSTRUMENTS Cast DISPOSABLE BUCKETS CASTING PRODUCTS CAST INSTRUMENTS Cast Cast N/A N/A N/A Cast N/A N/A N/A Cast N/A N/A N/A Cast N/A N/A N/A Cast N/A N/A N/A Cast CAST SPREADER CASTING PRODUCTS CAST INSTRUMENTS Cast BOEHLER CAST BREAKER CASTING PRODUCTS CAST INSTRUMENTS Cast STOCKINETTE, 2 CASTING PRODUCTS STOCKINETTE Cast STOCKINETTE, 3 CASTING PRODUCTS STOCKINETTE Cast STOCKINETTE, 4 CASTING PRODUCTS STOCKINETTE Cast STOCKINETTE, 5 CASTING PRODUCTS STOCKINETTE Cast Cast N/A N/A N/A Cast N/A N/A N/A Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; Cast A4580 E t supplies (e.g. plaster) 0270 Medical surgical supplies general; ZIMMER AIR DERMATOME SKIN GRAFT PRODUCTS DERMATOMES Skin Grafting Skin Grafting N/A N/A N/A COMPLETE KIT ZIMMER AIR DERMATOME SKIN GRAFT PRODUCTS DERMATOMES Skin Grafting Skin Grafting N/A N/A N/A HANDPIECE ZIMMER ELECTRIC DERMATOME SKIN GRAFT PRODUCTS DERMATOMES Skin Grafting Skin Grafting N/A N/A N/A COMPLETE KIT ZIMMER ELECTRIC DERMATOME SKIN GRAFT PRODUCTS DERMATOMES Skin Grafting Skin Grafting N/A N/A N/A HANDPIECE ZIMMER TISSUE BANK DERMATOME SKIN GRAFT PRODUCTS DERMATOMES Skin Grafting Skin Grafting N/A N/A N/A MESHGRAFT II TISSUE EXPANSION SKIN GRAFT PRODUCTS MESHERS Skin Grafting Skin Grafting N/A N/A N/A SYSTEM MESHGRAFT II TISSUE EXPANSION UNIT SKIN GRAFT PRODUCTS MESHERS Skin Grafting Skin Grafting ZIMMER SKIN GRAFT MESHER SKIN GRAFT PRODUCTS MESHERS Skin Grafting Skin Grafting N/A N/A N/A 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 126

127 # EDI Item # Item Header 1 Header 2 Type ZIMMER SKIN GRAFT MESHER COMPLETE ZIMMER SKIN GRAFT MESHER W/ CUTTERS ZIMMER DERMATOME BLADES STERILE SKIN GRAFT PRODUCTS MESHERS Skin Grafting Skin Grafting N/A N/A N/A SKIN GRAFT PRODUCTS MESHERS Skin Grafting Skin Grafting N/A N/A N/A SKIN GRAFT PRODUCTS DISPOSABLE DERMATOME BLADES Skin Grafting Skin Grafting ZIMMER TISSUE BANK DERMATOME BLADES STERILE SKIN GRAFT PRODUCTS DISPOSABLE DERMATOME BLADES Skin Grafting Skin Grafting AIR DERMATOME HOSE SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A DERMATOME AUTOCLAVE CASE SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A WIDTH PLATE, 1 IN SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A WIDTH PLATE, 2 IN SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting WIDTH PLATE, 3 IN SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting WIDTH PLATE, 4 IN SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting WIDTH PLATE, 1.5 IN SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting DERMATOME SCREWDRIVER SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A WIDTH PLATE SCREWS SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting ZIMMER ELECTRIC DERMATOME SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A POWER SUPPLY ZIMMER TISSUE BANK DERMATOME SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A AUTOCLAVE CASE ZIMMER TISSUE BANK DERMATOME SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A 3 IN WIDTH PLATE ZIMMER TISSUE BANK DERMATOME SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A 4 IN WIDTH PLATE ZIMMER TISSUE BANK DERMATOME SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A POWER SUPPLY AIR DERMATOME MANUAL SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A ELECTRIC DERMATOME MANUAL SKIN GRAFT PRODUCTS DERMATOME ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A DERMACARRIER II, 1.5:1, STERILE SKIN GRAFT PRODUCTS DERMACARRIERS Skin Grafting Skin Grafting DERMACARRIER II, 3:1, STERILE SKIN GRAFT PRODUCTS DERMACARRIERS Skin Grafting Skin Grafting 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 127

128 # EDI Item # Item Header 1 Header 2 Type DERMACARRIER II, 6:1, STERILE SKIN GRAFT PRODUCTS DERMACARRIERS Skin Grafting Skin Grafting DERMACARRIER II, 9:1, STERILE SKIN GRAFT PRODUCTS DERMACARRIERS Skin Grafting Skin Grafting ZIMMER SKIN GRAFT CARRIER, 8 IN, STERILE SKIN GRAFT PRODUCTS DERMACARRIERS Skin Grafting Skin Grafting ZIMMER SKIN GRAFT CARRIER, 16 IN, STERILE SKIN GRAFT PRODUCTS DERMACARRIERS Skin Grafting Skin Grafting MESHGRAFT II AUTOCLAVE CASE SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting MESHGRAFT II RATCHET HANDLE SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting ZIMMER SKIN GRAFT MESHER SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A AUTOCLAVE CASE ZIMMER SKIN GRAFT MESHER SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A RATCHET HANDLE ZIMMER SKIN GRAFT MESHER SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A COMB CUTTER 1.5:1 EXPANSION RATIO SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A CUTTER 2:1 EXPANSION RATIO SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A CUTTER 3:1 EXPANSION RATIO SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A CUTTER 4:1 EXPANSION RATIO SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A ZIMMER SKIN GRAFT MESHER SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A MANUAL MESHGRAFT II MANUAL SKIN GRAFT PRODUCTS MESHER ACCESSORIES Skin Grafting Skin Grafting N/A N/A N/A ZIMMER AIR DERMATOME REPAIR SKIN GRAFT PRODUCTS DERMATOME REPAIRS Skin Grafting Skin Grafting N/A N/A N/A CHARGE AIR DERMATOME HOSE ( ) SKIN GRAFT PRODUCTS DERMATOME REPAIRS Skin Grafting Skin Grafting N/A N/A N/A REPAIR CHARGE ZIMMER ELECTRIC DERMATOME SKIN GRAFT PRODUCTS DERMATOME REPAIRS Skin Grafting Skin Grafting N/A N/A N/A REPAIR CHARGE ELECTRIC DERMATOME POWER SKIN GRAFT PRODUCTS DERMATOME REPAIRS Skin Grafting Skin Grafting N/A N/A N/A SUPPLY REPAIR CHARGE TISSUE BANK DERMATOME REPAIR SKIN GRAFT PRODUCTS DERMATOME REPAIRS Skin Grafting Skin Grafting N/A N/A N/A CHARGE MESHGRAFT II REPAIR CHARGE SKIN GRAFT PRODUCTS MESHER REPAIRS Skin Grafting Skin Grafting N/A N/A N/A MESHGRAFT II RATCHET HANDLE SKIN GRAFT PRODUCTS MESHER REPAIRS Skin Grafting Skin Grafting N/A N/A N/A REPAIR CHARGE ZIMMER SKIN GRAFT MESHER SKIN GRAFT PRODUCTS MESHER REPAIRS Skin Grafting Skin Grafting N/A N/A N/A REPAIR CHARGE MESHER RATCHET HANDLE REPAIR SKIN GRAFT PRODUCTS MESHER REPAIRS Skin Grafting Skin Grafting N/A N/A N/A TUCK SHEET, 58 IN X 108 IN, STERILE SKIN GRAFT PRODUCTS SHEETING Skin Grafting Skin Grafting 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 128

129 # EDI Item # Item Header 1 Header 2 Type FLAT SHEET, 40 IN X 72 IN, STERILE SKIN GRAFT PRODUCTS SHEETING Skin Grafting Skin Grafting HALF SHEET, 58 IN X 54 IN, STERILE SKIN GRAFT PRODUCTS SHEETING Skin Grafting Skin Grafting MINI-SHEET, 20 IN X 30 IN, STERILE SKIN GRAFT PRODUCTS SHEETING Skin Grafting Skin Grafting DISPENSER ROLL, 40 IN X 25 YD, NON-STERILE SKIN GRAFT PRODUCTS SHEETING Skin Grafting Skin Grafting PALACOS R 1X40 SINGLE BONE CEMENT& ACCESSORIES PALACOS BONE CEMENT Bone Palacos Bone Cement N/A N/A N/A 0278-Medical/Surgical Supplies and Devices - Cement & Other Implant Accessories PALACOS R+G 1X40 SINGLE (WITH GENTAMICIN) BONE CEMENT& ACCESSORIES PALACOS BONE CEMENT Bone Palacos Bone Cement N/A N/A N/A 0278-Medical/Surgical Supplies and Devices - Cement & Other Implant Accessories PALACOS LV 1X40 SINGLE BONE CEMENT& ACCESSORIES PALACOS BONE CEMENT Bone Palacos Bone Cement N/A N/A N/A 0278-Medical/Surgical Supplies and Devices - Cement & Other Implant Accessories PALACOS LVG 1X40 SINGLE BONE CEMENT& ACCESSORIES PALACOS BONE CEMENT Bone Palacos Bone Cement N/A N/A N/A 0278-Medical/Surgical Supplies and Devices - Cement & Other Implant Accessories OSTEOBOND COPOLYMER BONE CEMENT SINGLE KIT 40GM OSTEOBOND COPOLYMER BONE CEMENT TEN PK 40GM BONE CEMENT& ACCESSORIES OSTEOBOND COPOLYMER BONE CEMENT Bone Bone Cement N/A N/A N/A 0278-Medical/Surgical Supplies and Devices - Cement & Other Implant Accessories BONE CEMENT& ACCESSORIES OSTEOBOND COPOLYMER BONE CEMENT Bone Bone Cement N/A N/A N/A 0278-Medical/Surgical Supplies and Devices - Cement & Other Implant Accessories QUIK-USE CURETTE 10 PACK BONE CEMENT& ACCESSORIES FEMORAL PREP KITS Bone Bone Cement Cement & Accessories Accessories FEMORAL BONE CEMENT PREP KIT BONE CEMENT& ACCESSORIES FEMORAL PREP KITS Bone Bone Cement Cement & Accessories Accessories FEMORAL BONE CEMENT PREP KIT 10 PACK BONE CEMENT& ACCESSORIES FEMORAL PREP KITS Bone Bone Cement Cement & Accessories Accessories FEMORAL BONE BRUSHES BONE CEMENT& ACCESSORIES FEMORAL PREP KITS Bone Bone Cement Cement & Accessories Accessories ORTHO DRI FEMORAL CANAL SPONGE BONE CEMENT& ACCESSORIES FEMORAL PREP KITS Bone Bone Cement Cement & Accessories Accessories 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 129

130 # EDI Item # Item Header 1 Header HARRIS FEMORAL PRESSURIZER INTACT GREATER TROC Type BONE CEMENT& ACCESSORIES PRESSURIZERS Bone Bone Cement Cement & Accessories Accessories FEMORAL NOZZLE SEAL INTACT GREATER TROCHANTER BONE CEMENT& ACCESSORIES PRESSURIZERS Bone Bone Cement Cement & Accessories Accessories FEMORAL NOZZLE SEAL TROCHANTER OFF BONE CEMENT& ACCESSORIES PRESSURIZERS Bone Bone Cement Cement & Accessories Accessories MILLER FEMORAL CANAL PRESSURIZERS MEDIUM BONE CEMENT& ACCESSORIES PRESSURIZERS Bone Bone Cement Cement & Accessories Accessories MILLER BONE CEMENT INJECTOR CANCELLOUS PRESS SMALL BONE CEMENT& ACCESSORIES PRESSURIZERS Bone Bone Cement Cement & Accessories Accessories MILLER BONE CEMENT INJECTOR CANCELLOUS PRESS LARGE BONE CEMENT& ACCESSORIES PRESSURIZERS Bone Bone Cement Cement & Accessories Accessories MILLER FEMORAL CANAL PRESURIZERS SMALL BONE CEMENT& ACCESSORIES PRESSURIZERS Bone Bone Cement Cement & Accessories Accessories MILLER FEMORAL CANAL PRESSURIZERS LARGE BONE CEMENT& ACCESSORIES PRESSURIZERS Bone Bone Cement Cement & Accessories Accessories CHARNLEY TYPE ACETABULAR CUP CEMENT RESTRICTORS BONE CEMENT& ACCESSORIES RESTRICTORS Bone Bone Cement Cement & Accessories Accessories CEMENT RESTRICTORS BONE CEMENT& ACCESSORIES RESTRICTORS Bone Bone Cement Cement & Accessories Accessories CEMENT RESTRICTORS FLAT DISK BONE CEMENT& ACCESSORIES RESTRICTORS Bone Bone Cement Cement & Accessories Accessories ZIMMER DOUGH-TYPE BONE CEMENT 40GM/20ML SINGLE ZIMMER DOUGH-TYPE BONE CEMENT 40GM/20ML 10 PACK BONE CEMENT& ACCESSORIES ZIMMER BONE CEMENT Bone Bone Cement N/A N/A N/A 0278-Medical/Surgical Supplies and Devices - Cement & Other Implant Accessories BONE CEMENT& ACCESSORIES ZIMMER BONE CEMENT Bone Bone Cement N/A N/A N/A 0278-Medical/Surgical Supplies and Devices - Cement & Other Implant Accessories ZIMMER POLY-PLUG INSERTER BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 130

131 # EDI Item # Item Header 1 Header ZIMMER POLY-PLUG MEDULLARY PLUG, 9MM Type BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories ZIMMER POLY-PLUG MEDULLARY PLUG, 11MM BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories ZIMMER POLY-PLUG MEDULLARY PLUG, 13MM BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories ZIMMER POLY-PLUG MEDULLARY PLUG, 15MM BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories ZIMMER POLY-PLUG MEDULLARY PLUG, 17MM BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories ZIMMER POLY-PLUG MEDULLARY PLUG, 19MM BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories MM/16MM PLUGS WITH INSERTER BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories MM/24MM PLUGS WITH INSERTER BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories ALLEN PLUG HDPE/BAS04 7C/12FL BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories ALLEN PLUG HDPE/BASO4 8C/16FL BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories ALLEN PLUG HDPE/BASO4 10C/20FL BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories ALLEN PLUG HDPE/BASO4 12C/24FL BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories ALLEN PLUG HDPE/BASO4 14C/28FL BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 131

132 # EDI Item # Item Header 1 Header 2 Type ALLEN PLUG HDPE/BASO4,16C/32FL BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories MM/32MM PLUGS WITH INSERTER BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories ALLEN PLUG INSERTER METAL BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories STUHMER/WEBER INTRAMED PLUG, PLUG SIZE 1 BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories STUHMER/WEBER INTRAMED PLUG, PLUG SIZE 2 BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories STUHMER/WEBER INTRAMED PLUG, PLUG SIZE 2.5 BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories STUHMER/WEBER INTRAMED PLUG, PLUG SIZE 3 BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories STUHMER/WEBER INTRAMED PLUG, PLUG SIZE 3.5 BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories STUHMER/WEBER INTRAMED PLUG, PLUG SIZE 4 BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories STUHMER/WEBER INTRAMED PLUG, PLUG SIZE 5 BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories STUHMER/WEBER INTRAMED PLUG, PLUG SIZE 6 BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories STUHMER/WEBER INTRAMED PLUG, SIZE 7 BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement Cement & Accessories Accessories S/W INTRAMED PLUG W/ DRAIN SIZE BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement 1, 8.1MM DIAMETER Cement & Accessories Accessories 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 132

133 # EDI Item # Item Header 1 Header 2 Type S/W INTRAMED PLUG W/ DRAIN SIZE BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement 2, 10.6MM DIAMETER Cement & Accessories Accessories S/W INTRAMED PLUG W/ DRAIN SIZE BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement 2.5,11.8MM DIAMETE Cement & Accessories Accessories S/W INTRAMED PLUG W/ DRAIN SIZE BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement 3, 13.5MM DIAMETER Cement & Accessories Accessories S/W INTRAMED PLUG W/ DRAIN SIZE BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement 3.5, 14.7MM DIAMET Cement & Accessories Accessories S/W INTRAMED PLUG W/ DRAIN SIZE BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement 4, 16.0MM DIAMETER Cement & Accessories Accessories S/W INTRAMED PLUG W/ DRAIN SIZE BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement 5, 18.5MM DIAMETER Cement & Accessories Accessories S/W INTRAMED PLUG W/ DRAIN SIZE BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement 6, 21.0MM DIAMETER Cement & Accessories Accessories S/W INTRAMED PLUG W/ DRAIN SIZE BONE CEMENT& ACCESSORIES BONE PLUGS/INSERTERS Bone Bone Cement 7, 24.0MM DIAMETER Cement & Accessories Accessories MILLER RATCHET INJECTOR BONE CEMENT& ACCESSORIES INJECTORS/NOZZLES Bone Bone Cement Cement & Accessories Accessories POWER-FLO CEMENT INJECTOR (CGUN) BONE CEMENT& ACCESSORIES INJECTORS/NOZZLES Bone Bone Cement Cement & Accessories Accessories MILLER 90-DEGREE INJECTOR NOZZLE BONE CEMENT& ACCESSORIES INJECTORS/NOZZLES Bone Bone Cement Cement & Accessories Accessories DEGREE BREAKAWAY NOZZLE BONE CEMENT& ACCESSORIES INJECTORS/NOZZLES Bone Bone Cement Cement & Accessories Accessories MILLER BONE CEMENT INJECTOR FLEX NOZZLE 12X0.25IN BONE CEMENT& ACCESSORIES INJECTORS/NOZZLES Bone Bone Cement Cement & Accessories Accessories 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 133

134 # EDI Item # Item Header 1 Header MILLER BONE CEMENT INJECTOR FLEX NOZZLE 16X0.38IN Type BONE CEMENT& ACCESSORIES INJECTORS/NOZZLES Bone Bone Cement Cement & Accessories Accessories MILLER BONE CEMENT INJECTOR BEZEL BONE CEMENT& ACCESSORIES INJECTORS/NOZZLES Bone Bone Cement Cement & Accessories Accessories MILLER TAPERED CEMENT NOZZLE BONE CEMENT& ACCESSORIES INJECTORS/NOZZLES Bone Bone Cement Cement & Accessories Accessories MILLER 90-DEGREE SHORT TIP INJECTOR NOZZLE BONE CEMENT& ACCESSORIES INJECTORS/NOZZLES Bone Bone Cement Cement & Accessories Accessories QUICK-VAC MIXING BOWL SINGLE BONE CEMENT& ACCESSORIES VACUUM MIXING SYSTEMS Bone Bone Cement Cement & Accessories Accessories QUICK-VAC MIXING BOWL 10 PACK BONE CEMENT& ACCESSORIES VACUUM MIXING SYSTEMS Bone Bone Cement Cement & Accessories Accessories QUICK-VAC MIXING SYSTEM SINGLE BONE CEMENT& ACCESSORIES VACUUM MIXING SYSTEMS Bone Bone Cement Cement & Accessories Accessories N/A N/A N/A N/A N/A N/A N/A N/A N/A ZIMMER POWER-MIX VACUUM CEMENT MIXING SYSTEM BONE CEMENT& ACCESSORIES VACUUM MIXING SYSTEMS Bone Bone Cement Cement & Accessories Accessories N/A N/A N/A ZIMMER COMPACT MIXING SYS BONE CEMENT& ACCESSORIES VACUUM MIXING SYSTEMS Bone Bone Cement Cement & Accessories Accessories N/A N/A N/A DOSE COMPACT VACUUM MIXING SYSTEM BONE CEMENT& ACCESSORIES VACUUM MIXING SYSTEMS Bone Bone Cement Cement & Accessories Accessories N/A N/A N/A MONOMER BOWL DEFLECTOR RING BONE CEMENT& ACCESSORIES MONOMER FUME EVACUATION BOWLS Bone Bone Cement Cement & Accessories Accessories MONOMER BOWL WITH DEFLECTOR RING BONE CEMENT& ACCESSORIES MONOMER FUME EVACUATION BOWLS Bone Bone Cement Cement & Accessories Accessories SUPER BOWL MIXING/EVACUATING SYSTEM BONE CEMENT& ACCESSORIES MONOMER FUME EVACUATION BOWLS Bone Bone Cement Cement & Accessories Accessories N/A N/A N/A SUPER BOWL SECOND USE KIT BONE CEMENT& ACCESSORIES MONOMER FUME EVACUATION BOWLS Bone Bone Cement Cement & Accessories Accessories DISPOSABLE MIXING BOWLS WITH SPATULA BONE CEMENT& ACCESSORIES DISPOSABLE MIXING BOWLS Bone Bone Cement Cement & Accessories Accessories 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 134

135 # EDI Item # Item Header 1 Header 2 Type BONE CEMENT MIXING SPATULAS BONE CEMENT& ACCESSORIES DISPOSABLE MIXING BOWLS Bone Bone Cement Cement & Accessories Accessories DISPOSABLE MIXING BOWL W/SPATULA (12 PK, NON-STER) BONE CEMENT& ACCESSORIES DISPOSABLE MIXING BOWLS Bone Bone Cement Cement & Accessories Accessories MEDULLARY VENT TUBING* BONE CEMENT& ACCESSORIES ACCESSORIES Bone Bone Cement Cement & Accessories Accessories STRYKER/QUICK-VAC ADAPTER BONE CEMENT& ACCESSORIES ACCESSORIES Bone Bone Cement Cement & Accessories Accessories N/A N/A N/A N/A N/A N/A ZIMMER VACUUM FOOT PUMP II NITROGEN BONE CEMENT& ACCESSORIES ACCESSORIES Bone Bone Cement Cement & Accessories Accessories N/A N/A N/A ZIMMER VACUUM FOOT PUMP II AIR BONE CEMENT& ACCESSORIES ACCESSORIES Bone Bone Cement Cement & Accessories Accessories N/A N/A N/A MONOMER FUME FILTER WITH 3/8 ADAPTORS BONE CEMENT& ACCESSORIES ACCESSORIES Bone Bone Cement Cement & Accessories Accessories N/A N/A N/A MILLER CARTRIDGE KITS BONE CEMENT& ACCESSORIES ACCESSORIES Bone Bone Cement Cement & Accessories Accessories GLOVE LINER, SMALL BONE CEMENT& ACCESSORIES SURGICAL GLOVE LINERS Bone Bone Cement Cement & Accessories Accessories GLOVE LINER, MEDIUM BONE CEMENT& ACCESSORIES SURGICAL GLOVE LINERS Bone Bone Cement Cement & Accessories Accessories GLOVE LINER, LARGE BONE CEMENT& ACCESSORIES SURGICAL GLOVE LINERS Bone Bone Cement Cement & Accessories Accessories GLOVE LINER, X-LARGE BONE CEMENT& ACCESSORIES SURGICAL GLOVE LINERS Bone Bone Cement Cement & Accessories Accessories BOPS CHARGER CORD BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) PMX00505 PMX00505 BOPS POWER MODULE BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) PMX00520 PMX00520 BOPS 4-BAY CHARGER BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) PMX00521 PMX00521 BOPS CHARGER BAY COVER BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) PMX00530 PMX00530 BOPS CHARGER MODULE BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) Brasseler BS Large Bone Common N/A N/A N/A Accessrs Brasseler BS Large Bone Common N/A N/A N/A Accessrs Brasseler BS Large Bone Common N/A N/A N/A Accessrs Brasseler BS Large Bone Common N/A N/A N/A Accessrs Brasseler BS Large Bone Common N/A N/A N/A Accessrs 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 135

136 # EDI Item # Item Header 1 Header 2 PMX00550 PMX00550 BOPS STERILE TRANS SLEEVE BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) PMX00570 PMX00570 BOPS AUTOCLAVE CASE BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) PMX00580 PMX00580 BOPS CANISTER LID BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) Type Brasseler BS Large Bone Common Accessrs Brasseler BS Large Bone Common N/A N/A N/A Accessrs Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08500 PMX08500 BOPS MODULAR HANDPIECE BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) PMX12500 PMX12500 BOPS SAGITTAL/OSCIL SAW BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) PMX14500 PMX14500 BOPS RECIPROCATOR SAW BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) Brasseler BS Large Bone Handpieces Brasseler BS Large Bone Handpieces Brasseler BS Large Bone Handpieces N/A N/A N/A N/A N/A N/A N/A N/A N/A PMX14901 PMX14901 STERNUM SAW GUARD BRASSELER ORTHOPAEDIC POWER SYSTEM (BOPS) Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08901 PMX08901 BOPS PIN DRIVER BOPS PIN/WIRE DRIVERS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08902 PMX08902 BOPS WIRE DRIVER BOPS PIN/WIRE DRIVERS Brasseler BS Large Bone Common N/A N/A N/A Accessrs BOPS 5/32 CHUCK KEY LARGE BONE DRILL ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs BOPS 1/4 CHUCK KEY LARGE BONE DRILL ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08905 PMX08905 TRINKLE/AO DRILL LARGE BONE DRILL ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08910 PMX /4 JACOBS DRILL LARGE BONE DRILL ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08915 PMX /32 JACOBS CHUCK LARGE BONE DRILL ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08920 PMX08920 HUDSON DRILL LARGE BONE DRILL ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08925 PMX08925 ZIMMER DRILL LARGE BONE DRILL ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08930 PMX /4 KEYLESS CHUCK LARGE BONE DRILL ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08935 PMX MM KEYLESS CHUCK LARGE BONE DRILL ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08911 PMX08911 HI TORQUE 1/4 CHUCK LARGE BONE REAMER ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08950 PMX08950 HUDSON REAMER LARGE BONE REAMER ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08955 PMX08955 ZIMMER REAMER LARGE BONE REAMER ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs PMX08960 PMX08960 AO REAMER LARGE BONE REAMER ATTACHMENTS Brasseler BS Large Bone Common N/A N/A N/A Accessrs B B ST 90.0 X 11.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 136

137 # EDI Item # Item Header 1 Header 2 Type B B ST 90.0 X 11.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large B B ST 90.0 X 18.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large B B ST 90.0 X 18.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large B B ST X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large B B ST 75.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large B B ST 90.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large B B ST 90.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 19.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200001T K200001T LI 90.0 X 19.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 19.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 31.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 31.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 137

138 # EDI Item # Item Header 1 Header 2 Type K200005I K200005I LI 90.0 X 25.4MM.058 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200005J K200005J LI 90.0 X 25.4MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200006I K200006I LI 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 12.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 12.5MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K MD 90.0 X 19.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200021T K200021T MD 90.0 X 19.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K MD 90.0 X 19.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K MD 90.0 X 31.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K MD 90.0 X 31.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K MD 90.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200025I K200025I MD 90.0 X 25.4MM.058 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 138

139 # EDI Item # Item Header 1 Header 2 Type K200025J K200025J MD 90.0 X 25.4MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K MD 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200026F K200026F MD 90.0 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200026I K200026I MD 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K MD 90.0 X 12.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 85.0 X 25.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 70.0 X 25.0MM.015 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 95.0 X 25.0MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 19.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 19.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 31.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200045I K200045I ST 90.0 X 25.4MM.058 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 139

140 # EDI Item # Item Header 1 Header 2 Type K200045J K200045J ST 90.0 X 25.4MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 12.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K SY 70.0 X 19.0MMM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K SY 70.0 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K SY 70.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K SY 70.0 X 25.4MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K SY 50.0 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K SY 50.0 X 12.5MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K SY 90.0 X 19.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200051T K200051T SY 90.0 X 19.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K SY 90.0 X 19.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K SY 90.0 X 31.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 140

141 # EDI Item # Item Header 1 Header 2 Type K K SY 90.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200055I K200055I SY 90.0 X 25.4MM.058 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200055J K200055J SY 90.0 X 25.4MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K SY 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200056I K200056I SY 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K SY 90.0 X 12.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K SY 90.0 X 12.5MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 19.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 19.5MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 31.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 31.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200065I K200065I ST 90.0 X 25.4MM.058 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 141

142 # EDI Item # Item Header 1 Header 2 Type K200065J K200065J ST 90.0 X 25.4MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200065T K200065T ST 90.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200066I K200066I ST 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200066IS K200066IS LI 25.0 X 90.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 12.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200067J K200067J ST 90.0 X 12.5MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 12.5MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST X 19.0MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 19.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 19.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 31.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 31.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 142

143 # EDI Item # Item Header 1 Header 2 Type K K LI 90.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200075I K200075I LI 90.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200075J K200075J LI 90.0 X 25.4MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K200076I K200076I LI 90.0 X 25.4MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 12.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 12.5MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 12.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 12.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 12.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST X 19.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 75.0 X 19.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 19.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 143

144 # EDI Item # Item Header 1 Header 2 Type K K ST 90.0 X 19.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 19.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 75.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K ST 90.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 12.5MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 12.5MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 19.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 144

145 # EDI Item # Item Header 1 Header 2 Type K K LI 90.0 X 19.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 19.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI X 25.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 25.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 25.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 25.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 25.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 25.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large K K LI 90.0 X 25.0MM K2000 LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM101L KM101L MD 90.0 X 19.0MM.062 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM102L KM102L MD 90.0 X 29.0MM.066 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM10P KM10P MD 53.6 X 9.4MM RECIP LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM1100 KM1100 ST 62.5/11.5MM CUT EDGE LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 145

146 # EDI Item # Item Header 1 Header 2 Type KM KM MD 90.0 X 25.4MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM ST 90.0 X 25.4MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM LI 90.0 X 25.4MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM ST 90.0 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM ST 90.0 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM MD 90.0 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM11065 KM11065 ST 13.0MM CUT EDGE LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM ST 60.0 X 12.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM MD 90.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM ST 90.0 X 25.4MM.056 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM MD 90.0 X 25.4MM.056 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM LI 90.0 X 25.4MM.056 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM ST 60.0 X 12.4MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 146

147 # EDI Item # Item Header 1 Header 2 Type KM KM ST 90.0 X 25.4MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM ST 90.0 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM X 12.7MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM ST 60.0 X 12.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM ST 84.5 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM ST 90.0 X 25.0MM.058 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM ST 90.0 X 25.5MM.049 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM MD 90.0 X 12.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM LI 90.0 X 12.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM LI 90.0 X 12.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM LI 90.0 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM LI 90.0 X 25.4MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM ST 85.0 X 12.7MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 147

148 # EDI Item # Item Header 1 Header 2 Type KM KM ST 90.0 X 12.7MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM11P KM11P MD 54.4 X 9.4MM RECIP LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM MD 19.5 X 86MM 1.27MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM LI 86.0 X 19.5MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM ST 19.5 X 86MM 1.27MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM SY 19.5 X 86MM 1.27MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM12P KM12P MD 78.0 X 9.4MM RECIP LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM13P KM13P MD 78.0 X 9.4MM RECIP LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM MD 13.5 X 64MM 0.9MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM ST 60.0 X MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM SY 64.0 X 13.5MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM193L KM193L MD 90.0 X 25.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM195L KM195L MD 25.0 X 9.5MM.025 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 148

149 # EDI Item # Item Header 1 Header 2 Type KM196L KM196L MD 85.0 X 25.4MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM197L KM197L MD 90.0 X 19.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM198L KM198L MD 90.0 X 30.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM205L KM205L MD 85.0 X 31.0MM.039 OS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM21L KM21L MD 60.0 X 15.5MM.062 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM MD 12.5 X 76MM 0.9MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM ST 71.6 X 12.7MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM22L KM22L MD 61.5 X 31.5MM.062 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM23L KM23L MD 60.0 X 15.5MM.043 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM24L KM24L MD 61.5 X 31.5MM.044 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM250R KM250R ST 60.0 X 6.35MM RECIP LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM251 KM251 LI 60.0X32.0MM OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM256 KM256 LI 60.0X33.0MM OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 149

150 # EDI Item # Item Header 1 Header 2 Type KM25L KM25L MD 30.0 X 7.0MM.040 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM26L KM26L MD 60.0 X 15.2MM.062 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM272 KM272 LI 70.0X19.0MM OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM274 KM274 LI 80.0X19.0MM OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM275R KM275R ST 70.0MM RECIPROCATING LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM27L KM27L MD 61.5 X 31.5MM.058 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM28L KM28L MD 61.5 X 31.5MM.036 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM29L KM29L MD 60.0 X 15.5MM.038 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM305 KM305 ST 70.0X25.4MM.039 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM307 KM307 ST 75.0X28.5MM.038 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM309 KM309 ST 85.0X25.4MM.039 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM30L KM30L MD 70.0 X 28.5MM.043 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM310 KM310 ST 70.0X25.4MM.060 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 150

151 # EDI Item # Item Header 1 Header 2 Type KM311 KM311 ST 85.0X25.4MM.066 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM315 KM315 ST 75.0X19.1MM.037 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM325R KM325R ST 77.5 X 11.2MM RECIP LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM330 KM330 ST 50.0X25.4MM.039 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM337Z KM337Z 30.0 X 82.0MM.040 STERN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM340 KM340 ST 60.0X32.0MM.039 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM350 KM350 ST 70.0X12.5MM.035 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM360 KM360 ST 70.0X25.4MM.046 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM375 KM375 ST 60.0X9.6MM.037 IN SAG LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM385 KM385 ST 110X19.0MM.058 IN SAG LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM393 KM393 ST 90.0X25.0MM.039 IN SA LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM405 KM405 LI 90.0X25.0MM OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM407 KM407 LI X 19.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 151

152 # EDI Item # Item Header 1 Header 2 Type KM408 KM408 LI 90.0 X 30.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM450 KM450 LI 60.0 X 49.0MM.040 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM451 KM451 LI 60.0 X 32.0MM.039 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM452 KM452 LI 60.0 X 12.5MM.039 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM453 KM453 LI 60.0 X 19.0MM.039 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM454 KM454 LI 70.0 X 19.0MM.067 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM455 KM455 LI 70.0 X 33.0MM.068 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM456 KM456 LI 60.0 X 33.0MM.049 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM458 KM458 LI 89.0 X 12.5MM RECIP LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM459 KM459 LI 52.6 X 9.4MM RECIP LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM460 KM460 LI 38.0 X 9.6MM.024 REC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM461 KM461 LI 89.0 X 12.2MM.068 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM472 KM472 LI 70.0 X 19.0MM.037 OSC LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 152

153 # EDI Item # Item Header 1 Header 2 Type KM473 KM473 LI 73.5 X 12.7MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM479 KM479 LI 76.0 X 12.7MM.038 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM493 KM493 LI 90.0 X 25.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM V KM V LI 60.0 X 19.0MM.036 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM V KM V LI 90.0 X 19.8MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM ST 86.0 X 19.5MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM ST 86.0 X 19.5MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM51910 KM51910 SY 50.0 X 27.0MM.026 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM SY 90.0 X 27.0MM.042 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM51915 KM51915 SY 45.0 X 14.0MM.026 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM51917 KM51917 SY 70.0 X 27.0MM.032 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM SY 70.0 X 14.0MM.040 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM51919 KM51919 SY 70.0 X 50.0MM.030 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 153

154 # EDI Item # Item Header 1 Header 2 Type KM51921 KM51921 SY 70.0 X 27.0MM.046 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM51925 KM51925 SY 25.0 X 14.0MM.023 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM600 KM600 ST 70.0 X 25.0MM.040 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM602 KM602 ST 90.0 X 25.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM605 KM605 ST 70.0 X 25.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM609 KM609 ST 85.0 X 20.5MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM610 KM610 ST 73.0 X 25.0MM.059 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM611 KM611 ST 78.7 X 25.0MM.057 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM613 KM613 ST 34.0 X 16.5MM.068 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM615 KM615 ST 73.2 X 19.0MM.037 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM618 KM618 ST 78.7 X 25.0MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM619 KM619 ST 98.3 X 25.0MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM620 KM620 ST 60.5 X 19.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 154

155 # EDI Item # Item Header 1 Header 2 Type KM622 KM622 ST 95.0 X 19.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM625 KM X 42.0MM.040 STERN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM626 KM626 ST 90.0 X 25.0MM.053 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM627 KM627 ST 97.8 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM628 KM628 ST 90.0 X 30.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM631 KM631 ST 47.5 X 17.1MM.042 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM637 KM X 80.5MM.040 STERN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM640 KM640 ST 58.0 X 29.0MM.041 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM644 KM644 ST 24.0 X 6.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM645 KM645 ST 24.0 X 9.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM648 KM648 ST 34.5 X 9.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM650 KM650 ST 70.0 X 12.5MM.040 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM651 KM651 ST 85.0 X 25.0MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 155

156 # EDI Item # Item Header 1 Header 2 Type KM652 KM652 ST 81.5 X 12.5MM.047 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM655 KM655 ST 73.0 X 12.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM656 KM656 ST 80.0 X 12.5MM.057 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM658 KM658 ST 81.5 X 12.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM660 KM660 ST 73.0 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM675 KM675 ST 60.0 X 9.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM676 KM676 ST 80.0 X 25.0MM.058 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM677 KM677 ST 85.0 X 25.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM682 KM682 ST 83.0 X 18.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM683 KM683 ST 83.5 X 29.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM685 KM685 ST X 18.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM689 KM689 ST 81.5 X 25.0MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM692 KM692 ST 40.0 X 20.0MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 156

157 # EDI Item # Item Header 1 Header 2 Type KM693 KM693 ST 81.5 X 25.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM695 KM695 ST 90.0 X 48.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM697 KM697 ST 60.0 X 48.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7010 KM X 9.5MM STERNUM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71201 KM71201 LI 86.0 X 19.5MM HARDENED LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71232 KM71232 LI 41.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71233 KM71233 LI 25.0 X 9.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71234 KM71234 LI 41.0 X 9.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7126 KM7126 LI 15.0 X 63.0MM.032 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7127 KM7127 LI 35.0 X 8.5MM.032 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71520 KM71520 LI 95.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71523 KM71523 LI 95.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71524 KM71524 LI 95.0 X 25.4MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 157

158 # EDI Item # Item Header 1 Header 2 Type KM71540 KM71540 LI 80.0 X 25.4MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71542 KM71542 LI 90.0 X 25.4MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71543 KM71543 LI 90.0 X 25.4MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71545 KM71545 LI 72.0 X 13.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71550 KM71550 LI 63.0 X 49.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71551 KM71551 LI 63.0 X 32.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71552 KM71552 LI 64.0 X 13.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71553 KM71553 LI 63.0 X 19.5MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71554 KM71554 LI 71.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71555 KM71555 LI 71.0 X 33.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71556 KM71556 LI 64.0 X 35.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71561 KM71561 LI 90.0 X 25.4MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71563 KM71563 LI 90.0 X 25.4MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 158

159 # EDI Item # Item Header 1 Header 2 Type KM71567 KM71567 LI 90.0 X 19.5MM HARDENED LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71572 KM71572 LI 71.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71574 KM71574 LI 86.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71577 KM71577 LI 71.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71578 KM71578 LI 80.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71580 KM71580 LI 85.0 X 10.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71581 KM71581 LI 86.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71585 KM71585 LI 80.0 X 19.5MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71586 KM71586 LI 64.0 X 32.0MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71595 KM71595 LI 80.0 X 19.5MM HARDENED LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM71596 KM71596 LI 90.0 X 25.4MM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7201 KM7201 LI 85.0 X 20.0MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7228 KM7228 LI 40.0 X 45.0MM.032 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 159

160 # EDI Item # Item Header 1 Header 2 Type KM7229 KM7229 LI 40.0 X 55.0MM.032 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7230 KM7230 LI 40.0 X 66.0MM.032 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7232 KM7232 LI 40.0 X 19.0MM.032 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7233 KM7233 LI 25.0 X 9.5MM.024 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7234 KM7234 LI 40.0 X 9.0MM.024 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7235 KM7235 LI 30.0 X 5.0MM.043 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7325 KM7325 LI 45.0 X 41.0MM.040 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7540 KM7540 LI 80.0 X 25.4MM.055 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7541 KM7541 LI 80.0 X 19.5MM.055 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7542 KM7542 LI 90.0 X 25.4MM.055 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7543 KM7543 LI 90.0 X 25.4MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7544 KM7544 LI 85.0 X 25.4MM.059 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7545 KM7545 LI 70.0 X 13.0MM.059 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 160

161 # EDI Item # Item Header 1 Header 2 Type KM7550 KM7550 LI 65.0 X 49.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7551 KM7551 LI 60.0 X 33.0MM.040 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7552 KM7552 LI 65.0 X 13.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7553 KM7553 LI 60.0 X 19.0MM.036 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7554 KM7554 LI 70.0 X 19.0MM.059 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7555 KM7555 LI 70.0 X 33.0MM.063 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7556 KM7556 LI 60.0 X 33.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7561 KM7561 LI 90.0 X 25.4MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7566 KM7566 LI 60.0 X 32.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7572 KM7572 LI 70.0 X 19.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7574 KM7574 LI 85.0 X 19.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7577 KM7577 LI 70.0 X 19.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7578 KM7578 LI 80.0 X 19.0MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 161

162 # EDI Item # Item Header 1 Header 2 Type KM7579 KM7579 LI 90.0 X 25.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7580 KM7580 LI 90.0 X 19.5MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7581 KM7581 LI 90.0 X 30.0MM.054 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM KM LI 85.0 X 19.8MM.050 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7593 KM7593 LI 90.0 X 25.0MM.039 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM7595 KM7595 LI 80.0 X 19.5MM.035 IN LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM97 KM X 6.35MM STERNUM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM97N KM97N 32.0 X 6.0MM STERNUM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM98 KM X 6.35MM STERNUM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large KM98N KM98N 32.0 X 6.35MM STERNUM LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X73X0.99MM (0.64) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X90X0.99MM (0.89) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X73X0.99MM (0.89) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 162

163 # EDI Item # Item Header 1 Header 2 PMX PMX S/O 20.5X85X0.99MM (0.89)BRASSELER BOPS Type LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X73X1.50MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X78X1.45MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 16.5X34X1.73MM (1.27)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 19X73X0.94MM (0.79) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X78X1.27MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X98X1.27MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 17.5X47.5X1.07MM(.64)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 29X58X1.04MM (0.64) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 12.5X73X0.99MM (0.64)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X85X1.19MM (1.19) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 12.5X81.5X1.19MM(1.19) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X80X1.47MM (1.47) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 163

164 # EDI Item # Item Header 1 Header 2 PMX PMX S/O 19X83.5X1.27MM (1.27)BRASSELER BOPS Type LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 19X86X1.27MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 19X60.5X0.97MM (0.64)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 40.5X47.5X1.02MM(.64)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X90X1.37MM (1.37) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 19X97X1.37MM (1.37) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 6.0X24X0.84MM (0.64) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 9.5X24X0.84MM (0.64) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 9.5X34.5X0.84MM(0.64)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 12.5X73X1.45MM (1.27)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 12.5X80X1.45MM (1.27)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 12.5X81.5X1.27MM(1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X73X1.40MM (0.89) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 164

165 # EDI Item # Item Header 1 Header 2 PMX PMX S/O 9.5X60.5X1.02MM(0.64)BRASSELER BOPS Type LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X86.5X1.35MM (1.35)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 29X83.5X1.27MM (1.27)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 19X104X1.27MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 81.5X1.27MM(1.27)BRASSELER BOPS PMX PMX S/O 25X81.5X 0.99MM(0.99)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 48.5X90X0.99MM (0.99)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 19.5X86X1.27MM (1.27)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X90X1.25MM (0.99) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X90X1.27MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 12.5X60X1.27MM (1.27)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 12.5X90X1.27MM (1.27)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X86X1.47MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 165

166 # EDI Item # Item Header 1 Header 2 PMX PMX S/O 12.5X90X0.89MM (0.89)BRASSELER BOPS Type LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 12.5X90X1.37MM (1.37)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 19X100X1.27MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 19X75X0.89MM (0.89) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 19X90X0.89MM (0.89) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 19X90X1.37MM (1.37) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 19X100X1.19MM (1.19) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 19X90X0.99MM (.099) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X100X1.27MM (1.27) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X75X0.89MM (0.89) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X90X0.89MM (0.89) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X90X0.99MM (0.99) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X90X1.19MM (1.19) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 166

167 # EDI Item # Item Header 1 Header 2 PMX PMX S/O 25X90X1.27MM (1.27) BRASSELER BOPS Type LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X90X1.37MM (1.37) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X90X1.47MM (1.47) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 19X95X1.37MM (1.37) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X90X1.37MM (1.37) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 31X90X0.99MM (0.99) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 31X90X1.37MM (1.37) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 12.5X70X1.27MM (1.27)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 11X90X0.89MM (0.79) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 11X90X1.27MM (1.12) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 18X90X0.89MM (0.79) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 18X90X1.27MM (1.12) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X100X1.27MM (1.12) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 167

168 # EDI Item # Item Header 1 Header 2 PMX PMX S/O 25X75X0.89MM (0.79) BRASSELER BOPS Type LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X90X1.27MM (1.12) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX S/O 25X90X1.35MM (1.19) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX RCP 6.3X60X1.04MM (0.64) BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX RCP 12.5X70X1.00 MM(0.64)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX RCP 6.3X77.5X1.04MM(0.64)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX STERNM 6.3X32X1.04MM(.80)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large PMX PMX STERNM 6.3X32X1.02MM(.64)BRASSELER BOPS LARGE BONE SAW BLADES Brasseler BS BOPS Blades - Large ST ST X25.0X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X25.0X0.89MM (.035IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X12.5X0.89MM (.035IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X25.0X0.89MM (.035IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X21.0X0.89MM (.035IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 168

169 # EDI Item # Item Header 1 Header 2 ST ST X25.0X1.24MM (.049IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Type Brasseler BS Blades - Large Bone ST ST X25.0X1.25MM (.049IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X18.5X0.76MM (.031IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X25.0X1.24MM (.049IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X18.5X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X40.5X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X17.5X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X29.0X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X9.0X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X9.0X0.64MM ).025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X12.5X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X25.0X1.19MM (.047IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X12.5X1.19MM (.047IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 169

170 # EDI Item # Item Header 1 Header 2 ST ST X12.5X1.24MM (.049IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Type Brasseler BS Blades - Large Bone ST ST X12.5X1.24MM (.049IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X12.5X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X25.0X0.89MM (.035IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X9.5X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X25.0X1.50MM (.058IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X25.0X1.32MM (.052IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X18.5X1.24MM (.049IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X29.0X1.24MM (.049IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X18.5X1.24MM (.049IN LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X25.0X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X25.0X1.04MM (.041IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X48.5X0.96MM (.038IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 170

171 # EDI Item # Item Header 1 Header 2 ST ST X48.5X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Type Brasseler BS Blades - Large Bone ST ST X25.0X1.24MM (.049IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X11X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X18X0.89MM (.035IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X18X0.89MM (.035IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X18X1.19MM (.047IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X18X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X18X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X18X1.35MM (.053IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X18X1.37MM (.054IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X25X0.64MM (.025IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X25X0.89MM (.035IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X25X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 171

172 # EDI Item # Item Header 1 Header 2 ST ST X25X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Type Brasseler BS Blades - Large Bone ST ST X25X1.35MM (.053IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone ST ST X25X1.47MM (.058IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K K X12.5X0.99MM (.039IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K K X12.5X01.19MM (.047IN LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K K X12.5X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K K X12.5X1.37MM (.054IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K K X19.0X1.19MM (.047IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K K X19.0X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K K X19.0X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K K X19.0X0.99MM (.039IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K K X19.0X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K K X19.0X1.37MM (.054IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 172

173 # EDI Item # Item Header 1 Header 2 K K X25.4X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Type Brasseler BS Blades - Large Bone K K X25.4X0.89MM (.035IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K K X25.4X0.99MM(.039IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K F K F 90.0X25.4X0.99MM (.039IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K K X25.4X1.19MM(.047IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K F K F 90.0X25.4X1.19MM (.047IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K K X25.4X1.27MM(.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K F K F 90.0X25.4X1.27MM (.050IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K K X25.4X1.37MM (.054IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K F K F 90.0X25.4X1.37MM (.054IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K K X25.4X1.47MM (.058) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone K F K F 90.0X25.4X1.47MM (.058IN) LARGE BONE SAW BLADES/STRYKER SYSTEM 6 Brasseler BS Blades - Large Bone BO BO RCP 11.2X78X1.19MM BLADE SNGL BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 173

174 # EDI Item # Item Header 1 Header BO BO S/O 12.5X90X0.99MM BLADE BRASSELER BOPS Type ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS BO BO S/O 12.5X90X1.19MM BLADE BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS BO BO S/O 12.5X90X1.27MM BLADE BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS BO BO RCP 12.7X76X0.97MM BLADE DBL BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS BO BO RCP 12.7X76X1.27MM BLADE DBL BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS BO BO S/O 19.0X90X1.27MM BLADE BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS BO BO S/O 19.0X110X1.27MM BLADEBRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS BO BO S/O 25.4X90X0.99MM BLADE BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS BO BO S/O 25.4X90X1.19MM BLADE BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS BO BO S/O 25.4X90X1.27MM BLADE BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS BO BO S/O 25.4X90X1.47MM BLADE BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS BO BO S/O 31.0X65X0.99MM BLADE BRASSELER BOPS ZIMMER SURGICAL SAW BLADES/BRASSELER Brasseler BS Blades - Large Bone SYSTEMS LP LP RCP 11.2X78X1.19MM BLADE SNGL LINVATEC ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 174

175 # EDI Item # Item Header 1 Header LP LP S/O 12.5X90X0.99MM BLADE LINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Type Brasseler BS Blades - Large Bone LV LV S/O 12.5X90X0.99MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone LP LP S/O 12.5X90X1.19MM BLADE LINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone LV LV S/O 12.5X90X1.19MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone LP LP S/O 12.5X90X1.27MM BLADE LINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone LV LV S/O 12.5X90X1.27MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone LP LP RCP 12.7X76X0.97MM BLADE DBL LINVATEC ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone LP LP RCP 12.7X76X1.27MM BLADE DBL LINVATEC ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone LP LP S/O 19.0X90X1.27MM BLADE LINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone LV LV S/O 19.0X90X1.27MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone LP LP S/O 19.0X110X1.27MM BLADELINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone LV LV S/O 19.0X110X1.27MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone LP LP S/O 25.4X90X0.99MM BLADE LINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 175

176 # EDI Item # Item Header 1 Header LV LV S/O 25.4X90X0.99MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Type Brasseler BS Blades - Large Bone LP LP S/O 25.4X90X1.19MM BLADE LINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone LV LV S/O 25.4X90X1.19MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone LP LP S/O 25.4X90X1.27MM BLADE LINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone LV LV S/O 25.4X90X1.27MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone LP LP S/O 25.4X90X1.47MM BLADE LINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone LV LV S/O 25.4X90X1.47MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone LP LP S/O 31.0X65X0.99MM BLADE LINVATEC PP, VPP ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone LV LV S/O 31.0X65X0.99MM BLADE LINVATEC VP,OA,SYS 3&4 ZIMMER SURGICAL SAW BLADES/LINVATEC SYSTEMS Brasseler BS Blades - Large Bone MD MD RCP 11.2X78X1.19MM BLADE SNGL 3M MAXI-DRIVER ZIMMER SURGICAL SAW BLADES/3M SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A MD MD S/O 12.5X90X0.99MM BLADE 3M MAXI- DRIVER MD MD S/O 12.5X90X1.19MM BLADE 3M MAXI- DRIVER MD MD S/O 12.5X90X1.27MM BLADE 3M MAXI- DRIVER MD MD RCP 12.7X76X0.97MM BLADE DBL 3M MAXI-DRIVER MD MD RCP 12.7X76X1.27MM BLADE DBL 3M MAXI-DRIVER MD MD S/O 19.0X90X1.27MM BLADE 3M MAX- DRIVER ZIMMER SURGICAL SAW BLADES/3M SYSTEMS ZIMMER SURGICAL SAW BLADES/3M SYSTEMS ZIMMER SURGICAL SAW BLADES/3M SYSTEMS ZIMMER SURGICAL SAW BLADES/3M SYSTEMS ZIMMER SURGICAL SAW BLADES/3M SYSTEMS ZIMMER SURGICAL SAW BLADES/3M SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A Brasseler BS Blades - Large Bone N/A N/A N/A Brasseler BS Blades - Large Bone N/A N/A N/A Brasseler BS Blades - Large Bone N/A N/A N/A Brasseler BS Blades - Large Bone N/A N/A N/A Brasseler BS Blades - Large Bone N/A N/A N/A MD MD S/O 19.0X110X1.27MM BLADE3M MAXI-DRIVER ZIMMER SURGICAL SAW BLADES/3M SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A MD MD S/O 25.4X90X0.99MM BLADE 3M MAXI- DRIVER ZIMMER SURGICAL SAW BLADES/3M SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 176

177 # EDI Item # Item Header 1 Header MD MD S/O 25.4X90X1.19MM BLADE 3M MAXI- DRIVER ZIMMER SURGICAL SAW BLADES/3M SYSTEMS Type Brasseler BS Blades - Large Bone N/A N/A N/A MD MD S/O 25.4X90X1.27MM BLADE 3M MAXI- DRIVER ZIMMER SURGICAL SAW BLADES/3M SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A MD MD S/O 25.4X90X1.47MM BLADE 3M- MAXI-DRIVER ZIMMER SURGICAL SAW BLADES/3M SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A MD MD S/O 31.0X65X0.99MM BLADE 3M MAXI- DRIVER ZIMMER SURGICAL SAW BLADES/3M SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A SS SS RCP 11.2X78X1.19MM BLADE SNGL STRYKER SYS 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone SS SS S/O 12.5X90X0.99MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A SS SS S/O 12.5X90X1.19MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A SS SS S/O 12.5X90X1.27MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A SS SS RCP 12.7X76X0.97MM BLADE DBL STRYKER SYS 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone SS SS RCP 12.7X76X1.27MM BLADE DBL STRYKER SYS 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone SS SS S/O 19.0X90X1.27MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A SS SS S/O 19.0X110X1.27MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A SS SS S/O 25.4X90X0.99MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A SS SS S/O 25.4X90X1.19MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A SS SS S/O 25.4X90X1.27MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A SS SS S/O 25.4X90X1.47MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A SS SS S/O 31.0X65X0.99MM BLADE STRYKER SYSTEM 2000/4&5 ZIMMER SURGICAL SAW BLADES/STRYKER SYSTEMS Brasseler BS Blades - Large Bone N/A N/A N/A PMM09200 PMM09200 HI SPEED DRILL SMALL BONE SMALL BONE POWER SYSTEM DRILLS Brasseler BS Small Bone Handpieces N/A N/A N/A PMM10200 PMM10200 MEDIUM SPEED DRILL SMALL BONE SMALL BONE POWER SYSTEM DRILLS Brasseler BS Small Bone Handpieces N/A N/A N/A PMM12200 PMM12200 SAGITTAL SAW W/WRENCH SMALL BONE SMALL BONE POWER SYSTEM SAWS Brasseler BS Small Bone Handpieces N/A N/A N/A PMM13200 PMM13200 OSCILLATING SAW W/WRENCH SMALL BONE SMALL BONE POWER SYSTEM SAWS Brasseler BS Small Bone Handpieces N/A N/A N/A PMM14200 PMM14200 RECIPROCATING SAW SMALL BONE SMALL BONE POWER SYSTEM SAWS Brasseler BS Small Bone Handpieces N/A N/A N/A PM-M PMM11200 WIREDRIVER SMALL BONE POWER SYSTEM WIREDRIVER Brasseler BS Small Bone Handpieces N/A N/A N/A 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 177

178 # EDI Item # Item Header 1 Header 2 KMA90200 KMA90200 PNUEMICRO HOSE 10 FT SMALL BONE SMALL BONE POWER SYSTEM ACCESSORIES KM-A KMA HOSE 15 FT SMALL BONE POWER SYSTEM ACCESSORIES Type Brasseler BS Other Small Bone N/A N/A N/A Brasseler BS Other Small Bone N/A N/A N/A KMA90201 KMA90201 CLEANING CAP SMALL BONE SMALL BONE POWER SYSTEM ACCESSORIES Brasseler BS Other Small Bone N/A N/A N/A KMA KMA PNUEMICRO HOSE 15 FT SMALL BONE SMALL BONE POWER SYSTEM ACCESSORIES Brasseler BS Other Small Bone N/A N/A N/A KMA91000 KMA91000 FOOT CONTROL SMALL BONE SMALL BONE POWER SYSTEM ACCESSORIES Brasseler BS Other Small Bone N/A N/A N/A KMA95000 KMA95000 STERIL'N CASE 11 X7 X1 SMALL BONE SMALL BONE POWER SYSTEM ACCESSORIES Brasseler BS Other Small Bone N/A N/A N/A PMA95000 PMA95000 STERIL'N CASE 12 X7 X4 SMALL BONE SMALL BONE POWER SYSTEM ACCESSORIES Brasseler BS Other Small Bone N/A N/A N/A PMM10901 PMM10901 MEDIUM BUR GUARD SMALL BONE SMALL BONE POWER SYSTEM ACCESSORIES Brasseler BS Other Small Bone N/A N/A N/A PMM10902 PMM10902 LONG BUR GUARD SMALL BONE SMALL BONE POWER SYSTEM ACCESSORIES Brasseler BS Other Small Bone N/A N/A N/A PM-M PMM11201 WIRE GUARD SMALL BONE POWER SYSTEM ACCESSORIES Brasseler BS Small Bone Handpieces N/A N/A N/A PMM12001 PMM12001 WRENCH SYSTEM SMALL BONE SMALL BONE POWER SYSTEM ACCESSORIES Brasseler BS Other Small Bone N/A N/A N/A KMB46111 KMB X63.5MM DRILL SMALL BONE DRILL BITS Brasseler BS Bits - Small Bone KMB46113 KMB X63.5MM DRILL SMALL BONE DRILL BITS Brasseler BS Bits - Small Bone KMB46115 KMB X63.5MM DRILL SMALL BONE DRILL BITS Brasseler BS Bits - Small Bone KMB46120 KMB X63.5MM DRILL SMALL BONE DRILL BITS Brasseler BS Bits - Small Bone KMB46125 KMB X76.0MM DRILL SMALL BONE DRILL BITS Brasseler BS Bits - Small Bone KMB46127 KMB X76.0MM DRILL SMALL BONE DRILL BITS Brasseler BS Bits - Small Bone KMB46132 KMB X76.0MM DRILL SMALL BONE DRILL BITS Brasseler BS Bits - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 178

179 # EDI Item # Item Header 1 Header 2 Type KMB46135 KMB X76.0MM DRILL SMALL BONE DRILL BITS Brasseler BS Bits - Small Bone KM060 KM060 RCP 8X25.4X0.63MM (0.4) SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM070 KM070 RCP 7.6X38X0.63MM (0.4) SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM071 KM071 RCP 9.5X39X0.58MM (0.4) SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM50 KM50 RCP 5.0X7X0.84MM (0.50) SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM51 KM51 RCP 4X17.5X0.76MM (0.50) SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM53 KM53 RCP 7.0X25X0.89MM (0.50) SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM54 KM54 RCP 8.0X25X0.66MM (0.4) SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM80 KM80 RCP 11X5.5MM TEAR RASP SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM81 KM81 RCP 12.5X7.0MM TEAR RASP SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM82 KM82 RCP 11X5.5MM TEAR RASP SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM83 KM83 RCP 12.5X7.0MM TEAR RASP SMALL BONE RECIPROCATING BLADES Brasseler BS Blades - Small Bone KM300 KM300 ST 70.0X25.4MM.039 IN SA SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 179

180 # EDI Item # Item Header 1 Header 2 KM3000 KM3000 OSC 5.5X19X0.56MM (0.4) SMALL BONE OSCILLATING BLADES Type Brasseler BS Blades - Small Bone KM3001 KM3001 OSC 5.5X26.5X0.56MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3002 KM3002 OSC 9.5X29.6X0.56MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3003 KM3003 OSC 5.5X22.2X0.56MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3004 KM3004 OSC 9.5X27.8X0.56MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3004C KM3004C OSC 9.5X27.8X0.76MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3005 KM3005 OSC 9.5X19X0.56MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3006 KM3006 OSC 5.5X14.5X0.56MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3008 KM3008 OSC 18.5X29.6X0.63MM(0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM300R KM300R ST 77.5MM X 6.35MM SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3258 KM3258 OSC 9.5x11.7X0.63MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3259 KM3259 OSC 9.5X13.7X0.63MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3261 KM3261 OSC 9.5X13.2X0.63MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 180

181 # EDI Item # Item Header 1 Header 2 KM3265 KM3265 OSC 9.5X29.0X0.63MM (0.4) SMALL BONE OSCILLATING BLADES Type Brasseler BS Blades - Small Bone KM3267 KM3267 OSC 5.5X13.7X0.63MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3268 KM3268 OSC 9.5x13.7X0.63MM (0.4) SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM70 KM70 OSC 9X12X0.6MM (0.4) CRESCENTIC SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM71 KM71 OSC 13.5X25.5X0.6MM (0.4)CRESCENTIC SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM72 KM72 OSC 18X30X0.6MM (0.4) CRESCENTIC SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM76 KM76 OSC 13.5X32X0.6MM (0.4) CRESCENTIC SMALL BONE OSCILLATING BLADES Brasseler BS Blades - Small Bone KM3055 KM3055 SAG 3.8X25X6.3MM (0.4) DIAM ABRADER SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3056 KM3056 SAG 3.8X25X6.3MM (0.4) DIAM ABRADER SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3057 KM3057 SAG 3.8X25X6.3MM (0.4) DIAM ABRADER SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3100C KM3100C SAG 14X41X0.70MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3101 KM3101 SAG 9.5X25.5X0.63MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3101C KM3101C SAG 9.5X25.5X0.70MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 181

182 # EDI Item # Item Header 1 Header 2 KM3102 KM3102 SAG 4.5X25.5X0.56MM (0.4) Type SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3104 KM3104 SAG 9.5X15X0.63MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3105 KM3105 SAG 4.5X15X0.63MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3106 KM3106 SAG 5.5X25.5X0.70MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3107 KM3107 SAG 6X34X0.63MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3108 KM3108 SAG 4X34X0.63MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3109C KM3109C SAG 19.5X25.5X0.70MM(0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3228 KM3228 SAG 9.5X7.5X0.63MM (0.63) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3229 KM3229 SAG 9.5X13.5X0.63MM(0.63) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3231 KM3231 SAG 19.5X41X0.70MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3234 KM3234 SAG 5.5X9X0.97MM (0.6) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3235 KM3235 SAG 5.5X18X0.97MM (0.6) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3236 KM3236 SAG 14X15.5X0.63MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 182

183 # EDI Item # Item Header 1 Header 2 KM3237 KM3237 SAG 14X25.5X0.71MM (0.4) Type SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3240 KM3240 SAG 9.5X41X0.63MM (0.4) SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3406 KM3406 SAG 20X6MM HARVEST SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3408 KM3408 SAG 20X8MM HARVEST SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3409 KM3409 SAG 20X9MM HARVEST SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3410 KM3410 SAG 20X10MM HARVEST SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3411 KM3411 SAG 20X11MM HARVEST SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone KM3412 KM3412 SAG 20X12MM HARVEST SMALL BONE SAGITTAL BLADES Brasseler BS Blades - Small Bone 01S S X19X37MM WIRE PASS DRLSS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 01S S X19X37MM WIRE PASS DRLSS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 01S S X19X37MM WIRE PASS DRLSS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 03C C X10X48MM BARREL BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 03C C X48MM OVAL BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 183

184 # EDI Item # Item Header 1 Header 2 03C C X48MM OVAL BUR CARB Type SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 03D D X48MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 03D D X48MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 03D D X8X48MM OVAL BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 03D D X15X48MM STRT BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 03D D X15X48MM STRT BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 03S S X48MM FLAME BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X51MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X51MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X51MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X51MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X51MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X51MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 184

185 # EDI Item # Item Header 1 Header 2 04C C X51MM RND BUR CARB Type SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X51MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X51MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X51MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X6X51MM STRT BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X6X51MM STRT BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X7.5X51MM STRT BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X4.3X51MM STRT BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X10X51MM BARREL BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X4.2X51MM STRT-RND-ENDBUR CARB SIDCUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X5.2X51MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X5.2X51MM TAPRD-FISSURBUR CARB SIDCUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X6X51MM TAPRD BUR CARBSIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 185

186 # EDI Item # Item Header 1 Header 2 04C C X4.2X51MM TAPRD-FISSURBUR CARB SIDCUT Type SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X4.3X51MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X10X51MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X4.6X51MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X4.9X51MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X7.5X51MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X6X51MM TAPRD BUR CARBSIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04C C X13X51MM LINDEMN BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04D D X51MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04D D X51MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04D D X15X51MM DERMABRADE BURDIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04D D X15X51MM TAPRD BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04S S X51MM CYL RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 186

187 # EDI Item # Item Header 1 Header 2 04S S X12X51MM SHANNON BUR SS Type SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04S S X19X51MM WIRE PASS DRLSS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04S S X19X51MM WIRE PASS DRLSS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 04S S X19X51MM WIRE PASS DRLSS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 06C C X19X57MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 06S S X57MM SWANSON REAMR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 07S S X62MM SWANSON REAMR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 07S S X62MM SWANSON REAMR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 07S S X62MM SWANSON REAMR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 08S S X25X67MM LINDEMAN BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09C C X70MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09C C X12X70MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09C C X70MM OVAL BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 187

188 # EDI Item # Item Header 1 Header 2 09C C X70MM OVAL BUR CARB Type SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 188

189 # EDI Item # Item Header 1 Header 2 09D D X70MM RND BUR DIAM Type SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR CRS DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR CRS DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR CRS DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR CRS DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR CRS DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR CRS DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR CRS DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM RND BUR CRS DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 189

190 # EDI Item # Item Header 1 Header 2 09D D0403 2X15X70MM RHINOPLASTY BURDIAM Type SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D0911 4X8X70MM OVAL BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09D D X70MM OVL BUR CRS DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND FIN BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND FIN BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 190

191 # EDI Item # Item Header 1 Header 2 Type 09S S X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND FIN BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND FIN BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND FIN BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND FIN BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 09S S X70MM RND FIN BUR SS SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 10C C X73MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 10C C X73MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 191

192 # EDI Item # Item Header 1 Header 2 10C C X73MM RND BUR CARB Type SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 10C C X73MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 10C C X73MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 10C C X7.5X73MM STRT BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 10C C X10X73MM BARREL BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 10C C X7.5X73MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 10D D X73MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 10D D X73MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 11C C X19X80MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 24NC NC X26.5MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 24NC NC X26.5MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 24NC NC X26.5MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 24NC NC X7.5X25.5MM STRT BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 192

193 # EDI Item # Item Header 1 Header 2 24NC NC X10X25.5MM TAPRD BUR CARB SIDECUT Type SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 24NC NC X12X34.5MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 24NC NC X7.5X25.0MM TAPRD BUR CARB SIDECUT SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65C C X95MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65C C X95MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65C C X95MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65C C X95MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65C C X95MM RND BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65C C X95MM OVAL BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65C C X95MM OVAL BUR CARB SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65D D X95MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65D D X95MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65D D X95MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 65D D X95MM RND BUR DIAM SMALL BONE BURS & BLADES Brasseler BS Burrs - Small Bone 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 193

194 Part A OPPS Status Indicators Status indicators are assigned to HCPCS/CPT codes to indicate how the service is processed and/or paid under the (OPPS). Providers may reference Addendum B to determine the status indicator assigned to a particular code. Addendum B is published quarterly in January, April, July and October and posted on the CMS Web site at ADDENDUM D1. FINAL OPPS PAYMENT STATUS INDICATORS FOR CY 2011 Indicator Item/Code/Service OPPS Payment Status A Services furnished to a hospital outpatient that are paid under a fee schedule or payment system other than OPPS, for example: Ambulance Services Clinical Diagnostic Laboratory Services Non-Implantable Prosthetic and Orthotic Devices EPO for ESRD Patients Physical, Occupational, and Speech Therapy Routine Dialysis Services for ESRD Patients Provided in a Certified Dialysis Unit of a Hospital Diagnostic Mammography Screening Mammography Not subject to deductible or coinsurance. Not subject to deductible. B Codes that are not recognized by OPPS when submitted on an outpatient hospital Part B bill type (12x and 13x). Not paid under OPPS. C Inpatient Procedures Not paid under OPPS. Admit patient. Bill as inpatient. D Discontinued Codes Not paid under OPPS or any other Medicare payment system. E Items, Codes, and Services: That are not covered by any Medicare outpatient benefit based on statutory exclusion. That are not covered by any Medicare outpatient benefit for reasons other than statutory exclusion. That are not recognized by Medicare for outpatient claims but for which an alternate code for the same item or service may be available. For which separate payment is not provided on outpatient claims. May be paid by fiscal intermediaries/macs when submitted on a different bill type, for example, 75x (CORF), but not paid under OPPS. An alternate code that is recognized by OPPS when submitted on an outpatient hospital Part B bill type (12x and 13x) may be available. Not paid by Medicare when submitted on outpatient claims (any outpatient bill type). F Corneal Tissue Acquisition; Certain CRNA Services and Hepatitis B Vaccines Not paid under OPPS. Paid at reasonable cost. G Pass-Through Drugs and Biologicals Paid under OPPS; separate APC payment. H Pass-Through Device Categories Separate cost-based pass-through payment; not subject to copayment. K Nonpass-Through Drugs and Nonimplantable Biologicals, Including Therapeutic Radiopharmaceuticals Paid under OPPS; separate APC payment. L Influenza Vaccine; Pneumococcal Pneumonia Vaccine Not paid under OPPS. Paid at reasonable cost; not subject to deductible or coinsurance. M Items and Services Not Billable to the Fiscal Intermediary/MAC Not paid under OPPS. N Items and Services Packaged into APC Rates Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment. P Partial Hospitalization Paid under OPPS; per diem APC payment. Q1 STVX-Packaged Codes Paid under OPPS; Addendum B displays APC assignments when services are (1) Packaged APC payment if billed on the same date of service as a HCPCS code assigned status indicator S, T, V, or X. (2) In all other circumstances, payment is made through a separate APC payment. Q2 T-Packaged Codes Paid under OPPS; Addendum B displays APC assignments when services are (1) Packaged APC payment if billed on the same date of service as a HCPCS code assigned status indicator T. (2) In all other circumstances, payment is made through a separate APC payment. Q3 Codes That May Be Paid Through a Composite APC Paid under OPPS; Addendum B displays APC assignments when services are R Blood and Blood Paid under OPPS; separate APC payment. S Significant Procedure, Not Discounted When Multiple Paid under OPPS; separate APC payment. T Significant Procedure, Multiple Reduction Applies Paid under OPPS; separate APC payment. U Brachytherapy Sources Paid under OPPS; separate APC payment. V Clinic or Emergency Department Visit Paid under OPPS; separate APC payment. X Ancillary Services Paid under OPPS; separate APC payment. Addendum M displays composite APC assignments when codes are paid through a composite APC. (1) Composite APC payment based on OPPS composite-specific payment criteria. Payment is packaged into a single payment for specific combinations of service. (2) In all other circumstances, payment is made through a separate APC payment or packaged into payment for other services. Y Non-Implantable Durable Medical Equipment Not paid under OPPS. All institutional providers other than home health agencies bill to DMERC Medical Learning, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 194

195 Zimmer Surgical Trademarks August 11, 2011 A.T.S. 750, 1200, 2000, 3000 and 4000 Automatic Tourniquet Systems A.T.S. Cuffs A.T.S. Dual Bladder Control Valve Brown Air Dermatome Powered Skin Grafting Instrument Brown Dermatome Blades Brown Electro-Dermatome Powered Skin Grafting Instr. CDIS Controlled Distention Irrigation System Cemlock Medullary Plug Cemplug Medullary Plug Cushion Rocker Cast Shoe Dermacarriers Skin Graft Carriers Dermacarriers II Skin Graft Carriers Drop-Lok Cartilage Knee Brace H.A.S. Autotransfusion System Hemovac Autotransfusion System Hemovac Closed Autotransfusion System Hemovac Compact Evacuator Hemovac Hydrocoat Drains Hemovac Device Hys-T-Tube Hysterectomy Tube McLeod Padded Clavicle Splint Meshgraft Manual Dermatome Meshgraft II Manual Dermatome Meshgraft Tissue Expansion System Miller Bone Cement Injector Miller Cement Delivery System Mini-Snyder Hemovac Device Orthoblend Powered Bone Mill Ortho-Dri Absorbent Packing Ortho-Dri Copolymer Bone Cement Ortho-Dri Vacuum Mixing System Power-Flo Bone Cement Injector Pulsavac Debridement System Pulsavac Plus Debridement System Pulsavac Plus AC Debridement System Pulsavac III Debridement System Quad-Lumen Drain Quick-Vac Vacuum Mixing System Quik-Use Curette Quik-Use Femoral Bone Cement Preparation Kit Skin-Trac Skin Traction Strips Smooth-Trac Traction Bar Snyder Hemovac Device Sports-Caster ACL Brace Sports-Caster Derotational Super Bowl Mixing/Evacuating System Sure-Closure Skin Stretching System Surgivac Device TempSeal Resorbable Medullary Plug Ultra-Care Heel and Elbow Protector Ultra-Care Sheeting Ultra-Care Slippers Urevac Urinary Kit Var-A-Pulse Debridement System Y-Tube Tube Z-Drape X-Ray Cassette Bag Zimcode Traction Components & Cord Zimcode Traction Weight Bags Zim-Flex Synthetic Cast Tape and Elastic Bandages Zim-Flex II Knit Elastic Bandages Zimfoam Head Halter Zimfoam Patient Pad and Positioners Zimfoam Splint Padding Zim-Plicity Arm Sling Zim-Trac Perforated Traction Splint Zimmer Air Dermatome Zimmer Ambulatory Pump Zimmer Blood Reinfusion System Zimmer Cold Therapy System Zimmer Contour Thigh Cuff Zimmer Disposable Cuffs Zimmer Electric Dermatome Zimmer L.V.C. Low Viscosity Bone Cement Zimmer Patient Helper HD Zimmer PCS Anti-Embolism Stockings Zimmer Poly-Plug Intramedullary System Zimmer Portable Cold Therapy System Zimmer Skin Graft Mesher Zimmer Sterile Disposable Tourniquet Cuff Zimmer Surgical Power System 700 Zimmer Ultra Power System Zimmer Universal Power System The listed trademarks of the following companies require marking and attribution: Alvarado Surgical Knee Holder is a trademark of Thomas D. Peterson A.O.R. Instrumentation is a trademark of Alvarado Orthopedic Research Coolbrace Cervical Orthosis is a trademark of Leonard G. Davis and Dr. Lytton Williams EASYMIX Vacuum Cartridge Cement Mixing EASYMIX Pro Vacuum Cartridge Cement Mixing System Hi-Fatigue Bone Cement are trademarks of aap Biomaterials GmbH EZblade is a trademark of Gebr. Brasseler GmbH & Co.KG Hug-U-Vac Surgical Positioning Device is a trademark of Sports-Doc, Inc. Corporation Jacob Chuck is a trademark of Jacob Chuck Manufacturing MIXIGUN Bone Cement Mixing and Dispensing System is a trademark of Asept Medical AB, Sweden MultiDrive and TraumaDrive Powered Medical Instruments are trademarks of desoutter Medical Limited Orth-O Rad Radiation Resistant Surgical Gloves is a trademark of The Branford Companies, Inc Palm Pump Pain Management System is a trademark of Sorenson Medical, Inc PALACOS Bone Cement is a trademark of Heraeus Kulzer GmbH Philadelphia Cervical Collar is a trademark of Philadelphia Cervical Collar Company REX Cement Stop Bone Plug is a trademark of Spierings Orthopedics B.V. SynPlug Intramedullary Plug is a trademark of Integra Life Sciences Corporation 2011 Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 195

196 Regulatory References used in this document: Medicare Claims Processing (PUB ) Chapter 4 - Part B Hospital (Including Inpatient Hospital Part B and OPPS) CMS-1504-FC Final Changes to the Hospital and CY 2011 Payment Rates Administered by Noridian Administrative Services, LLC (NAS) provides HCPCS coding assistance and national pricing information via searches for HCPCS Level II codes and modifiers, DMEPOS (durable medical equipment, and prosthetics Zimmer Surgical, Inc. This document may not be reproduced, distributed, transmitted, displayed, published or broadcast in whole or in part without prior written permission. PAGE 196