National Health

No. 41 of 1970

An Act to amend the National Health Act 1953-1969.

[Assented to 24 June 1970]

BE it enacted by the Queen’s Most Excellent Majesty, the Senate, and the House of Representatives of the Commonwealth of Australia, as follows:—

Part I.—Preliminary.

Short title and citation.

1.—(1.) This Act may be cited as the National Health Act 1970.

(2.) The National Health Act 1953-1969 is in this Act referred to as the Principal Act.

(3.) The Principal Act, as amended by this Act, may be cited as the National Health Act 1953-1970.

Commencement.

2.—(1.) This Part and sections 4, 6, 7, 59 and 60 of this Act shall come into operation on the day on which this Act receives the Royal Assent.

(2.) Sections 35 and 48 of this Act shall come into operation on the first day of July, One thousand nine hundred and seventy-one.

(3.) The remaining provisions of this Act shall come into operation on a date to be fixed by Proclamation.

Parts.

3. This Act is divided into Parts, as follows:—

Part I.—Preliminary (Sections 1-3).

Part II.—Amendments of the Principal Act (Sections 4-58).

Part III.—Transitional Provisions (Sections 59-64).

Part II.—Amendments of the Principal Act.

Parts.

4. Section 3 of the Principal Act is amended—

(a) by omitting the words—

Part II.—National Health Services (Sections 7-11).


and inserting in their stead the words—

Part II.—National Health Services (Sections 9-11).; and

(b) by omitting the words—

Division 3.—Insured Patients in Approved Hospitals (Sections 46-52).

Division 4.—Uninsured Patients and Pensioners in Approved Hospitals (Sections 53-55).

and inserting in their stead the words—

Division 3.—Certain Insured Patients in Approved Hospitals (Sections 46-52).

Division 4.—Certain Uninsured Patients, and Pensioners, in Approved Hospitals (Sections 53-55).

Division 4a.—Patients treated without Charge in Approved Hospitals (Sections 55a-55b)..

Interpretation.

5. Section 4 of the Principal Act is amended—

(a) by inserting in sub-section (1.), after the definition of registered organization, the following definition:—

“‘restricted membership organization means an organization the rules of which restrict eligibility for membership by reference to—

(a) employment or former employment in a profession, trade, industry or calling;

(b) employment or former employment by a particular employer or by an employer included in a particular class of employers;

(c) membership or former membership of a particular profession, professional association or union;

(d) membership or former membership of the Defence Force or of a part of the Defence Force; or

(e) any other prescribed matter,

not being an organization that has notified the Director-General in writing that it does not wish to be subject to the provisions of this Act relating to restricted membership organizations;; and

(b) by adding at the end of sub-section (1.) the following definitions:—

“‘the Northern Territory means the Northern Territory of Australia;

the proclaimed date means the date fixed by Proclamation under sub-section (3.) of section two of the National Health Act 1970..

Repeal of sections 7 and 8.

6. Sections 7 and 8 of the Principal Act are repealed.


7. Section 9b of the Principal Act is repealed and the following section inserted in its stead:—

Provision of vaccines.

9b. The Minister may provide, or arrange for the provision of, vaccine for the purpose of immunizing persons against any of the following diseases:—

(a) poliomyelitis;

(b) measles; and

(c) rubella..

Interpretation.

8. Section 13 of the Principal Act is amended—

(a) by omitting from sub-section (1.) the definition of contributor and inserting in its stead the following definition:—

“‘contributor means a person—

(a) who pays contributions, or on whose behalf contributions are paid, to a medical benefits fund conducted by a registered medical benefits organization; and

(b) who is, if there is rendered to him any professional service, entitled, subject to the rules of the organization—

(i) to receive from the organization an amount equal to the amount set out as the fund medical benefit in relation to a professional service of that kind in the table of fund medical benefits in respect of a State, being a State in which the organization is lawfully carrying on business as a registered medical benefits organization, set out in a Schedule to this Act as in force at the time when the service is rendered; or

(ii) to have the professional service provided without charge under a contract arrangement,

and, except in relation to the payment of contributions, includes a dependant of such a person;;

(b) by omitting from sub-section (1.) the definitions of professional service and the Committee and inserting in their stead the following definitions:—

“‘medical service means a service that is specified in an item in the First Schedule to this Act;

professional service means—

(a) a medical service that is rendered by, or on behalf of, a medical practitioner; or

(b) a prescribed medical service that is rendered in an operating theatre of an approved hospital by a legally qualified dentist or dental practitioner approved by the Director-General for the purposes of this definition;


the basic Commonwealth medical benefit, in relation to a professional service, means the amount that was, at the date on which the professional service was rendered, the amount indicated as the basic Commonwealth benefit in relation to a professional service of that kind in the table of Commonwealth medical benefits set out in the First Schedule to this Act;

the Committee means the Registration Committee referred to in section seventy of this Act;

the specified excess, in respect of a professional service, means the amount indicated as the specified excess in respect of that professional service in the relevant table of fund medical benefits in relation to the contributor to whom the professional service is rendered.; and

(c) by adding at the end thereof the following sub-sections:—

“(4.) A reference in this Part to the relevant table of fund medical benefits shall be read, in relation to a contributor, as a reference to the table of fund medical benefits set out in a Schedule to this Act that is the relevant table, in accordance with the rules of the organization concerned, in respect of the contributor and where a reference is in relation to a particular professional service, shall be read as a reference to that table as in force at the time at which that professional service was rendered.

(5.) Where a medical service rendered to a person includes a medical procedure that would, but for this sub-section, itself be a medical service, that procedure shall, in respect of that person, be deemed not to be a medical service..

9. After section 13 of the Principal Act the following section is inserted:—

Schedules to this Act to have effect as varied by regulation.

13a.—(1.) The regulations may provide that this Act shall have effect as if a table in a Schedule to this Act were varied—

(a) by omitting an item from the table;

(b) by inserting an item in the table; or

(c) by substituting another amount for an amount set out in an item in the table.

“(2.) Regulations under this section shall, unless sooner repealed, cease to be in force on the day next following the fifteenth sitting day of the House of Representatives after the expiration of a period of twelve months commencing on the day on which the regulations are notified in the Gazette, and shall be deemed to have been repealed on that first-mentioned day..

Entitlement to Commonwealth benefit.

10. Section 14 of the Principal Act is amended by omitting sub-section (1.) and inserting in its stead the following sub-sections:—

“(1.) Where, on or after the proclaimed date, medical expenses are incurred by a contributor in respect of a professional service rendered to the contributor or to a dependant of the contributor, an amount equal


to the basic Commonwealth medical benefit in respect of that professional service is payable subject to and in accordance with the provisions of this Part.

(1a.) Where—

(a) on or after the proclaimed date, medical expenses are incurred by a contributor in respect of professional services consisting of two or more operations performed on the one occasion on the contributor or on one dependant of the contributor;

(b) an additional Commonwealth medical benefit is not payable under the next succeeding sub-section in respect of professional services that include those operations; and

(c) the aggregate of the specified excesses in respect of those professional services exceeds Five dollars,

an additional Commonwealth medical benefit of an amount equal to the amount by which that aggregate exceeds Five dollars is payable, subject to and in accordance with the provisions of this Part, in respect of those professional services.

(1b.) Where—

(a) on or after the proclaimed date, medical expenses are incurred by a contributor in respect of one or more professional services (not being an operation or operations) rendered to the contributor, or to a dependant of the contributor—

(i) in preparation for, and immediately preceding, the rendering to the contributor or to the dependant, as the case may be, of a professional service that consists of an operation or of professional services that consist of two or more operations performed on the one occasion;

(ii) by way of assistance at such an operation or such operations; or

(iii) by way of providing, immediately after such an operation or such operations, care required by the contributor or the dependant, as the case may be, in consequence of the operation or operations; and

(b) the aggregate of the specified excesses in respect of all the professional services (including the operation or operations) exceeds Five dollars,

an additional Commonwealth medical benefit of an amount equal to the amount by which that aggregate exceeds Five dollars is payable, subject to and in accordance with the provisions of this Part, in respect of all the professional services.

(1c.) Where—

(a) on or after the proclaimed date, medical expenses are incurred by a contributor in respect of a professional service rendered to the contributor or to a dependant of the contributor;

(b) the professional service is a service to which an item in Division 9 or 10 of Part 10 of the First Schedule applies;

(c) an additional Commonwealth medical benefit is not payable under either of the last two preceding sub-sections in respect of professional services that include that professional service; and


(d) the specified excess in respect of the professional service is to be ascertained in accordance with a formula set out in a Schedule to this Act and the amount so ascertained exceeds Five dollars,

an additional Commonwealth medical benefit of an amount equal to the amount by which the specified excess exceeds Five dollars is payable, subject to and in accordance with the provisions of this Part, in respect of the professional service..

11. Sections 15a and 16 of the Principal Act are repealed and the following sections inserted in their stead:—

Calculation of Commonwealth benefit payable where two or more operations are performed.

16a.—(1.) Subject to this section, for the purpose of calculating the amount of Commonwealth benefit payable in respect of the medical expenses incurred by a contributor in respect of two or more operations, each constituting a professional service covered by an item in the First Schedule to this Act, that are performed on the one occasion on the contributor or on one dependant of the contributor, the amounts indicated in those items as basic Commonwealth benefit, other than the greatest of those amounts, shall be deemed to be reduced as follows:—

(a) the greatest of the amounts to be deemed to be reduced shall be deemed to be reduced by one-half; and

(b) the other amount, or each of the other amounts, to be deemed to be reduced shall be deemed to be reduced by three-quarters,

and, where an item in a Schedule to this Act other than the First Schedule relates to an item in the First Schedule to this Act that indicates an amount of basic Commonwealth benefit that is, in accordance with the foregoing provisions of this sub-section, to be deemed to be reduced by a specified fraction, the amounts indicated as the fund medical benefit and as the specified excess in that item in that other Schedule shall be deemed to be reduced by the same fraction.

“(2.) For the purposes of this section, where two amounts are equal, one of those amounts shall be treated as being greater than the other or others of those amounts.

“(3.) This section does not apply in relation to an operation, being one of two or more operations performed under the one anaesthetic on the same person, if the medical practitioner who performed the operation—

(a) did not perform, or assist at, the other operation or any of the other operations; and

(b) did not administer the anaesthetic.

“(4.) In this section, operation does not include a medical service specified in Division 2 of Part 10 of the First Schedule to this Act.

Total benefits not to exceed expenses incurred.

“16.—(1.) Where, in respect of professional services rendered to a contributor or to a dependant of a contributor (being professional services in respect of which an additional Commonwealth medical benefit is payable under section fourteen of this Act), the aggregate of—

(a) the amount of Commonwealth benefit that would, but for this section, be payable in respect of the professional services; and


(b) the amounts indicated as fund medical benefit in respect of the professional services in the relevant table of fund medical benefits,

exceeds the medical expenses incurred by the contributor in respect of the professional services—

(c) the additional Commonwealth medical benefit payable, but for this section, in respect of the professional services shall be reduced by the amount of the excess; or

(d) if the excess is equal to or greater than the additional Commonwealth medical benefit so payable, that additional Commonwealth medical benefit is not payable in respect of the professional services.

“(2.) The rules of a registered medical benefits organization may include a rule that where, in respect of a professional service rendered to a contributor or to a dependant of a contributor, the aggregate of—

(a) the amount of the basic Commonwealth medical benefit in respect of the professional service; and

(b) the amount indicated as the fund medical benefit in respect of the professional service in the relevant table of fund medical benefits,

exceeds the medical expenses incurred by the contributor in respect of the professional service—

(c) fund benefit payable, but for that rule, in respect of the professional service shall be reduced by the amount of the excess; or

(d) if the excess is equal to or greater than the fund benefit so payable, fund benefit is not payable in respect of that professional service.

“(3.) Where, in respect of a professional service rendered to a contributor or to a dependant of a contributor, the aggregate of—

(a) the amount of Commonwealth benefit that would, but for this sub-section, be payable in respect of the professional service; and

(b) the amount of fund benefit payable in respect of the professional service,

exceeds the medical expenses incurred by the contributor in respect of the professional service—

(c) any Commonwealth benefit payable, but for this sub-section, in respect of the professional service shall be reduced by the amount of the excess; or

(d) if the excess is equal to or greater than the Commonwealth benefit so payable, Commonwealth benefit is not payable in respect of that professional service..

Administration of anaesthetic and assistance at operation.

12. Section 17 of the Principal Act is amended by omitting sub-section (3.) and inserting in its stead the following sub-section:—

“(3.) Where an item in the First Schedule to this Act relates to a professional service constituted by—

(a) assistance at an operation;

(b) the administration of an anaesthetic; or

(c) assistance in the administration of an anaesthetic,


the amount indicated in that item as the amount of basic Commonwealth benefit is the amount payable in respect of that professional service whether the assistance is rendered or the anaesthetic is administered by one or more than one medical practitioner..

Post-operative treatment deemed to form part of professional service.

13. Section 18 of the Principal Act is amended by omitting the words the Schedule and inserting in their stead the words the First Schedule.

14. Section 18a of the Principal Act is repealed and the following section inserted in its stead:—

Commonwealth benefit not payable in respect of first two months.

18a. Where a person becomes a contributor on or after the proclaimed date (not being a person who, immediately before he so becomes a contributor, was a contributor within the meaning of Part III. of the National Health Act 1953-1969 and had been such a contributor for a period of two months or more), Commonwealth benefit is not payable in respect of medical expenses incurred by the person during a period of two months commencing—

(a) in the case of a person who, immediately before becoming a contributor, was a contributor within the meaning of Part III. of the National Health Act 1953-1969—on the day on which that person became a contributor within the meaning of that Part; or

(b) in any other case—on the day on which that person becomes a contributor,

unless, under the rules of the registered medical benefits organization concerned, fund benefit is paid by the organization in respect of those medical expenses..

Commonwealth benefit not payable where medical expenses payable to public hospitals.

15. Section 19 of the Principal Act is amended by omitting from subsection (2.) the definition of professional service and inserting in its stead the following definition:—

“‘professional service does not include a medical service covered by item 631, 641, 651 or 661 in the First Schedule to this Act or by any item in Part 7 or Part 8 of that Schedule;.

Commonwealth benefit not payable where contributor is entitled to compensation or damages.

16. Section 21 of the Principal Act is amended—

(a) by omitting sub-sections (1.) and (2.) and inserting in their stead the following sub-sections:—

(1.) Where, in respect of medical expenses incurred by a contributor, he has received or established his right to receive a payment by way of compensation or damages (including a payment in settlement of a claim for compensation or damages) under the law of the Commonwealth or of a State or Territory, and the amount of that payment is not less than the aggregate of the amount of Commonwealth benefit and the amount of fund benefit that would be payable in respect of those medical expenses if he had not received or established his right to receive that payment, Commonwealth benefit is not payable in respect of those medical expenses.


(2.) Where, in respect of medical expenses incurred by a contributor, he has received or established his right to receive a payment of the kind referred to in the last preceding subsection, but the amount of that payment is less than the aggregate referred to in that sub-section, Commonwealth benefit is not payable in respect of those medical expenses except to the extent of such amount as the Director-General determines, but not exceeding the amount by which that aggregate exceeds the sum of the amount of fund benefit payable in respect of those medical expenses and the amount of the payment of the kind referred to in the last preceding sub-section that he has received or established his right to receive.; and

(b) by omitting from sub-section (3.) the words may, in his discretion, and inserting in their stead the word shall.

Payment of Commonwealth benefit.

17. Section 23 of the Principal Act is amended by omitting from subsection (1.) all the words after the word contributor (second occurring).

18. Section 28 of the Principal Act is repealed and the following section inserted in its stead:—

Payment of Commonwealth benefit in event of suspension or cancellation of registration &c.

“28. Where a registration of a registered medical benefits organization is suspended or cancelled, the Minister may, by instrument in writing—

(a) direct that, subject to any further directions under this section, Commonwealth benefit shall continue to be paid, for such period as is specified in the direction, as if the suspension or cancellation had not taken place; and

(b) give further directions with respect to the persons to whom, the manner in which and the conditions subject to which such Commonwealth benefit is to be paid..

19. After section 29 of the Principal Act the following sections are inserted:—

Specialist Recognition Advisory Committee.

29a.—(1.) There shall be, in respect of—

(a) each State;

(b) the Australian Capital Territory; and

(c) the Northern Territory,

a Specialist Recognition Advisory Committee.

“(2.) Each Committee shall consist of five medical practitioners appointed by the Minister in accordance with section twenty-nine c of this Act.

“(3.) The exercise or performance of the powers or functions of a Committee is not affected by reason only of there being a vacancy or vacancies in the membership of the Committee.

“(4.) A member of a Committee holds office for a period of three years but he shall be removable by the Minister in any case of misconduct or incapacity.


“(5.) A member of the Specialist Recognition Appeal Committee is not eligible to be nominated or appointed under this section to a Committee.

“(6.) At a meeting of a Committee three members form a quorum.

“(7.) The regulations may make provision for and in relation to the procedure of the Committee.

Specialist Recognition Appeal Committee.

29b.—(1.) There shall be a Specialist Recognition Appeal Committee, which shall consist of five medical practitioners appointed by the Minister in accordance with the next succeeding section.

“(2.) The exercise or performance of the powers or functions of the Committee is not affected by reason only of there being a vacancy or vacancies in the membership of the Committee.

“(3.) A member of the Committee holds office for a period of three years but he shall be removable by the Minister in any case of misconduct or incapacity.

“(4.) A member of a Specialist Recognition Advisory Committee is not eligible to be nominated or appointed under this section to the Committee.

“(5.) At a meeting of the Committee three members form a quorum.

“(6.) The regulations may make provision for and in relation to the procedure of the Committee.

Panels for the appointment of Committees.

29c.—(1.) Before making appointments to a Committee, the Minister shall request each of the following bodies to nominate a panel of not less than three medical practitioners for consideration for appointment to the Committee:—

(a) the Australian Medical Association;

(b) the Royal Australasian College of Surgeons;

(c) the Royal Australasian College of Physicians;

(d) the Australian Council of the Royal College of Obstetricians and Gynaecologists; and

(e) the Royal Australian College of General Practitioners.

“(2.) When, in accordance with a request under the last preceding sub-section, each of the bodies referred to in that sub-section has nominated a panel of medical practitioners for consideration for appointment to a Committee, the Minister shall appoint to the Committee one medical practitioner from each of the panels.

“(3.) Where a member of a Committee dies or resigns or the appointment of a member of a Committee is terminated, the Minister shall request the body by whom the member was nominated to nominate a panel of not less than three medical practitioners for consideration for appointment to fill the place of the member, and the Minister shall appoint one of those medical practitioners to fill that place.

“(4.) In this section, Committee means a Specialist Recognition Advisory Committee or the Specialist Recognition Appeal Committee.


Recognition of consultant physician, &c.

29d.—(1.) The Director-General may refer to a Specialist Recognition Advisory Committee the question whether a particular medical practitioner should, having regard to his qualifications, experience and standing in the medical profession and the nature of his practice, be recognized for the purposes of this Act as a specialist, or as a consultant physician, in a particular specialty.

“(2.) Before considering a question referred to it under the last preceding sub-section, a Committee may, with the Ministers approval, engage as a consultant a medical practitioner who has qualifications, experience and standing in the medical profession in the specialty to which the question before the Committee relates.

“(3.) A Committee shall consider a question referred to it under sub-section (1.) of this section and shall submit to the Director-General a recommendation agreed to by a majority of the members present at a meeting of the Committee.

“(4.) On the receipt of a recommendation under the last preceding sub-section, the Director-General shall determine, for the purposes of this Act, in accordance with the said recommendation, that the medical practitioner concerned is to be recognized as a consultant physician or as a specialist, as the case may be, in the specialty concerned or that he is not to be so recognized.

“(5.) Where the Director-General makes a determination under the last preceding sub-section, he shall—

(a) notify each registered medical benefits organization, in writing, accordingly; and

(b) where the determination is that the medical practitioner is not to be recognized—notify the medical practitioner, in writing, accordingly.

“(6.) The Director-General shall not determine that a medical practitioner is not to be recognized as a consultant physician or as a specialist in respect of a specialty in respect of which the medical practitioner is registered as a consultant physician or as a specialist, as the case may be, under a law of a State or of a Territory forming part of the Commonwealth.

“(7.) Nothing in this section prevents the recognition, for the purposes of this Act, as a consultant physician or as a specialist in respect of a specialty, of a medical practitioner in relation to whom no determination has been made under this section.

“(8.) A determination of the Director-General that a medical practitioner is not to be recognized as a consultant physician or as a specialist does not affect entitlement to Commonwealth benefit in respect of a professional service rendered before the date of the determination.

Appeal against refusal of recognition as a consultant physician, &c.

29e.—(1.) Where the Director-General notifies a medical practitioner that the Director-General has determined that the medical practitioner is not to be recognized, for the purposes of this Act, as


a consultant physician, or as a specialist, in a specialty, the medical practitioner may, within one month after the receipt of that notification, lodge an appeal with the Specialist Recognition Appeal Committee.

“(2.) Before considering an appeal, the Specialist Recognition Appeal Committee may, with the Ministers approval, engage as a consultant a medical practitioner who has qualifications, experience and standing in the medical profession in the specialty to which the appeal relates.

“(3.) The Committee shall consider an appeal so lodged and, if a majority of the members present at a meeting of the Committee is of opinion that the appeal should be allowed, the Committee shall allow the appeal, but otherwise shall dismiss the appeal.

“(4.) Where the Committee allows or dismisses an appeal, it shall notify the appellant and the Director-General, in writing, accordingly.

“(5.) Where the Committee allows an appeal, the Director-General shall make the appropriate determination in relation to the appellant.

Fees for consultants.

29f. A medical practitioner engaged as a consultant under either of the last two preceding sections shall be paid such professional fee in respect of his services as the Minister determines..

Agreement with Australian Medical Association.

20. Section 32 of the Principal Act is amended by adding at the end of sub-section (1.) the words and the conditions of the agreement shall be reviewed at least once every two years.

Interpretation.

21. Section 38 of the Principal Act is amended—

(a) by omitting from the definition of contributor in sub-section (1.) the words the hospital benefits fund and inserting in their stead the words a hospital benefits fund;

(b) by omitting from the definition of dependant in sub-section (1.) the words the fund of a registered hospital benefits organization and inserting in their stead the words a hospital benefits fund conducted by a registered hospital benefits organization; and

(c) by omitting from sub-section (2.) the words the hospital benefits fund of a registered hospital benefits organization and inserting in their stead the words a hospital benefits fund conducted by a registered hospital benefits organization .

Heading to Division 3.

22. The heading to Division 3 of Part V. of the Principal Act is amended by inserting before the words Insured Patients the word Certain.

Payment of benefit.

23. Section 47 of the Principal Act is amended by omitting subsection (2.) and inserting in its stead the following sub-section:—

“(2.) Commonwealth benefit under this Division in respect of any day is not payable to the organization unless and until the organization has paid to the contributor, or to the proprietor on behalf of the contributor, otherwise than by way of hospital fund benefit, an amount equal to the amount of Commonwealth benefit..


Benefit not payable if benefit payable under certain other provisions.

24. Section 49 of the Principal Act is amended by adding at the end thereof the words or under Division 4a of this Part.

25. Section 50 of the Principal Act is repealed and the following section inserted in its stead:—

Payment of Commonwealth benefits in the event of suspension or cancellation of registration, &c.

“50. Where a registration of a registered hospital benefits organization is suspended or cancelled, the Minister may, by instrument in writing—

(a) direct that, subject to any further directions under this section, Commonwealth benefit shall continue to be paid, for such period as is specified in the direction, as if the suspension or cancellation had not taken place; and

(b) give further directions with respect to the persons to whom, the manner in which and the conditions subject to which such Commonwealth benefit is to be paid..

Heading to Division 4.

26. The heading to Division 4 of Part V. of the Principal Act is repealed and the following heading inserted in its stead:—

Division 4.—Certain Uninsured Patients, and Pensioners, in Approved Hospitals.

Benefit payable in respect of certain patients who are not contributors.

27. Section 53 of the Principal Act is amended—

(a) by adding at the end of sub-section (2.) the words or under Division 4a of this Part;

(b) by omitting from paragraph (b) of sub-section (3.) the word or; and

(c) by omitting paragraph (c) of sub-section (3.).

28. After Division 4 of Part V. of the Principal Act the following Division is inserted:—

Division 4a.—Patients treated without Charge in Approved Hospitals.

Commonwealth benefit payable in certain cases.

55a. Subject to this Part, where the proprietor of an approved hospital certifies in the authorized form that no fees were charged in respect of some or all of the qualified hospital patients in that hospital during a specified period, there is payable to the proprietor of that hospital, in respect of each patient to whom the certificate relates, Commonwealth benefit of Two dollars for each day on which the patient was a qualified hospital patient in that hospital during that period.

Benefit under this Division not payable if benefit payable under section 54.

55b. A Commonwealth benefit under this Division is not payable in respect of a qualified hospital patient for any day for which Commonwealth benefit is payable in respect of that patient under section fifty-four of this Act..

Interpretation.

29. Section 66 of the Principal Act is amended—

(a) by omitting from sub-section (1.) the definitions of special account contributor and standard rate benefit and inserting in their stead the following definitions:—

“‘special account means a special account established by a


registered organization for the purposes of Division 2 of this Part.

special account contributor means a contributor the amounts of whose contributions are for the time being required to be credited to a special account, and includes a person who is a contributor by virtue of being a dependant of a special account contributor;; and

(b) by adding at the end thereof the following sub-sections:—

(3.) For the purposes of this Part, a registered medical benefits organization shall be deemed to carry on business as a registered medical benefits organization in a State or Territory if, for the purposes of, or purposes related to, the enrolment of contributors to a medical benefits fund conducted by it or the payment of benefits to such contributors—

(a) it uses premises in that State or Territory; or

(b) it uses, in that State or Territory, the services of a servant or agent.

(4.) For the purposes of this Part, a registered hospital benefits organization shall be deemed to carry on business as a registered hospital benefits organization in a State or Territory if, for the purposes of, or purposes related to, the enrolment of contributors to a hospital benefits fund conducted by it or the payment of benefits to such contributors—

(a) it uses premises in that State or Territory; or

(b) it uses, in that State or Territory, the services of a servant or agent.

(5.) A reference in this Part to the relevant table of fund medical benefits shall be read, in relation to a contributor, as a reference to the table of fund medical benefits set out in a Schedule to this Act that is the relevant table, in accordance with the rules of the organization concerned, in respect of the contributor.

(6.) For the purposes of this Part, the Australian Capital Territory shall be deemed to form part of the State of New South Wales..

30. Sections 67 and 68 of the Principal Act are repealed and the following sections inserted in their stead:—

Application by organizations for registration as medical benefits organizations.

“67.—(1.) An organization may apply for registration as a registered medical benefits organization in respect of a specified State or in respect of the Northern Territory, or may make more than one such application.

“(2.) An organization (not being a restricted membership organization) is not eligible to be registered as a registered medical benefits organization in respect of a State unless, under the rules of the organization—

(a) a medical benefits fund is to be conducted by the organization in respect of that State;


(b) there is to be credited to that fund the whole of the income of the organization arising out of the carrying on in that State of business as a registered medical benefits organization or if, in accordance with those rules, the Northern Territory is to be treated as part of that State, the whole of the income of the organization arising out of the carrying on of such business in that State and in the Northern Territory;

(c) no amount is to be debited to that fund other than—

(i) payments by the organization of medical fund benefits, or any other benefits payable under the rules of the organization, in respect of contributors to the fund;

(ii) costs incurred by the organization wholly and exclusively in the carrying on in that State of business as a registered medical benefits organization or if, in accordance with those rules, the Northern Territory is to be treated as part of that State, incurred by the organization wholly and exclusively in carrying on such business in that State and in the Northern Territory;

(iii) such proportion of any costs incurred by the organization in the carrying on of business as a registered medical benefits organization, not being costs incurred wholly and exclusively in relation to business in a particular State or in the Northern Territory, as is approved by the Director-General as being an equitable proportion; and

(iv) any amount transferred, with the approval of the Minister, to another medical benefits fund conducted by the organization; and

(d) where a person who contributes to that fund, or a dependant of such a person, has a professional service rendered to him, the person is, subject to those rules, entitled—

(i) to be paid out of that fund an amount equal to the fund medical benefit indicated in respect of the professional service, in the relevant table of fund medical benefits; or

(ii) to have the professional service provided without charge under a contract arrangement.

“(3.) An organization (not being a restricted membership organization) is not eligible to be registered as a registered medical benefits organization in respect of the Northern Territory unless—

(a) under the rules of the organization—

(i) the Northern Territory is to be treated as part of a State in respect of which the organization is registered or is eligible to be registered as a registered medical benefits organization; or

(ii) a medical benefits fund is to be conducted by the organization in respect of the Northern Territory; and


(b) where, under the rules of the organization, a medical benefits fund is to be conducted by the organization in respect of the Northern Territory, those rules contain provisions complying with the requirements of the last preceding sub-section, as modified by the substitution of references to the Northern Territory for references to a State.

“(4.) A restricted membership organization is not eligible to be registered as a registered medical benefits organization in respect of any State or in respect of the Northern Territory unless, under the rules of the organization—

(a) a medical benefits fund is to be conducted by the organization;

(b) there is to be credited to that fund the whole of the income of the organization arising out of the carrying on by the organization of business as a registered medical benefits organization;

(c) no amount is to be debited to that fund other than—

(i) payments by the organization of medical fund benefits, or any other benefits payable under the rules of the organization, in respect of contributors to the fund; and

(ii) costs incurred by the organization in the carrying on of business as a registered medical benefits organization; and

(d) where a person who contributes to that fund, or a dependant of such a person, has a professional service rendered to him, the person is, subject to those rules, entitled—

(i) to be paid out of that fund an amount equal to the fund benefit set out, in respect of the professional service, in the relevant table of fund medical benefits; or

(ii) to have that professional service provided without charge under a contract arrangement.

“(5.) An organization is not eligible to be registered as a registered medical benefits organization in respect of any State or in respect of the Northern Territory unless, under the rules of the organization—

(a) a person who contributes to a medical benefits fund conducted by the organization is not eligible to contribute to another medical benefits fund conducted by the organization; and

(b) a person who contributes to a medical benefits fund conducted by another registered medical benefits organization is not eligible to contribute to a medical benefits fund conducted by the first-mentioned organization.

Application by organizations for registration as hospital benefits organizations.

“68.—(1.) An organization may apply for registration as a registered hospital benefits organization in respect of a specified State or in respect of the Northern Territory, or may make more than one such application.

“(2.) An organization (not being a restricted membership organization) is not eligible to be registered as a registered hospital benefits organization in respect of a State unless, under the rules of the organization

(a) a hospital benefits fund is to be conducted by the organization in respect of that State;


(b) there is to be credited to that fund the whole of the income of the organization arising out of the carrying on by the organization in that State of business as a registered hospital benefits organization and if, in accordance with those rules, the Northern Territory is to be treated as part of that State, the whole of the income of the organization arising out of the carrying on of such business by the organization in the Northern Territory; and

(c) no amount is to be debited to that fund other than—

(i) payments by the organization of hospital fund benefits, or any other benefits payable under the rules of the organization, in respect of contributors to the fund;

(ii) costs incurred by the organization wholly and exclusively in the carrying on in that State of business as a registered hospital benefits organization or if, in accordance with those rules, the Northern Territory is to be treated as part of that State, incurred by the organization wholly and exclusively in carrying on such business in that State and in the Northern Territory;

(iii) such proportion of any costs incurred by the organization in respect of the carrying on of business as a registered hospital benefits organization, not being costs incurred wholly and exclusively in relation to business in a particular State or in the Northern Territory, as is approved by the Director-General as being an equitable proportion; and

(iv) any amount transferred, with the approval of the Minister, to another hospital benefits fund conducted by the organization.

“(3.) An organization (not being a restricted membership organization) is not eligible to be registered as a registered hospital benefits organization in respect of the Northern Territory unless—

(a) under the rules of the organization—

(i) the Northern Territory is to be treated as part of a State in respect of which the organization is registered or is eligible to be registered as a registered hospital benefits organization; or

(ii) a hospital benefits fund is to be conducted by the organization in respect of the Northern Territory; and

(b) where, under the rules of the organization, a hospital benefits fund is to be conducted by the organization in respect of the Northern Territory, those rules contain provisions complying with the requirements of the last preceding sub-section, as modified by the substitution of references to the Northern Territory for references to a State.

“(4.) A restricted membership organization is not eligible to be registered as a registered hospital benefits organization in respect of any


State or in respect of the Northern Territory unless, under the rules of the organization—

(a) a hospital benefits fund is to be conducted by the organization;

(b) there is to be credited to that fund the whole of the income of the organization arising out of the carrying on by the organization of business as a registered hospital benefits organization; and

(c) no amount is to be debited to that fund other than—

(i) payments by the organization of hospital fund benefits, or any other benefits payable under the rules of the organization, in respect of contributors to the fund; and

(ii) costs incurred by the organization in carrying on a business as a registered hospital benefits organization..

Furnishing of information by applicant organizations.

31. Section 69 of the Principal Act is amended—

(a) by omitting from sub-section (1.) the word may and inserting in its stead the word shall; and

(b) by omitting from sub-section (2.) the word may and inserting in its stead the word shall.

32. Section 72 of the Principal Act is repealed and the following sections are inserted in its stead:—

Report of the Committee.

“72. The Committee shall submit to the Minister a report on the application and, in its report, recommend to the Minister that registration of the organization be granted or refused.

Matters to be taken into account by Committee and by Minister.

72a. The Committee, in making a recommendation with respect to an application for registration of an organization in respect of a State or Territory, and the Minister, in exercising his powers with respect to such an application, shall consider whether the organization is eligible to be registered and shall also take into account—

(a) the number of persons who contribute, or are likely to contribute, to the relevant fund of the organization;

(b) the rates of contributions to that fund;

(c) the rules of the organization relating to that fund and, in particular, whether those rules contain appropriate provisions, having regard to the provisions of this Act;

(d) the ratio that the likely amount of the management and administrative expenses in respect of the conduct of that fund bears to the likely amount of contributions to that fund; or

(e) any other matter that the Minister or the Committee, as the case may be , considers relevant, having regard to the public interest..

Registration.

33.—(1.) Section 73 of the Principal Act is amended by omitting subsection (1.) and inserting in its stead the following sub-section:—

“(1.) The Minister may, after considering the report of the Committee, grant, subject to such terms and conditions (if any) as he thinks fit, or refuse, the application and, if he grants the application, he shall register the organization accordingly..


(2.) Section 73 of the Principal Act is further amended by adding at the end thereof the following sub-sections:—

“(7.) Where the Minister grants an application for registration of an organization, he shall, within one month after he has so granted the application, publish in the Gazette a notification to that effect setting out—

(a) the name of the organization;

(b) the name of the State or Territory to which the registration relates;

(c) the date of registration;

(d) the fact that the registration is subject to the conditions set out in section seventy-three b of this Act; and

(e) if the grant is subject to any other terms or conditions—those other terms and conditions.

“(8.) Where the Minister refuses an application for registration of an organization, he shall, within one month after he has so refused the application, publish in the Gazette a notification of the refusal.

“(9.) Where the Minister takes action in pursuance of sub-section (6.) of this section in relation to an organization, he shall, within one month after so taking action, publish in the Gazette a notification setting out—

(a) the name of the organization;

(b) particulars of the action so taken, including—

(i) where a term or condition has been varied—the term or condition as so varied;

(ii) where a term or condition has been revoked—the term or condition so revoked; or

(iii) where a term or condition has been added—the term or condition so added; and

(c) the date on which the action was taken..

34. After section 73a of the Principal Act the following section is inserted:—

Conditions to which registrations are to be deemed to be subject.

73b. Where an organization is registered after the proclaimed date, the registration shall be deemed to be subject to each of the following conditions:—

(a) a condition that the rules of the organization will at all times include such provision as is required to enable section eighty-two s and section eighty-two t of this Act to apply in relation to the organization;

(b) a condition that the organization will not carry on business in Australia as a registered medical benefits organization or as a registered hospital benefits organization except in a State or Territory in respect of which it is registered as a registered medical benefits organization or as a registered hospital benefits organization, as the case may be; and

(c) a condition that the organization will cause such alterations to be made to its rules as are necessary to enable it to comply with any direction given to it by the Minister with respect to the variation of the rates of contributions payable to the organization by all or any contributors..


35. Section 76 of the Principal Act is repealed and the following sections are inserted in its stead:—

Particulars to be furnished annually to the Director-General.

“76.—(1.) A registered organization which makes any report to all or any of its members at any time after the thirtieth day of June, One thousand nine hundred and seventy-one, shall, within one month after making the report or within such further time as the Director-General allows, furnish a copy of the report to the Director-General.

“(2.) A registered organization shall, within three months after the expiration of each year commencing with the year ending on the thirtieth day of June, One thousand nine hundred and seventy-one, or within such further time as the Director-General allows, furnish to the Director-General—

(a) such financial accounts and statements in respect of that year as. the Director-General requires to be furnished for use in preparing the report referred to in the next succeeding section; and

(b) such other statements in respect of that year as are prescribed,

certified on behalf of the organization, as prescribed, to be true and correct.

Penalty: Two hundred dollars.

Annual report by Director-General.

76a.—(1.) The Director-General shall, as soon as practicable after the thirtieth day of June in each year, commencing with the year One thousand nine hundred and seventy-one, furnish to the Minister a report on the operations of registered organizations during the year ending on that date.

“(2.) The report shall include, in respect of each medical benefits fund or hospital benefits fund conducted by the registered organization during the year to which the report relates, the following information in respect of the fund or, if the fund includes a special account, in respect of the part of the fund other than the special account:—

(a) contributions payable to the fund;

(b) other amounts payable to the fund;

(c) medical fund benefits or hospital fund benefits payable out of the fund;

(d) other benefits payable out of the fund;

(e) management expenses;

(f) other amounts payable out of the fund;

(g) the balance of the fund as at the end of that year;

(h) details of how the reserves of the fund have been invested; and (i) such other information as the Minister requires to be included.

“(3.) Where a special account is maintained in a fund during a year the report in respect of that year shall include, in respect of that special account, similar information as is required to be included in respect of the remainder of the fund.


“(4.) The Minister shall lay each report under this section before each House of the Parliament within fifteen sitting days of that House after it is received by the Minister..

Changes of rules, &c., by registered organizations.

36. Section 78 of the Principal Act is amended by omitting from subsections (2.) and (5.) the words the medical benefits fund or the hospital benefits fund of (wherever occurring) and inserting in their stead the words any medical benefits fund or any hospital benefits fund conducted by.

Cancellation or suspension of registration.

37. Section 79 of the Principal Act is amended by inserting in subsection (1.), before the word where, the words in respect of a State or in respect of the Northern Territory,.

38. After section 80 of the Principal Act the following section is: inserted:—

Limits in respect of management expenses of funds.

80a. The regulations—

(a) may, for the purpose of the exercise by the Minister of the powers referred to in the next succeeding paragraph, prescribe limits in respect of management expenses in relation to all or any medical benefits funds and hospital benefits funds conducted by all or any registered organizations; and

(b) may empower the Minister to deduct from any Commonwealth benefit payable to a registered organization in relation to the conduct of a medical benefits fund or hospital benefits fund by the organization an amount equal to the amount by which any management expenses in relation to that fund exceed any limit so prescribed that is applicable in respect of that fund..

Notification of registrations, &c.

39. Section 81 of the Principal Act is amended by omitting from subsection (1.) the words the names of organizations registered and inserting in their stead the words particulars of all subsisting registrations of organizations.

40.(1.) Section 82a of the Principal Act is repealed and the following section inserted in its stead:—

Establishment of special account.

82a. For the purposes of this Division, a registered organization may, with the approval of the Minister, establish a special account in a medical benefits fund or hospital benefits fund conducted by the registered organization..

(2.) A special account established under the section repealed by the last preceding sub-section that was subsisting immediately before the commencement of this section shall be deemed, for the purposes of the Principal Act, as amended at any time, to have been established under the section inserted in the Principal Act by that sub-section.


Contributors suffering from pre-existing ailments, chronic illnesses, &c.

41. Section 82c of the Principal Act is amended—

(a) by omitting sub-section (1.) and inserting in its stead the following sub-section:—

(1.) Where, after the establishment of a special account by a registered medical benefits organization—

(a) a claim for medical fund benefit is lodged by, or on behalf of, an ordinary contributor (being a contributor with respect to the medical benefits fund in which the special account is established) in respect of a professional service that is rendered to him or to one of his dependants; and

(b) by reason only of the rules of the organization relating to the eligibility of an ordinary contributor to be paid fund benefit in respect of a pre-existing ailment or relating to the maximum fund benefit payable to an ordinary contributor, the organization is entitled to disallow, and does disallow, the claim,

the organization shall credit to the special account the amount of the contributions referred to in sub-section (2.) of this section.;

(b) by inserting in paragraph (a) of sub-section (1a.), after the word contributor, the words (being a contributor with respect to the hospital benefits fund in which the special account is established); and

(c) by inserting in paragraph (a) of sub-section (3.), after the words ordinary contributor, the words (being a contributor with respect to the hospital benefits fund in which the special account is established).

Certain contributors may be made special account contributors.

42. Section 82ca of the Principal Act is amended by omitting from sub-section (1.) all the words after paragraph (b) and inserting in their stead the words—

the organization may elect to treat the contributor as having become, on any day that is included in the days in respect of which the benefit is so payable, a special account contributor in relation to the special account established in the hospital benefits fund in respect of which he is a contributor and, if it so elects, shall, subject to section eighty-two g of this Act, credit to that special account contributions by or on behalf of that contributor in respect of the week in which that day is included and all subsequent weeks..

Payment of benefits.

43. Section 82d of the Principal Act is amended by inserting in subsection (1.), after the words special account contributor, the words in relation to that special account.

Rules of organization establishing special account to contain certain provisions.

44. Section 82e of the Principal Act is amended—

(a) by inserting in paragraph (a) of sub-section (1.), after the wordcontributor (first occurring), the words in relation to the special account;


(b) by inserting in paragraph (b) of sub-section (1.), after the word contributor (first occurring), the words in relation to the special account;

(c) by inserting in paragraph (c) of sub-section (1.), after the word contributor (first occurring), the words in relation to the special account;

(d) by omitting paragraph (ca) of sub-section (1.) and inserting in its stead the following paragraph:—

(ca) in the case of a registered medical benefits organization, a special account contributor in relation to the special account is not, in respect of a claim for medical fund benefit in relation to professional services (being professional services rendered on or after the date of the establishment of the special account or the day on which there became payable the first contribution in respect of the contributor the amount of which was credited to the special account, whichever is the later) excluded from entitlement to fund benefit by any rule of the organization relating to the eligibility of a contributor for payment of fund benefit in respect of a pre-existing ailment or relating to maximum fund benefit payable;;

(e) by inserting in paragraph (d) of sub-section (1.), after the word contributor (first occurring), the words in relation to the special account;

(f) by adding at the end of paragraph (g) of sub-section (1.) the word and;

(g) by omitting paragraph (h) and paragraph (j) of sub-section (1.) and inserting in their stead the following paragraph:—

(h) in the case of a registered hospital benefits organization, benefit is not payable from the special account in respect of a period during which a special account contributor in relation to the special account was a patient in an institution other than an approved hospital, unless payment of the benefit has been approved by the Director-General;

(h) by omitting from sub-section (2.) the words of the fund; and

(i) by inserting in sub-section (2.) after the word contributor (first occurring), the words in relation to the special account.

Contributors at concessional rates.

45. Section 82f of the Principal Act is amended—

(a) by inserting after the words special account contributors (first occurring) the words in relation to a special account;

(b) by omitting the words the special account contributors within that specified class and inserting in their stead the words those special account contributors; and


(c) by adding at the end thereof the following sub-section:—

(2.) A person who is a special account contributor shall be deemed, for the purposes of the last preceding sub-section, not to be a special account contributor during any period during which there is in force in respect of him a determination under section eighty-two u of this Act that is a Class B determination or a Class C determination for the purposes of Division 3 of Part VI..

Special account contributor may be made an ordinary contributor in certain cases.

46. Section 82g of the Principal Act is amended by adding at the end of sub-section (2.) the words in relation to which he was a special account contributor.

Records relating to special account contributors.

47. Section 82j of the Principal Act is amended by inserting in subsection (1.), after the word contributor (first occurring), the words in relation to the special account.

Reimbursement of organization in respect of amount standing to debit of special account.

48. Section 82l of the Principal Act is amended by adding at the end thereof the following sub-section:—

(3.) In this section, accounting year means the year ending on the thirtieth day of June, One thousand nine hundred and seventy-one, or on any subsequent thirtieth day of June..

Interpretation.

49. Section 82q of the Principal Act is amended—

(a) by omitting from sub-section (1.) the definitions of approved scale of benefits and Assistant Director-General and inserting in their stead the following definitions:—

“‘approved scale of benefits means a scale of hospital benefits approved by the Minister under section eighty-two r of this Act;

Assistant Director-General means an Assistant Director-General of Social Services;

Class A determination means a determination under subsection (4.) of section eighty-two u of this Act in terms of sub-paragraph (i) of paragraph (a) or (b) of that subsection;

Class B determination means a determination under subsection (4.) of section eighty-two u of this Act in terms of sub-paragraph (ii) of paragraph (a) or (b) of that subsection;

Class C determination means a determination under subsection (4.) of section eighty-two u of this Act in terms of sub-paragraph (iii) of paragraph (a) or (b) of that subsection;;

(b) by omitting from paragraph (d) of sub-section (2.) the words Thirty-nine dollars and inserting in their stead the words a particular amount; and


(c) by adding at the end thereof the following sub-section:—

(3.) In this Division—

(a) a reference to a professional service shall be read as including a reference to any service (including the supply of any article) in respect of which a benefit is payable under the rules of the registered organization concerned; and

(b) a reference to hospital treatment shall be read as including a reference to any service or treatment in respect of which a benefit is payable under the rules of the registered organization concerned..

50.—(1.) Sections 82r, 82s and 82t of the Principal Act are repealed and the following sections inserted in their stead:—

Power of Minister to approve scale of benefits.

82r.—(1.) The Minister may, in relation to a hospital benefits fund conducted by a registered hospital benefits organization, by instrument in writing, approve, for the purposes of this Division, a scale of hospital benefits provided by the organization, in accordance with the rules of the organization, to contributors to that fund, being a scale that the Minister considers appropriate having regard to the charges made for hospital treatment in public wards of public hospitals.

“(2.) In the case of a restricted membership organization, a scale approved under this section may provide for different hospital benefits in respect of hospital treatment received in different States (for which purpose the Northern Territory shall be deemed to be a State).

Waiver of contributions, and reimbursement by Commonwealth of fund benefits, where contributor in receipt of unemployment or sickness benefit.

“82s.—(1.) Where—

(a) a contributor to a medical benefits fund lodges with the organization that conducts the fund a claim in respect of a professional service that has been rendered (whether before or after the contributor became a contributor) to himself or to one of his dependants;

(b) the professional service was rendered on or after the proclaimed date, and during a period in relation to which this section applies in respect of the contributor;

(c) under a provision included in the rules of the organization for the purpose of enabling this section and the next succeeding section to apply in relation to the organization, contributions were not payable by the contributor to the fund in respect of that period or the payment of contributions by the contributor to the fund in respect of that period has been waived; and

(d) the organization pays to, or to a person on behalf of, the contributor fund benefit in respect of the professional service,

there is payable to the organization by the Commonwealth an amount equal to the fund benefit referred to in paragraph (d) of this sub-section.


“(2.) Where—

(a) a contributor to a hospital benefits fund lodges with the organization that conducts the fund a claim in respect of hospital treatment that has been received (whether before or after the contributor became a contributor) by himself or by one of his dependants;

(b) the hospital treatment was received on or after the proclaimed date and during a period in relation to which this section applies in respect of the contributor;

(c) the contributor is a contributor for the approved scale of benefits in relation to the fund or for a scale of benefits greater than those provided by the approved scale of benefits;

(d) under a provision included in the rules of the organization for the purpose of enabling this section and the next succeeding section to apply in relation to the organization, contributions were not payable by the contributor to the fund in respect of that period or the payment of contributions by the contributor to the fund in respect of that period has been waived; and

(e) the organization pays to, or to a person on behalf of, the contributor, as fund benefit in respect of that hospital treatment—

(i) the amount of fund benefit in accordance with the scale of benefits for which the contributor is a contributor; or

(ii) if that amount exceeds the prescribed amount, an amount equal to the prescribed amount, and no more,

there is payable to the organization by the Commonwealth—

(f) if the contributor is a contributor for the approved scale of benefits—an amount equal to the amount paid as fund benefit in accordance with paragraph (e) of this sub-section; or

(g) in any other case—an amount equal to the amount that would have been paid as fund benefit in accordance with paragraph (e) of this sub-section if the contributor had been, when the hospital treatment was received, a contributor for the approved scale of benefits.

(3.) Where a contributor was, in respect of a period, a contributor for a scale of benefits greater than those provided by the approved scale of benefits, a reference in paragraph (d) of the last preceding sub-section to contributions shall, in relation to the contributor, be read as not including a reference to any contributions payable by the contributor in respect of that period that would not have been so payable if the contributor had been, in respect of that period, a contributor for the approved scale of benefits.

(4.) In sub-section (2.) of this section, the prescribed amount means the amount (if any) by which the sum of the gross fees and extra charges incurred in respect of the hospital treatment is greater than the amount of Commonwealth and miscellaneous fund benefit payable in respect of the hospital treatment.


(5.) Subject to the next succeeding sub-section, this section applies, in respect of a contributor, in relation to—

(a) a period (in this sub-section called a benefit period) in respect of which benefit was paid or is payable to the contributor under Part VII. of the Social Services Act 1947-1970; or

(b) a period in respect of which benefit was not paid and is not payable under that Part, being—

(i) a period, not exceeding seven days, during which the contributor was unemployed or incapacitated and which immediately preceded a benefit period other than a benefit period that commenced from a date fixed under section one hundred and twenty of the Social Services Act 1947-1970; or

(ii) a period of four weeks that immediately followed a benefit period other than a benefit period that ended by reason of the cancellation, under section one hundred and twenty or section one hundred and twenty-one of that Act, of payment of the benefit.

(6.) Notwithstanding the last preceding sub-section, where a contributor was not a contributor at the commencement of a period in relation to which, but for this sub-section, this section would apply in respect of the contributor, this section does not apply, in respect of the contributor, in relation to—

(a) the first two weeks of that period; or

(b) the part of that period before the contributor became a contributor, whichever is the shorter.

Waiver of, or reduction in, contributions and reimbursement of fund benefits, where income or means as assessed of contributor and family do not exceed a certain amount.

82t.—(1.) This section applies in respect of a contributor to a medical benefits fund or a hospital benefits fund (not being a person who is such a contributor by reason only that he or she is a dependant of another person who is such a contributor) in relation to a period if a determination under the next succeeding section in respect of the contributor (in this section referred to as the determination) was, or is to be deemed to have been, in force throughout that period.

“(2.) Where

(a) a contributor to a medical benefits fund lodges with the organization that conducts the fund a claim in respect of a professional service that has been rendered to himself or to one of his dependants (including, where the determination is a Class A determination, a professional service rendered before the contributor became a contributor);

(b) the professional service was rendered on or after the proclaimed date, and during a period in relation to which this section applies in respect of the contributor;


(c) under a provision included in the rules of the organization for the purpose of enabling this section and the last preceding section to apply in relation to the organization—

(i) where the determination is a Class A determination—contributions were not payable by the contributor to the fund in respect of that period or the payment of contributions by the contributor to the fund in respect of that period has been waived;

(ii) where the determination is a Class B determination—contributions were not payable by the contributor to the fund in respect of that period at a rate exceeding one-third of the rate that would have been applicable but for that provision; or

(iii) where the determination is a Class C determination—contributions were not payable by the contributor to the fund in respect of that period at a rate exceeding two-thirds of the rate that would have been applicable but for that provision; and

(d) the organization pays to, or to a person on behalf of, the contributor fund benefit in respect of the professional service,

there is payable to the organization by the Commonwealth an amount equal to—

(e) where the determination is a Class A determination—the fund benefit referred to in paragraph (d) of this section;

(f) where the determination is a Class B determination—two-thirds of the fund benefit referred to in paragraph (d) of this sub-section; or

(g) where the determination is a Class C determination—one-third of the fund benefit referred to in paragraph (d) of this sub-section.

“(3.) Where—

(a) a contributor to a hospital benefits fund lodges with the organization that conducts the fund a claim in respect of hospital treatment that has been received by himself or by one of his dependants (including, where the determination is a Class A determination, hospital treatment received before the contributor became a contributor);

(b) the hospital treatment was received on or after the proclaimed date, and during a period in relation to which this section applies in respect of the contributor;

(c) the contributor was, when the hospital treatment was received, a contributor for the approved scale of benefits in relation to the fund or for a scale of benefits greater than those provided by the approved scale of benefits;


(d) under a provision included in the rules of the organization for the purpose of enabling this section and the last preceding section to apply in relation to the organization—

(i) where the determination is a Class A determination—contributions were not payable by the contributor to the fund in respect of that period or the payment of contributions by the contributor to the fund in respect of that period has been waived;

(ii) where the determination is a Class B determination—contributions were payable by the contributor to the fund in respect of that period at a rate not exceeding one-third of the rate that would have been applicable but for that provision; or

(iii) where the determination is a Class C determination—contributions were payable by the contributor to the fund in respect of that period at a rate not exceeding two-thirds of the rate that would have been applicable but for that provision; and

(e) the organization pays to, or to a person on behalf of, the contributor, as fund benefit in respect of that hospital treatment—

(i) the amount of fund benefit in accordance with the scale of benefits for which the contributor is a contributor; or

(ii) if that amount exceeds the prescribed amount, the prescribed amount and no more,

there is payable to the organization by the Commonwealth—

(f) where the determination is a Class A determination—an amount equal to—

(i) if the contributor was, when the hospital treatment was received, a contributor for the approved scale of benefits—the amount paid as fund benefit in accordance with paragraph (e) of this sub-section; or

(ii) in any other case—the amount that would have been paid as fund benefit in accordance with paragraph (e) of this sub-section if the contributor had been, when the hospital treatment was received, a contributor for the approved scale of benefits;

(g) where the determination is a Class B determination—an amount equal to two-thirds of the amount that would be payable under the last preceding paragraph if the determination were a Class A determination; or

(h) where the determination is a Class C determination—an amount equal to one-third of the amount that would be payable under paragraph (f) of this sub-section if the determination were a Class A determination.


“(4.) Where a contributor was, in respect of a period, a contributor for a scale of benefits greater than those provided by the approved scale of benefits, a reference in paragraph (d) of the last preceding sub-section to contributions shall, in relation to the contributor, be read as not including a reference to any contributions payable by the contributor in respect of that period that would not have been so payable if the contributor had been, in respect of that period, a contributor for the approved scale of benefits.

“(5.) In sub-section (3.) of this section, the prescribed amount means the amount (if any) by which the sum of the gross fees and extra charges incurred in respect of the hospital treatment concerned is greater than the amount of Commonwealth and miscellaneous fund benefit payable in respect of the hospital treatment..

(2.) Notwithstanding the repeal effected by the last preceding subsection—

(a) a scale of benefits approved under section 82r of the Principal Act in relation to a registered hospital benefits organization that was in force immediately before the commencement of this section continues in force as if it had been approved under section 82r of the Principal Act, as amended at any time; and

(b) sections 82s and 82t of the Principal Act continue in force for the purpose of the payment by the Commonwealth to an organization of any amount in relation to a professional service rendered, or hospital treatment received, before the commencement of this section.

Application by person for determination that income or means as assessed do not exceed a certain amount.

51.—(1.) Section 82u of the Principal Act is amended by omitting subsection (4.) and inserting in its stead the following sub-sections:—

“(4.) If the Director-General is satisfied—

(a) in the case of an applicant who, being a man, has not attained the age of sixty-five years or, being a woman, has not attained the age of sixty years—

Class A determination.

(i) that the weekly income of the applicant does not exceed Forty-two dollars fifty cents or, if a higher amount is prescribed for the purposes of this sub-paragraph, the amount so prescribed;

Class B determination.

(ii) that the weekly income of the applicant does not exceed Forty-five dollars fifty cents or, if a higher amount is prescribed for the purposes of this sub-paragraph, the amount so prescribed; or

Class C determination.

(iii) that the weekly income of the applicant does not exceed Forty-eight dollars fifty cents or, if a higher amount is prescribed for the purposes of this sub-paragraph, the amount so prescribed; or

(b) in the case of any other applicant—

Class A determination.

(i) that the means as assessed of the applicant do not exceed


Two thousand two hundred and ten dollars or, if a higher amount is prescribed for the purposes of this subparagraph, the amount so prescribed;

Class B determination.

(ii) that the means as assessed of the applicant do not exceed Two thousand three hundred and sixty-six dollars or, if a higher amount is prescribed for the purposes of this subparagraph, the amount so prescribed; or

Class C determination.

(iii) that the means as assessed of the applicant do not exceed Two thousand five hundred and twenty-two dollars or, if a higher amount is prescribed for the purposes of this subparagraph, the amount so prescribed,

he shall make a determination to that effect but, if not so satisfied, he shall refuse the application.

(4a.) In dealing with an application under this section, the Director-General—

(a) shall not make a Class C determination if he can make a Class A determination or a Class B determination; and

(b) shall not make a Class B determination if he can make a Class A determination..

(2.) Notwithstanding the amendments made by the last preceding sub-section, a determination in force under section 82u of the National Health Act 1953-1970 as in force immediately before the commencement of this section continues in force as if it were a Class A determination within the meaning of Division 3 of Part VI. of the National Health Act 1953-1970 as in force after the commencement of this section.

52. Section 82v of the Principal Act is repealed and the following section inserted in its stead:—

Certain contributors deemed not to be special account contributors.

82v. A contributor who, but for this section, would be a special account contributor shall be deemed not to be a special account contributor in relation to any period in relation to which—

(a) section eighty-two s of this Act applies in respect of the contributor; or

(b) section eighty-two t of this Act applies in respect of the contributor by reason of a Class A determination.

Reimbursement by Commonwealth of fund benefit in respect of service rendered or treatment received during two months after immigrant enters Australia.

53. Section 82w of the Principal Act is amended—

(a) by omitting from paragraph (a) of sub-section (1.) the words for an approved scale of benefits;

(b) by omitting paragraphs (d) and (e) of sub-section (1.) and inserting in their stead the following word and paragraph:—

and (d) the organization pays to, or to a person on behalf of, the contributor fund benefit in respect of the professional service,; and

(c) by omitting sub-section (2.).


54. Section 82zc of the Principal Act is repealed and the following section inserted in its stead:—

Review of determinations.

82zc.—(1.) The Director-General may, at any time, review a determination of the Director-General, or of a delegate of the Director-General, in force under section eighty-two u of this Act and—

(a) shall review every such determination at the expiration of twelve months after the determination was made or last reviewed, as the case may be; and

(b) in the case of a determination that was made in relation to a person before the person, being a man, attained the age of sixty-five years or, being a woman, attained the age of sixty years—shall review the determination when the person attains that age.

“(2.) A review of a determination under this section shall be made by the Director-General on the basis of the circumstances existing at the time of the review and, upon the review, the Director-General shall, as appropriate—

(a) affirm the determination;

(b) cancel the determination and make a further determination, being a Class A determination, a Class B determination, or a Class C determination; or

(c) cancel the determination.

“(3.) If the Director-General—

(a) cancels a determination without making a further determination;

(b) cancels a Class A determination and makes a further determination that is a Class B determination or a Class C determination; or

(c) cancels a Class B determination and makes a further determination that is a Class C determination,

the cancellation does not, or the cancellation and the further determination do not, take effect until the expiration of four weeks after notice of the cancellation, or of the cancellation and further determination, as the case may be, is served on the person to whom the determination relates—

(d) by sending it by post to that person at his address last known to the Director-General; or

(e) in such other manner as is prescribed..

Pharmaceutical Benefits Advisory Committee.

55. Section 101 of the Principal Act is amended by inserting after sub-section (2b.) the following sub-section:—

(2c.) The names and qualifications of persons appointed to be members of the Committee shall be published in the Gazette..


Evidence.

56. Section 139a of the Principal Act is amended by omitting paragraphs (b) and (c) of sub-section (1.) and inserting in their stead the following paragraphs:—

(b) an organization was or was not registered as a registered medical benefits organization or as a registered hospital benefits organization, or was or was not so registered in respect of a specified State or the Northern Territory;

(c) a registration of an organization was subject to terms and conditions stated in the certificate;.

Regulations.

57. Section 140 of the Principal Act is amended by adding at the end thereof the following sub-section:—

“(2.) Where an item in the First Schedule to this Act specifies a medical service that is to be rendered by a consultant physician or a specialist in the practice of his specialty to a patient who has been referred to him, the regulations may require that, for the purposes of the item, the patient be referred in a manner prescribed by the regulations..

The Schedules.

58. The Schedule to the Principal Act is repealed and the Schedules set out in the Schedule to this Act are inserted in its stead.

Part III.—Transitional Provisions.

Definition.

59. In this Part, the proclaimed date means the date fixed by Proclamation under sub-section (3.) of section 2 of this Act.

Making of regulations before date on which relevant provisions come into operation.

60.—(1.) At any time after this Act receives the Royal Assent and before the proclaimed date, regulations may be made for the purposes of the Principal Act as amended by any provision of this Act that is to come into force on the proclaimed date, but regulations so made shall not come into operation before the proclaimed date.

(2.) At any time after this Act receives the Royal Assent and before the first day of July, One thousand nine hundred and seventy-one, regulations may be made for the purposes of a provision to be inserted in the Principal Act by section 35 of this Act, but regulations so made shall not come into operation before that date.

Registrations of organizations to be registrations in respect of certain States, &c.

61.—(1.) The registration of an organization that was, immediately before the proclaimed date, a registered medical benefits organization or a registered hospital benefits organization shall be deemed, on and after that date, to be—

(a) a registration in respect of each State in which the organization was, immediately before that date, carrying on business as a registered medical benefits organization or as a registered hospital benefits organization, as the case may be; and


(b) if, immediately before that date, it was so carrying on business in the Northern Territory of Australia, a registration in respect of that Territory,

and each such deemed registration shall be deemed to be subject to the conditions that were applicable to the registration that was in force immediately before the proclaimed date.

(2.) A registration of an organization by virtue of the last preceding sub-section as a registered medical benefits organization is subject to the following conditions:—

(a) a condition that, under the rules of the organization, a contributor to the medical benefits fund conducted by the organization is not entitled to make a contribution in respect of fund benefits other than fund benefits set out in the relevant table of fund medical benefits where the contribution is made after, or is in respect of a period that ends after, the expiration of the period of three months commencing on the proclaimed date;

(b) a condition that, under the rules of the organization but subject to the rules referred to in paragraph (d) of this sub-section, a contributor to the medical benefits fund conducted by the organization who was such a contributor immediately before the proclaimed date will become, or will have an opportunity to become, before the specified date in relation to that contributor, a contributor for the fund benefits set out in the relevant table of fund medical benefits;

(c) a condition that, under the rules of the organization, the organization will not, on or after the proclaimed date, enrol a new contributor to the medical benefits fund conducted by the organization except as a contributor for the fund benefits set out in the relevant table of fund medical benefits; and

(d) a condition that, under the rules of the organization, a person who contributes to a medical benefits fund conducted by another registered medical benefits organization is not eligible to contribute to the medical benefits fund conducted by the first-mentioned organization for the fund benefits set out in a table of fund medical benefits set out in a Schedule to the National Health Act 1953-1970.

(3.) A registration of an organization by virtue of sub-section (1.) of this section is superseded by a similar registration granted to the organization in accordance with the next succeeding section.

(4.) In this section, the specified date, in relation to a contributor, means—

(a) in the case of a contributor whose contributions have, before the proclaimed date, been paid up to a date that is more than three


months after the proclaimed date—the date to which the contributions have been so paid up; or

(b) in any other case—the date three months after the proclaimed date.

Application for registration.

62.—(1.) An organization referred to in the last preceding section may, on or before the first day of October, One thousand nine hundred and seventy, apply, in accordance with section 67 or section 68 of the National Health Act 1953-1970, for registration as a registered medical benefits organization or a registered hospital benefits organization in respect of a specified State or in respect of the Northern Territory of Australia or may make more than one such application.

(2.) Where an organization (not being a restricted membership organization) referred to in the last preceding section makes application, in accordance with the last preceding sub-section, for registration as a registered medical benefits organization, or a registered hospital benefits organization, in respect of two or more States, the application shall set out a scheme for winding up the medical benefits fund or the hospital benefits fund, as the case may be, conducted by the organization.

(3.) A scheme referred to in the last preceding sub-section shall provide for allocating the moneys standing to the credit of the fund and not required for the purpose of meeting outstanding liabilities or other expenses in connexion with the winding up among the funds to be conducted by the organization in respect of the States specified in the applications.

(4.) The Minister may suggest to an organization that it make specified changes to its scheme, and the organization may make those changes accordingly.

(5.) The Minister shall refuse to register an organization referred to in sub-section (2.) of this section unless he is satisfied that the scheme set out in its application, or that scheme as altered, is a fair and proper one, and, if he does register the organization, he shall make each of the registrations subject to the condition that the organization shall carry out the scheme.

(6.) Where an application is made by an organization in accordance with sub-section (1.) of this section, the Minister, on or before the first day of January, One thousand nine hundred and seventy-one, and after report by the Registration Committee in accordance with section 72 of the National Health Act 1953-1970, shall determine the application in accordance with section 73 of that Act and furnish to the organization an appropriate notification in accordance with sub-section (5.) of that section.

(7.) In relation to an application for registration made in accordance with sub-section (1.) of this section, section 80 of the National Health Act 1953-1970 has effect as if—

(a) the refusal of the application were the cancellation of the registration of the organization; and


(b) the reference in sub-section (5.) of that section to the restoration of the registration were a reference to the grant of the registration to which the appeal relates either unconditionally or subject to such conditions as the Court thinks just and equitable.

Refusal or registration of organizations.

63.—(1.) This section applies to and in relation to an organization that has made, or is entitled to make, any application for registration in accordance with the last preceding section, and in this section registration means registration of the kind in respect of which that application is made or could be made, and registered has a corresponding meaning.

(2.) Where an organization fails to make, on or before the first day of October, One thousand nine hundred and seventy, the application for registration referred to in sub-section (1.) of this section, the organization ceases, on that first day of October, to be deemed to be registered by virtue of section 61 of this Act.

(3.) Where the Director-General furnishes to an organization that has made the application referred to in sub-section (1.) of this section a notification of the refusal of the application by the Minister and—

(a) the organization does not, before the last day of the period of one month from the date on which the notification is furnished to it, institute an appeal under section 80 of the National Health Act 1953-1970 against the refusal; or

(b) the organization so institutes an appeal but the appeal is dismissed, the organization ceases, on the last day of the period referred to in paragraph (a) of this sub-section, or on the day next following the day on which the Court dismisses the appeal, as the case may be, to be deemed to be registered by virtue of section 61 of this Act.

(4.) Where, under either of the last two preceding sub-sections, an organization has ceased to be deemed to be registered by virtue of section 61 of this Act, the organization shall, until such date as is fixed by the Minister by notice in writing served on the organization, be deemed by virtue of this sub-section to continue to be registered, but, in relation to that registration, the only contributors shall be persons who—

(a) were, immediately before the registration by virtue of section 61 of this Act ceased, contributors to the relevant medical benefits fund or hospital benefits fund conducted by the organization; and

(b) ordinarily paid their contributions in the State or Territory in respect of which that registration was deemed to exist.

(5.) The Minister shall not fix a date under the last preceding subsection until he is satisfied that all the contributors referred to in that sub-section have had an opportunity of becoming contributors, on terms not prejudicial to them, to a medical benefits fund or hospital benefits fund, as the case requires, conducted by another organization that is registered under the National Health Act 1953-1970 in respect of the relevant State or of the Northern Territory, as the case may be.


(6.) Where a contributor to the relevant fund conducted by an organization to which sub-section (4.) of this section applies wishes to become a contributor to a fund conducted by another organization, the Minister may pay to that other organization, on behalf of that person, an amount of contribution equal to the amount of any contribution paid by that person to the first-mentioned organization in respect of a period after the person will cease to be a contributor to the relevant fund conducted by the first-mentioned organization, and may deduct an amount equal to the amount so paid from any Commonwealth benefit becoming payable to that first-mentioned organization under the National Health Act 1953-1970.

Principal Act to continue in force for purpose of certain payments.

64. Notwithstanding the amendments made by this Act, the Principal Act, and the regulations that were in force under the Principal Act immediately before the proclaimed date, continue in force for the purpose of the payment of Commonwealth benefit in respect of—

(a) medical expenses incurred before the proclaimed date;

(b) medical expenses incurred during the period of three months commencing on the proclaimed date by a person who, at the time when the expenses were incurred—

(i) was a contributor within the meaning of Part III. of the Principal Act as so continued in force; and

(ii) was not a contributor within the meaning of Part III. of the National Health Act 1953-1970; and

(c) medical expenses incurred after the expiration of the period of three months commencing on the proclaimed date by a person who, at the time when the expenses were incurred—

(i) was, by virtue of a payment of contributions made before the proclaimed date, a contributor within the meaning of Part III. of the Principal Act as so continued in force; and

(ii) was not a contributor within the meaning of Part III. of the National Health Act 1953-1970.

 


THE SCHEDULE Section 58.

Schedules to be Inserted in the Principal Act

the schedules

first schedule Section 13.

Interpretation of Table

1. A reference in the table in this Schedule to an item shall be read as a reference to an item in that table.

2. Where an item in Part 1, 3 or 4 of the table in this Schedule includes the symbol “(S)”, the item shall be taken to relate to the service specified in the item when rendered by a specialist in the practice of his specialty.

3. Where an item in Part 1, 3 or 4 of the table in this Schedule includes the symbol(G)”, the item shall be taken to relate to the service specified in the item when rendered otherwise than by a specialist in the practice of his specialty.

4. Where an item in the table in this Schedule, other than an item in Part 1, 3 or 4 of that table, includes the symbol “(S)”, the item shall be taken to relate to the service specified in the item when rendered by a specialist in the practice of his specialty to a patient who has been referred to him.

5. Where an item in the table in this Schedule, other than an item in Part 1, 3 or 4 of that table, includes the symbol “(G)”, the item shall be taken to relate to the service specified in the item when rendered otherwise than by a specialist in the practice of his specialty to a patient who has been referred to him.

6. A reference in either of the last two preceding paragraphs or in Part I. of the table in this Schedule to the referring of a patient to a specialist shall be read as a reference to a referring by a medical practitioner and—

(a) where the specialist concerned is an ophthalmologist—shall be read as including a reference to a referring by a registered optometrist or a registered optician; and

(b) where a referring arises out of a dental service rendered to the person who has been referred—shall be read as including a reference to a referring by a registered dentist.

TABLE OF COMMONWEALTH MEDICAL BENEFITS

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

Part 1.—Professional attendances not covered by an item in any other Fart of this Schedule

2.

Professional attendance (not being an attendance covered by any other item in this Part)—each attendance at consulting rooms, hospital or nursing home

1.10

3.

Professional attendance (not being an attendance covered by any other item in this Part)—each attendance at a place other than consulting rooms, hospital or nursing home             

1.65

9.

Professional attendance by a specialist in the practice of his specialty where the patient is referred to him—an attendance (other than a second or subsequent attendance in a single course of treatment) where that attendance is at consulting rooms, hospital or nursing home             

4.25

11.

Professional attendance by a specialist in the practice of his specialty where the patient is referred to him—an attendance (other than a second or subsequent attendance in a single course of treatment) where that attendance is at a place other than consulting rooms, hospital or nursing home             

6.50

13.

Professional attendance by a specialist in the practice of his specialty where the patient is referred to him—each attendance that is a second or subsequent attendance in a single course of treatment             

2.00

15.

Professional attendance by a consultant physician in the practice of his specialty where the patient is referred to him by a medical practitioner—an attendance (other than a second or subsequent attendance in a single course of treatment) where that attendance is at consulting rooms, hospital or nursing home             

8.00


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

17.

Professional attendance by a consultant physician in the practice of his specialty where the patient is referred to him by a medical practitioner—an attendance (other than a second or subsequent attendance in a single course of treatment) where that attendance is at a place other than consulting rooms, hospital or nursing home             

10.00

18.

Professional attendance by a consultant physician in the practice of his specialty where the patient is referred to him by a medical practitioner—each attendance that is a second or subsequent attendance in a single course of treatment             

3.25

24.

Professional attendance by a specialist or a consultant physician in the practice of his specialty where the patient is not referred to him—each attendance             

1.10

37.

Prolonged professional attendance, for a period of not less than two hours but less than three hours, on a patient in a critical condition arising from electric shock, drowning, caisson disease, tetanus or respiratory paralysis that requires constant attention to the exclusion of all other patients             

8.50

38.

Prolonged professional attendance, for a period of not less than three hours but less than four hours, in the circumstances referred to in the last preceding item             

13.00

39.

Prolonged professional attendance, for a period of not less than four hours but less than five hours, in the circumstances referred to in Item 37             

17.00

40.

Prolonged professional attendance, for a period of five hours or more, in the circumstances referred to in Item 37             

22.50

43.

Pre-operative examination of a patient in preparation for the administration of an anaesthetic, being an examination carried out at an attendance other than that at which the anaesthetic is administered (G)             

1.10

45.

Pre-operative examination of a patient in preparation for the administration of an anaesthetic, being an examination carried out at an attendance other than that at which the anaesthetic is administered (S)             

2.00

 

Part 2.—Obstetrics

 

 

Division 1.—General

 

203.

Antenatal care where attendances do not exceed ten—each attendance..........

1.10

206.

Antenatal care where attendances exceed ten..........................

18.60

209.

Confinement and postnatal care for nine days where the medical practitioner has not given the antenatal care (G)             

17.40

210.

Confinement and postnatal care for nine days where the medical practitioner has not given the antenatal care (S)             

24.00

220.

Confinement, including a professional attendance that would, but for this item, be covered by item 9 (S) 

13.20

223.

Antenatal care, confinement and postnatal care for nine days (G).............

24.00

224.

Antenatal care, confinement and postnatal care for nine days (S).............

39.00

 

Division 2.—Special Services

 

226.

Antenatal care, confinement and postnatal care for nine days with surgical induction of labour (G) 

33.60

227.

Antenatal care, confinement and postnatal care for nine days with surgical induction of labour (S) 

51.00

230.

Antenatal care, confinement and postnatal care for nine days with surgical induction of labour; requiring major regional or field block (including abdominal; brachial plexus; caudal; cervical plexus; epidural (peridural); paravertebral (thoracic or lumbar); pudendal; sacral; spinal) (G)             

43.50

231.

Antenatal care, confinement and postnatal care for nine days with surgical induction of labour; requiring major regional or field block (including abdominal; brachial plexus; caudal; cervical plexus; epidural (peridural); paravertebral (thoracic or lumbar); pudendal; sacral; spinal) (S)             

66.00

235.

Caesarean section and postnatal care for nine days (G)....................

39.00

236.

Caesarean section and postnatal care for nine days (S)....................

57.00


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 2.—Special Services—continued

 

243.

Treatment of habitual miscarriage by injection of hormones—each injection up to a maximum of twelve injections             

1.00

247.

Threatened abortion, threatened miscarriage or hyperemesis gravidarum, requiring admission to hospital, treatment of—each attendance             

1.00

251.

Cervix, purse string ligation of, for threatened miscarriage (G)................

11.70

252.

Cervix, purse string ligation of, for threatened miscarriage (S).................

15.60

255.

Cervix, removal of purse string ligature of, under general anaesthesia (G).........

3.90

256.

Cervix, removal of purse string ligature of, under general anaesthesia (S).........

5.10

259.

Pre-eclampsia, eclampsia or antepartum haemorrhage, treatment of—each attendance.

1.00

263.

Amniocentesis................................................

5.10

267.

Version, external or internal, under anaesthesia (G)........................

3.90

268.

Version, external or internal, under anaesthesia (S)........................

5.10

271.

Surgical induction of labour.......................................

5.10

275.

Decapitation, craniotomy, cleidotomy or evisceration of foetus or any two or more of those services 

23.40

279.

Evacuation by intrauterine manual removal of the products of conception such as retained foetus, placenta, membranes or mole             

8.10

283.

Manipulative correction of acute inversion of uterus, with or without incision of cervix 

25.80

287.

Postpartum haemorrhage requiring special procedures such as packing, treatment of (G) 

3.90

288.

Postpartum haemorrhage requiring special procedures such as packing, treatment of (S) 

5.10

291.

Third degree tear, repair of, involving anal sphincter muscles.................

11.40

 

Part 3.—Anaesthetics

 

 

Division 1.—Anaesthetics other than Gaseous Anaesthetics not Covered by an Item in any other Part of this Schedule

 

301.

Administration of an anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit does not exceed $13.20 and where an anaesthetic referred to in Division 2 of this Part is not given (G)             

3.00

302.

Administration of an anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit does not exceed $13.20 and where an anaesthetic referred to in Division 2 of this Part is not given (S)             

4.20

305.

Administration of an anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $13.20 but does not exceed $24.00 and where an anaesthetic referred to in Division 2 of this Part is not given (G)             

4.50

306.

Administration of an anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $13.20 but does not exceed $24.00 and where an anaesthetic referred to in Division 2 of this Part is not given (S)             

5.10

309.

Administration of an anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $24.00 but does not exceed $51.00 and where an anaesthetic referred to in Division 2 of this Part is not given (G)             

8.10

310.

Administration of an anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $24.00 but does not exceed $51.00 and where an anaesthetic referred to in Division 2 of this Part is not given (S)             

10.20


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 1.—Anaesthetics, other than Gaseous, etc.—continued

$

313.

Administration of an anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $51.00 but does not exceed $81.00 and where an anaesthetic referred to in Division 2 of this Part is not given             

11.40

317.

Administration of an anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $81.00 and where an anaesthetic referred to in Division 2 of this Part is not given             

17.40

321.

Administration of an anaesthetic other than gaseous, in addition to a gaseous anaesthetic referred to in Division 2 of this Part             

1.50

323.

Administration of neuroleptal analgesia...................................

5.70

 

Division 2.—Gaseous Anaesthetics

 

341.

Administration of an anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit does not exceed $13.20 (G)             

4.50

342.

Administration of an anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit does not exceed $13.20 (S)             

5.70

344.

Administration of an anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $13.20 but does not exceed $24.00 (G)             

6.30

345.

Administration of an anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $13.20 but does not exceed $24.00 (S)             

7.80

347.

Administration of an anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $24.00 but does not exceed $51.00 (G)             

9.60

348.

Administration of an anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $24.00 but does not exceed $51.00 (S)             

12.00

351.

Administration of an anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $51.00 but does not exceed $81.00 (G)             

10.20

352.

Administration of an anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $51.00 but does not exceed $81.00 (S)             

12.60

355.

Administration of an anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $81.00 but does not exceed $117.00             

17.40

357.

Administration of an anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $117.00             

24.00

 

Division 3.—Groupings of Anaesthetics and Related Procedures

 

370.

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit does not exceed $13.20 (G)             

6.60

371.

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit does not exceed $13.20 (S)             

7.50

375.

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $13.20 but does not exceed $24.00 (G)             

8.10


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 3.—Groupings of Anaesthetics and Related Procedures—continued

 

376.

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $13.20 but does not exceed $24.00 (S)             

9.90

378.

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $24.00 but does not exceed $51.00 (G)             

11.70

379.

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $24.00 but does not exceed $51.00 (S)             

14.10

381.

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $51.00 but does not exceed $81.00 (G)             

12.30

382.

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $51.00 but does not exceed $81.00 (S)             

14.70

384.

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $81.00 but does not exceed $117.00             

19.50

386.

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $117.00             

26.10

388.

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $24.00 but does not exceed $51.00, and intravenous or subcutaneous infusion or injection of fluids—percutaneous (G)             

15.00

389.

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $24.00 but does not exceed $51.00, and intravenous or subcutaneous infusion or injection of fluids—percutaneous (S)             

16.80

391.

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $51.00 but does not exceed $81.00, and intravenous or subcutaneous infusion or injection of fluids—percutaneous (G)             

15.60

392.

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $51.00 but does not exceed $81.00, and intravenous or subcutaneous infusion or injection of fluids—percutaneous (S)             

17.40

394.

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $81.00 but does not exceed $117.00, and intravenous or subcutaneous infusion or injection of fluids—percutaneous

22.20


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 3.—Groupings of Anaesthetics and Related Procedures—continued

 

396.

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $24.00 but does not exceed $51.00, and blood transfusion, using pooled blood or blood already collected (G)             

17.70

397.

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $24.00 but does not exceed $51.00, and blood transfusion, using pooled blood or blood already collected (S)             

20.10

399.

Administration of a anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $51.00 but does not exceed $81.00, and blood transfusion, using pooled blood or blood already collected (G)             

18.30

400.

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $51.00 but does not exceed $81.00, and blood transfusion, using pooled blood or blood already collected (S)             

20.70

402.

Administration of an anaesthetic other than gaseous, in addition to the administration of a gaseous anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit exceeds $81.00 but does not exceed $117.00, and blood transfusion, using pooled blood or blood already collected             

25.50

 

Division 4.—Dental Anaesthetics

 

430.

Administration by a medical practitioner of an anaesthetic, other than an endotracheal anaesthetic, in connexion with a dental operation             

3.90

435.

Administration by a medical practitioner of an endotracheal anaesthetic in connexion with a dental operation (G)             

6.30

436.

Administration by a medical practitioner of an endotracheal anaesthetic in connexion with a dental operation (S)             

7.50

 

Part 4.—Regional Nerve or Field Block

 

451.

Major regional or field block, including abdominal; brachial plexus; caudal; cervical plexus; epidural (peridural); paravertebral (thoracic or lumbar); pudendal; sacral; spinal             

8.10

455.

Intravenous regional anaesthesia of limb by retrograde perfusion (G).............

5.40

456.

Intravenous regional anaesthesia of limb by retrograde perfusion (S).............

7.20

 

Part 5.—Assistance in Administration of an Anaesthetic

 

501.

Assistance in the administration of an anaesthetic in connexion with a professional service or a series or combination of professional services for which the basic Commonwealth medical benefit payable is not less than $96.00             

5.70

 

Part 6.—Miscellaneous Procedures

 

601.

Electrocardiography, phonocardiography, stethography or ballistocardiography......

3.30

611.

Continuous electrocardiographic monitoring during anaesthesia................

4.40

616.

Restoration of cardiac rhythm by electrical stimulation, other than in the course of cardiac surgery 

6.90

621.

Intracardiac pressure recording at operation..............................

17.40

625.

Blood pressure recording by intravenous cannula..........................

15.60

631.

Echoencephalography or echography..................................

5.10

641.

Electroencephalography, not covered by item 631, 651 or 661.................

8.10


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

651.

Electroencephalography, temporosphenoidal.............................

12.60

661.

Electrocorticography.............................................

17.40

681.

Electromyography—involving estimation of nerve conduction times or stimulating response recording 

4.00

691.

Electromyography—involving sampling of muscle activity—each attendance at which procedure is performed             

3.10

701.

Tonography, in the management of glaucoma............................

4.50

703.

Provocative test or tests for glaucoma, including water drinking................

2.70

705.

Electroretinography.............................................

9.00

707.

Audiogram, pure tone............................................

3.30

708.

Audiogram, pure tone, follow up.....................................

2.10

715.

Audiological assessment (pure tone speech audiogram and additional tests as required).

3.60

721.

Test of ear, or tests of ears on the same occasion, for integrity of static labyrinth.....

3.80

731.

Bronchospirometry, including gas analysis..............................

14.70

741.

Estimation of respiratory function by spirometer or other simple techniques—each attendance at which one or more tests are performed             

5.10

751.

Estimation of respiratory function requiring complicated techniques—each attendance at which one or more tests are performed             

7.50

761.

Perfusion of limb or organ using heart-lung machine or equivalent...............

42.00

771.

Whole body perfusion, cardiac by-pass, using heart-lung machine or equivalent......

63.00

781.

Dialysis involving use of artificial kidney...............................

48.00

791.

Dialysis, peritoneal, for acute renal failure..............................

11.40

801.

Induced controlled hypothermia—total body.............................

9.30

831.

Fluids, intravenous or subcutaneous infusion of—percutaneous.................

2.40

841.

Fluids, intravenous or subcutaneous infusion of—by open exposure..............

4.50

851.

Intravenous infusion or injection of a substance incorporating a cytotoxic agent......

4.20

861.

Intraarterial infusion or injection of a substance incorporating a cytotoxic agent, preparation for 

6.90

866.

Intralymphatic infusion or injection of a fluid containing a cytotoxic agent, with or without the incorporation of an opaque medium             

11.40

871.

Blood transfusion, including collection from donor.........................

8.10

881.

Blood transfusion, using pooled blood or blood already collected...............

5.10

891.

Blood transfusion with venesection and complete replacement of blood, including collection from donor 

21.00

901.

Blood transfusion with venesection and complete replacement of blood, using pooled blood or blood already collected             

17.40

906.

Intrauterine foetal blood transfusion using pooled blood or blood already collected, including necessary amniocentesis             

21.00

911.

Blood for purposes of transfusion, collection of, not covered by item 871 or 891

4.00

915.

Blood dye—dilution indicator test....................................

10.20

921.

Venesection, not covered by item 891 or 901—each attendance at which venesection is performed 

1.40

931.

Blood specimen for pathology test, intravenous collection of, for forwarding to another medical practitioner 

0.80

941.

Blood for pathology test, collection of, by arterial puncture...................

1.50

943.

Blood for pathology test, collection of, by femoral or external jugular vein puncture in infants 

1.80

945.

Collection of specimen of sweat by iontophoresis..........................

2.70

951.

Hormone or living tissue implantation—by incision........................

4.40

961.

Hormone or living tissue implantation—by cannula........................

2.50

971.

Intragastric freezing.............................................

11.40

976.

Intragastric cooling..............................................

23.40

981.

Electroconvulsive therapy—each attendance at which treatment is given...........

4.50

985.

Narcotherapy or similar psychiatric procedure involving intravenous injection-each attendance at which treatment is given             

5.70


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Part 7.—Pathology Services

 

 

Division 1.—Blood

 

 

Haematology—Erythrocytes

 

1000.

Blood film, examination of.........................................

1.00

1002.

Blood film, examination by special stains to demonstrate; basophilic stippling, foetal haemoglobin, haemoglobin H, Heinz bodies, reticulocytes, siderocytes or similar             

1.00

1004.

Malarial or other parasites, examination of blood for........................

1.50

1006.

Sickling, examination of blood for....................................

1.30

1008.

Haemoglobin estimation (where patient is referred by another medical practitioner for this service) 

1.00

1010.

Haemoglobin estimation and examination of blood film......................

2.10

1012.

Haemoglobin estimation and examination of blood film and blood grouping, ABO and Rh 

4.50

1014.

Haemoglobin estimation, leucocyte count, and differential leucocyte count.........

3.60

1016.

Haemoglobin estimation, haematocrit (packed cell volume) estimation, leucocyte count and differential leucoyte count             

3.90

1018.

Haemoglobin estimation, haematocrit (packed cell volume) estimation, leucocyte count and differential leucocyte count, and erythrocyte sedimentation rate             

5.70

1020.

Haemoglobin estimation, blood grouping, ABO and Rh, indirect Coombs test, total bilirubin and compatability testing             

12.30

1022.

Erythrocyte count...............................................

1.00

1024.

Erythrocyte sedimentation rate (where patient is referred by another medical practitioner for this service) 

1.00

1026.

Haematocrit (packed cell volume) estimation.............................

1.00

1028.

Erythrocyte fragility test, to hypotonic saline.............................

3.80

1030.

Erythrocyte fragility test, mechanical fragility............................

3.90

1032.

Erythrocyte, autohaemolysis test.....................................

3.80

1034.

Erythrocytes, estimation of mean cell diameter............................

2.10

1036.

Erythrocytes, tests for enzymes, acid phosphatase or similar, each enzyme.........

3.30

1038.

Erythrocytes, estimation of glutathione.................................

3.90

1040.

Erythrocytes, glutathione stability test.................................

3.90

1042.

Erythrocytes, glucose-6-phosphate dehydrogenase, pyruvate kinase deficiency, or similar, screening test 

3.30

1044.

Erythrocytes, glucose-6-phosphate dehydrogenase, pyruvate kinase deficiency, or similar, quantitative estimation             

4.50

1046.

Erythrocytes, test for paroxysmal nocturnal haemoglobinuria—screening test (sucrose water test) 

1.80

1048.

Erythrocytes, test for paroxysmal nocturnal haemoglobinuria—acid haemolysin test...

6.90

1050.

Erythrocytes, folate estimation of....................................

4.50

1052.

Erythrocytes, survival or life—radio-active technique.......................

13.20

1054.

Erythrocytes, direct Coombs test....................................

1.50

 

Haematology—Leucocytes

 

1060.

Leucocyte count................................................

1.00

1062.

Leucocyte count and differential count.................................

2.10

1064.

Eosinophil count, wet............................................

1.00

1066.

Leucocyte agglutinins, detection of...................................

2.70

1068.

Lupus erythematosus cells, examination of blood film for....................

3.00

1070.

Cytological sex determination from blood film............................

2.70

1072.

Leucocyte, (neutrophil) alkaline phosphatase determination...................

3.30

1074.

Leucocyte tests for phagocytic activity.................................

11.40

1076.

Blood film examination using special stains (P.A.S., Sudan black or similar) for leucocytes 

1.30

 

Haematology—Platelets

 

1080.

Platelet count..................................................

1.00

1082.

Platelet agglutinin test............................................

2.70

1084.

Platelet survival or life—radio-active technique...........................

13.20


First Schedule—continued

Item No.

Medical service

Basic Common wealth benefit

 

 

$

 

Division 1.—Blood—continued

 

 

Haematology—Blood Transfusion Procedures

 

1090.

Blood grouping, ABO and Rh.........................................

2.10

1092.

Blood grouping, MN or other, each system, not covered by Item 1090..............

2.10

1094.

Compatability testing—for each bottle tested up to five bottles...................

2.10

1096.

Compatability testing—for each subsequent bottle tested in excess of five............

1.80

1098.

Examination of serum for Rh or other blood group antibodies—screening test.........

2.40

1100.

Examination of serum for Rh or other blood group antibodies—quantitative estimation...

3.00

1102.

Examination of serum for Rh or other blood group antibodies—screening and quantitive estimation 

4.50

1104.

Coombs test—direct...............................................

1.50

1106.

Coombs test—indirect (if not part of Items 1094, 1096, 1098, 1100 or 1102)..........

2.10

1108.

Examination of serum for blood group haemolysins...........................

3.00

 

Haematology—Haemostasis

 

1110.

Antihaemophilic globulin, assay of, or other blood coagulation factor—quantitative.....

7.20

1112.

Bleeding time...................................................

1.00

1114.

Coagulation time (including qualitative clot retraction)........................

1.00

1116.

Bleeding time, coagulation time (including qualitative clot retraction), prothrombin estimation and platelet count             

6.90

1118.

Clot retraction, quantitative...........................................

2.10

1120.

Euglobulin lysis time, or similar.......................................

5.70

1122.

Fibrinogen estimation..............................................

3.30

1124.

Fibrinogen titre, determination of.......................................

2.10

1126.

Kaolin clotting time...............................................

2.70

1128.

Platelet count....................................................

1.00

1130.

Platelet adhesion test...............................................

3.90

1132.

Platelet aggregation test, qualitative.....................................

2.10

1134.

Platelet aggregation test, quantitative....................................

3.90

1136.

Platelet factor III availability..........................................

5.70

1138.

Prothrombin estimation.............................................

2.10

1140.

Prothrombin estimation—two stage.....................................

3.30

1142.

Prothrombin consumption test.........................................

3.60

1144.

Recalcified plasma clotting time.......................................

2.10

1146.

Thrombin clotting time.............................................

2.10

1148.

Thromboplastin generation screening test.................................

3.30

1150.

Thromboplastin generation test (full)....................................

5.70

1152.

Thrombin time, determination of (including test for presence of an inhibitor)..........

3.30

1154.

Thrombin time serial test for fibrinogenolysis...............................

2.70

1156.

Thromboplastin time (partial) with or without kaolin..........................

2.70

 

Haematology—Miscellaneous Procedures

 

1160.

Blood culture....................................................

3.30

1162.

Blood volume (dye method)..........................................

3.90

1164.

Folic acid, estimation of, in serum or plasma...............................

4.50

1166.

Vitamin B12, estimation of, in serum or plasma.............................

4.50

1168.

Marrow, examination of films made from aspirate............................

4.50

1170.

Marrow examination—histopathological examination of aspirate or trephine..........

5.10

1172.

Marrow, examination of films of, by special staining, e.g. iron, P.A.S., peroxidase, Sudan black or similar 

1.30

1174.

Spectroscopic examination of blood.....................................

2.10

1176.

Assay of concentration of antibiotic or chemotherapeutic agents in serum or plasma.....

2.70

 

Haematology—Serology

 

1180.

Agglutination tests, including agglutination tests for enteric fever, Brucella infection, one antigen 

2.10

1182.

Agglutination tests, including agglutination tests for enteric fever, Brucella infection, more than one antigen, each additional antigen             

1.00

1184.

Antistreptolysin titre, determination of...................................

3.30

1186.

Cold agglutinins, qualitative test.......................................

1.00


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 1.—Blood—continued

$

1188.

Cold agglutinins, quantitative test.............................................

2.10

1190.

Complement, estimation of, in serum..........................................

3.30

1192.

Complement fixation tests for the diagnosis of gonorrhoea, hydatid infestation, or similar, each antigen 

3.30

1194.

Complement fixation tests for the diagnosis of toxoplasmosis..........................

3.30

1196.

Complement fixation tests to detect antibodies to other bacterial, viral, fungal or parasitic infection not covered by any other item in this Part             

3.30

1198.

Haemagglutination or haemagglutination-inhibition test for the diagnosis of a virus infection.....

3.30

1200.

Latex flocculation test, or similar test, for rheumatoid arthritis or other conditions—each test.....

1.50

1202.

Methylene blue dye test for toxoplasmosis.......................................

3.60

1204.

Paul Bunnell test—screening................................................

2.10

1206.

Paul Bunnell test—titre with absorptions........................................

3.90

1208.

Rose Waaler test........................................................

3.30

1210.

Syphilis, complement fixation tests for the diagnosis of, one antigen......................

3.30

1212.

Syphilis, complement fixation tests for the diagnosis of, two antigens.....................

4.50

1214.

Syphilis, flocculation test for, Kahn, Kline, VDRL or similar, one antigen..................

1.00

1216.

Syphilis, flocculation test for, Kahn, Kline, VDRL or similar, two antigens.................

2.40

1218.

Syphilis, fluorescent antibody test for..........................................

4.50

 

Haematology—Chemistry

 

1220.

Alcohol, estimation of....................................................

6.00

1222.

Amino acids, total estimation of..............................................

6.00

1224.

Amino acid pattern, qualitative (chromatography or high voltage electrophoresis), estimation of...

10.20

1226.

Amino acid pattern, quantitative (ion exchange, gas liquid chromatography), estimation of.......

13.20

1228.

Ammonia, estimation of...................................................

4.50

1230.

Barbiturates, quantitative estimation of.........................................

6.00

1232.

Bicarbonate (CO2 combining power, alkali-reserve), estimation of.......................

3.30

1234.

Carbohydrate tolerance test (fructose, galactose, glucose, lactose, sucrose) not exceeding two hours, each 

5.70

1236.

Carbohydrate tolerance test (fructose, galactose, glucose, lactose, sucrose) exceeding two hours but not exceeding three hours, each             

7.20

1238.

Carbohydrate tolerance test (fructose, galactose, glucose, lactose, sucrose) exceeding three hours, each 

9.00

1240.

Carboxyhaemaglobin (carbon monoxide), qualitative estimation of.......................

2.10

1242.

Carboxyhaemoglobin (carbon monoxide), quantitative estimation of......................

3.90

1244.

Congo red test.........................................................

6.30

1246.

Cortisol, corticosteroids or similar, estimation of...................................

6.00

1248.

Cryoglobulins—qualitative estimation of........................................

1.50

1250.

Electrolytes, estimation of sodium, potassium, calcium, magnesium or chloride, estimation of one substance 

3.30

1252.

Estimation of two substances referred to in the last preceding item.......................

5.70

1254.

Estimation of three substances referred to in Item 1250..............................

7.80

1256.

Estimation of four substances referred to in Item 1250...............................

10.20

1258.

Estimation of five substances referred to in Item 1250...............................

12.60

1260.

Electrophoretic determination of serum or plasma for lipoprotein, protein, abnormal haemoglobin, haptoglobin, or other unspecified fractions, qualitative, each determination             

3.30

1262.

Electrophoretic determination of serum or plasma for lipoprotein, protein, abnormal haemoglobin, haptoglobin or other unspecified fractions, quantitative, each determination             

5.10

1264.

Enzymes (whole blood, serum or plasma), one estimation.............................

3.30

1266.

Enzymes (whole blood, serum or plasma), two estimations............................

5.70

1268.

Enzymes (whole blood, serum or plasma), three estimations...........................

7.80

1270.

Enzymes (whole blood, serum or plasma), four or more estimations......................

10.20

1272.

Folic acid, estimation of...................................................

4.50

1274.

Gas analysis including oxygen capacity, oxygen saturation and partial carbon dioxide (PCO2).....

13.20

1276.

Chemical analysis of blood or serum, five or more tests performed simultaneously on a single specimen on one multi-channel analyser             

7.20


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 1.—Blood—continued

 

1278.

Chemical tests, quantitative, of albumin, bromide, cholesterol, creatinine, globulin, glucose, phosphorus, salicylates, sulphonamides, total protein, urea, urea nitrogen, uric acid or similar substance, not covered by any other item, estimation of one substance, other than by reagent stick, strip, tablet or similar             

3.30

1280.

Two estimations of any substance or substances referred to in the last preceding item....

5.70

1282.

Three estimations of any substance or substances referred to in item 1278............

7.80

1284.

Four estimations of any substance or substances referred to in item 1278.............

10.20

1286.

Five or more estimations of any substance or substances referred to in item 1278.......

12.60

1288.

Hydrogen ion concentration (pH), estimation of.............................

4.50

1290.

Insulin tolerance test...............................................

6.90

1292.

Intravenous tolbutamide test..........................................

6.90

1294.

Iron, estimation of................................................

3.30

1296.

Iron-binding capacity, estimation of.....................................

2.10

1298.

Iron and iron-binding capacity, estimation of...............................

5.70

1301.

Liver function test (bilirubin, total; bilirubin, direct and indirect; enzymes; alkaline phosphatase, transaminase or similar; turbidity; or other liver function test not covered by any other item), any one test             

3.30

1302.

Two of any test or tests referred to in the last preceding item.....................

5.70

1304.

Three of any test or tests referred to in item 1301............................

7.80

1305.

Four of any test or tests referred to in item 1301.............................

10.20

1307.

Five or more of any test or tests referred to in item 1301.......................

12.60

1310.

Other unspecified liver function test not covered by any other item................

3.30

1313.

Methaemalbumin, qualitative test for....................................

2.10

1316.

Phenylketonuria, bacterial inhibition assay for, (Guthrie test)....................

3.30

1319.

Protein bound iodine, estimation of.....................................

5.40

1322.

Proteins, chemical estimation of, total (copper sulphate method)..................

1.50

1325.

Protamine sulphate titration..........................................

1.30

1328.

Spectroscopic examination for pigments..................................

2.10

1331.

Thyroxine, estimation of............................................

6.00

1334.

Triglycerides, phospholipids, total lipids, estimation of each substance..............

3.90

1337

Estimation of any two substances referred to in the last preceding item..............

6.30

1340.

Estimation of any three or more substances referred to in item 1334................

9.00

1343.

Triglycerides, phospholipids, total lipids, estimation of one substance and estimation of cholesterol 

6.30

1346.

Thyroxine or tri-iodothyronine, free plasma estimation of.......................

10.20

1349.

Trace elements (copper, lead, mercury, zinc or other unspecified trace elements), estimation of 

4.20

1352.

Vitamin A or carotenoids, estimation of..................................

4.50

1355.

Vitamin B12, estimation of...........................................

4.50

1358.

Assay of concentration of antibiotic or chemotherapeutic agent...................

2.70

 

Division 2.—Urine

 

 

Urine—Bacteriology

 

1380.

Microscopical examination of urine concentrate (where patient is referred by another medical practitioner for this service)             

1.00

1382.

Microscopical examination of urine concentrate and general examination for three or more of: reaction, specific gravity, blood, albumin, urobilinogen, sugar, acetone, bile pigments (where patient is referred by another medical practitioner for this service)             

1.50

1385.

Microscopical examination of urine concentrate and general examination for three or more of: reaction, specific gravity, blood, albumin, urobilinogen, sugar, acetone, bile pigments; and cultural examination of urine specimen for isolation and identification of organisms             

3.30

1388.

Microscopical examination of urine concentrate and general examination for three or more of: reaction, specific gravity, blood, albumin, urobilinogen, sugar, acetone, bile pigments; cultural examination of urine specimen; and antibiotic sensitivity testing of urine organisms, up to eight antibiotics             

5.70


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 2.—Urine—continued

$

1389.

Microscopical examination of urine concentrate and general examination for three or more of: reaction, specific gravity, blood, albumin, urobilinogen, sugar, acetone, bile pigments; cultural examination of urine specimen; and antibiotic sensitivity test of urine organism (each organism), for nine or more antibiotics             

7.20

1391.

Microscopical examination of urine concentrate and general examination for three or more of: reaction, specific gravity, blood, albumin, urobilinogen, sugar, acetone, bile pigments; bacterial count for organisms in urine (colony count), simplified technique; and cultural examination of urine specimen for isolation and identification of organisms             

4.50

1392.

Microscopical examination of urine concentrate, and general examination for three or more of: reaction, specific gravity, blood, albumin, urobilinogen, sugar, acetone, bile pigments; bacterial count for organisms in urine (colony count), simplified technique: cultural examination of urine specimen; and antibiotic sensitivity of urine organisms, up to eight antibiotics             

7.20

1394.

Microscopical examination of urine concentrate, and general examination for three or more of: reaction, specific gravity, blood, albumin, urobilinogen, sugar, acetone, bile pigments; bacterial count for organisms in urine (colony count), simplified technique; cultural examination of urine specimen; and antiobiotic sensitivity of urine organisms, for nine or more antiobiotics             

9.00

1395.

Microscopical examination of urine concentrate by special stain—Ziehl Neelsen or similar..

1.30

1397.

Microscopical examination of urine concentrate by special stain—Ziehl Neelsen or similar, and cultural examination of urine specimen for special pathogens, such as M. tuberculosis             

3.60

1399.

Bacterial count for organisms in urine (colony count), simplified technique............

1.00

1401.

Bacterial count for organisms in urine (colony count), noured Plate technique...........

2.10

1404.

Cultural examination of urine specimen, for isolation and identification of organisms......

1.50

1407.

Microscopical examination of urine concentrate and cultural examination of urine specimen, for isolation and identification of organisms             

3.30

1410.

Cultural examination of urine specimen for special pathogens, such as M. tuberculosis.....

2.10

1413.

Antibiotic sensitivity of urine organism (each organism), up to eight antibiotics

2.10

1416.

Antibiotic sensitivity of urine organism (each organism), nine or more antibiotics

3.90

1419.

Sensitivity testing of mycobacteria, each antibiotic............................

2.10

1421.

Sensitivity testing—tube dilution, each antibiotic.............................

2.70

1423.

Assay of concentration of antibiotic or chemotherapeutic agents in urine..............

2.70

1425.

Examination by animal inoculation.......................................

4.50

1428.

Addis count or quantitative estimation of sediments............................

2.70

 

Urine—Chemistry

 

1430.

Alcohol, quantitative estimation of.......................................

6.00

1432.

Aldosterone, estimation of............................................

13.20

1434.

Amino acid, total estimation of.........................................

3.30

1436.

Amino acids, identification of, screening tests, by chromatography..................

3.90

1438.

Amino acids, identification of, qualitative pattern (high voltage electrophoresis or chromatography) 

13.20

1441.

Amimo-levulinic acid, estimation of......................................

4.20

1444.

Ascorbic acid, estimation of...........................................

3.30

1447.

Barbiturates, estimation of, quantitative....................................

6.00

1450.

Catecholamines or similar, estimation of...................................

5.10

1453.

Chromatography of urine for separation and identification of sugars and other substances of diagnostic significance other than amino acids             

3.30

1456.

Electrophoresis of urinary protein, qualitative................................

4.50

1459.

Chemical tests, quantitative, not covered by any other item (calcium, phosphorus, protein, sugar, urea, enzymes, uric acid or similar substance), one estimation, other than by reagent stick, strip, tablet or similar             

3.30

1461.

Two estimations of any substance or substances referred to in the last preceding item......

5.70

1463.

Three estimations of any substance or substances referred to in item 1459.............

7.80

1466.

Four or more estimations of any substance or substances referred to in Item 1459........

10.20


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 2.—Urine—continued

$

1468.

Chorionic gonadotrophins (for diagnosis of pregnancy), using immunochemical.........

1.50

1470.

Chorionic gonadotrophins (for diagnosis of pregnancy), using animals...............

3.30

1472.

Chorionic gonadotrophins, quantitative estimation of..........................

4.50

1474.

Pituitary gonadotrophins, quantitative estimation of...........................

13.20

1476.

Hydroxycorticosteroids, estimation of....................................

4.80

1478.

Hydroxyindole-acetic acid, quantitative estimation of..........................

4.20

1481.

Lead, thallium, mercury or arsenic, estimation of.............................

4.20

1484.

Oestrogens, total, estimation of.........................................

10.20

1487.

Oxosteroids, estimation of............................................

4.80

1490.

Oxogenic steroids, estimation of........................................

4.80

1491.

Porphyrins, qualitative examination, other than by reagent stick, strip, tablet or similar....

1.50

1493.

Porphyrins, quantitative examination, each substance..........................

10.20

1494.

Quantitative estimation of pregnanediol, pregnanetriol or similar substances...........

13.20

1495.

Qualitative estimation of substances in urine (Bence-Jones protein, hydroxyindole-acetic acid, indican, melanogen, porphobilinogen or other similar substances not covered by any other item), each substance, other than by reagent stick, strip, tablet or similar (where patient is referred by another medical practitioner for this service)             

1.30

1496.

Spectroscopic examination for pigments...................................

2.10

1497.

Vanilmandelic acid, estimation of.......................................

5.10

 

UrineCytology

 

1499.

Cytological examination for malignancy...................................

4.50

Division 3.—Body Fluids: Exudates, including Pus, Sputum, Sweat and Amniotic Ascitic, Cerebrospinal, Pleural, Prostatic, Seminal, Synovial and Vaginal Fluids

 

Body Fluids—Bacteriology and Parasitology

 

1500.

Microscopical examination—wet film....................................

1.00

1502.

Microscopical examination—Gram stain or similar............................

1.00

1504.

Microscopical examination, by special stains, e.g. Ziehl-Neelsen or similar............

1.00

1506.

Microscopical examination by dark ground illumination or phase contrast.............

2.70

1508.

Cultural examination for, and identification of aerobic micro-organisms..............

2.00

1511.

Cultural examination for, and identification of anaerobic micro-organisms............

2.10

1513.

Cultural examination for special pathogens, such as M. tuberculosis, fungi, &c..........

2.10

1515.

Microscopical examination, Gram stain or similar, and cultural examination for and identification of aerobic micro-organisms             

3.60

1517.

Microscopical examination, Gram stain or similar; cultural examination for and identification of aerobic micro-organisms; and microscopical examination, by special stains, e.g. Ziehl-Neelsen or similar             

4.80

1519.

Microscopical examination, Gram stain or similar; cultural examination for and identification of aerobic micro-organisms; and sensitivity testing of up to eight antibiotics             

6.00

1521.

Microscopical examination, Gram stain or similar; culural examination for and identification of aerobic micro-organisms; sensitivity testing of up to eight antibiotics; and microscopical examination, by special stains, e.g. Ziehl-Neelsen or similar             

7.50

1523.

Microscopical examination, Gram stain or similar; cultural examination for and identification of aerobic micro-organisms; and sensitivity testing of nine or more antibiotics             

7.50

1525.

Microscopical examination by special stains, e.g. Ziehl-Neelsen or similar; and cultural examination for special pathogens, such as M. tuberculosis, fungi, &c.             

3.60

1527.

Examination by animal inoculation......................................

4.50

1529.

Autogenous vaccines, preparation of, for a single organism......................

2.70

1531.

Autogenous vaccines, preparation of, for multiple organisms.....................

5.10

1534.

Sensitivity testing—up to eight antibiotics.................................

2.10

 


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 3.—Body Fluids—continued

 

1537.

Sensitivity testing—nine or more antibiotics...............................

3.90

1539.

Sensitivity testing—tube dilution, each antibiotic............................

2.70

1541.

Sensitivity testing of mycobacteria, each antibiotic...........................

2.10

1543.

Assay of concentration of antibiotic or chemotherapeutic agents in body fluids

2.70

 

Body Fluids—Vaginal and Prostatic Fluids

 

1545.

Microscopical examination, wet film....................................

1.00

1546.

Microscopical examination, wet film; microscopical examination, Gram stain or similar; cultural examination for and identification of aerobic micro-organisms             

4.50

1548.

Microscopical examination, wet film; microscopical examination, Gram stain or similar; cultural examination for and identification of aerobic microorganisms; and sensitivity testing of up to eight antibiotics             

7.20

 

Body Fluids—Cerebrospinal Fluid

 

1551.

Cell count and differential; and quantitative chemical estimation of one substance......

4.50

1554.

Cell count and differential; quantitative chemical estimation of one substance; and Lange colloidal gold reaction             

8.10

1557.

Cell count and differential; quantitative chemical estimation of one substance; Lange colloidal gold reaction; and complement fixation test for syphilis             

12.00

1560.

Cell count and differential; quantitative chemical estimation of one substance; and complement fixation test for syphilis             

8.10

1562.

Cell count and differential; and quantitative chemical estimation of two substances......

7.20

1564.

Cell count and differential; quantitative chemical estimation of two substances; and Lange colloidal gold reaction             

11.10

1566.

Cell count and differential; and quantitative chemical estimation of three substances.....

9.60

1568.

Cell count and differential; quantitative chemical estimation of three substances; and Lange colloidal gold reaction             

13.50

 

Body Fluids—Seminal Fluid

 

1571.

Cell count; microscopical examination, wet film, and microscopical examination, Gram stain or similar 

4.20

 

Body Fluids—Serological Examination

 

1580.

Serological procedures, not covered by any other item; to identify organisms..........

2.10

1582.

Rh or similar blood group antibodies, qualitative examination for.................

2.40

1584.

Rh or similar blood group antibodies, quantitative examination for................

4.50

1586.

Flocculation tests for syphilis, rheumatoid factor or similar.....................

1.50

1588.

Syphilis, complement fixation tests for...................................

3.30

1590.

Complement, estimation of..........................................

3.30

 

Body Fluids—Chemistry

 

1601.

Quantitative chemical estimation of one substance...........................

3.30

1604.

Quantitative chemical estimation of two substances..........................

5.70

1607.

Quantitative chemical estimation of three substances..........................

7.80

1609.

Quantitative chemical estimation of four or more substances.....................

10.20

1611.

Lange colloidal gold reaction.........................................

3.00

1613.

Amniotic fluid, spectroscopic examination of..............................

4.20

1615.

Electrophoresis of protein or enzyme, qualitative............................

4.50

 

Body Fluids—Cytology

 

1616.

Cytological examination for malignancy..................................

4.50

 

Body Fluids—Miscellaneous

 

1621.

Cell count and differential...........................................

1.30

1623.

Assay of concentration of antibiotic or chemotherapeutic agent...................

2.70

1625.

Sweat plate test..................................................

1.60


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 3.—Body Fluids—continued

$

1627.

Huhner’s test...................................................

3.30

1629.

Milk, human, chemical analysis of.....................................

2.70

1631.

Calculi (gall stones, urinary calculi and other body concretions), chemical examination of 

2.10

 

Division 4.—Immunology

 

1640.

Immunoelectrophoresis of serum, cerebrospinal fluid, urine or other body fluids—qualitative 

6.90

1643.

Immunodiffusion for the detection of proteins in serum, cerebrospinal fluid, urine or other body fluids—qualitative—each protein             

3.60

1645.

Radio-immunodiffusion determination of protein in serum, cerebrospinal fluid, urine or other body fluids—quantitative—each protein             

3.60

1647.

Radio immune precipitation of globulins.................................

13.20

1649.

Lymphocyte (function studies) response to phytohaemagglutinin or antigen, visual transformation 

9.00

1651.

Lymphocyte (function studies) response to phytohaemagglutinin or antigen—using radio-active techniques, estimation of             

13.20

1653.

Skin sensitivity—induction and detection of sensitivity to chemical antigens.........

4.50

 

Immunology—Tissue Antibody Detection

 

1661.

Flocculation tests, e.g. latex—each antibody...............................

1.50

1664.

Agglutination immobilization test.....................................

7.20

1667.

Tanned erythrocyte haemagglutination technique—each antibody................

3.30

1670.

Complement fixation tests involving human tissue antibody—each antibody.........

3.30

1673.

Immunofluorescent detection of tissue antibody—each antibody.................

4.50

 

Division 5.—Faeces

 

 

Faeces—Bacteriology and Parasitology

 

1680.

Microscopical examination of wet preparation.............................

1.00

1682.

Microscopical examination with simple staining............................

1.00

1684.

Microscopical examination with special staining (iron haematoxylin, trichrome or similar) 

1.30

1686.

Microscopical examination for parasites or ova after concentration techniques ........

1.60

1688.

Identification of helminthes..........................................

2.10

1691.

Cultural examination for parasites.....................................

2.10

1694.

Cultural examination for isolation of micro-organisms, using selective media.........

2.70

1697.

Microscopical examination of wet preparation; and cultural examination for isolation of micro-organisms, using selective media             

4.20

1698.

Microscopical examination of wet preparation; microscopical examination for parasites or ova after concentration techniques; and cultural examination for isolation of micro-organisms, using selective media             

5.70

1700.

Special cultural examination for identification of intestinal pathogenic microorganisms using biochemical reactions             

2.10

1701.

Microscopical examination of wet preparation; microscopical examination for parasites or ova after concentration techniques; cultural examination for isolation of micro-organisms using selective media; and special cultural examination for identification of intestinal pathogenic micro-organisms using biochemical reactions             

8.40

1703.

Identification of intestinal pathogenic micro-organisms by specific serological techniques.

2.10

1706.

Sensitivity testing (each organism) using up to eight antibiotics..................

2.10

1707.

Sensitivity testing (each organism) using nine or more antibiotics.................

3.90

 

Faeces—Chemistry

 

1710.

Bilirubin, qualitative test other than by reagent stick, strip, tablet or similar ..........

1.00

1712.

Chloride, estimation of.............................................

3.30

1714.

Calcium, estimation of.............................................

3.30

1716.

Enzyme assay for amylase, trypsin, mucinase or similar enzyme, qualitative, each substance 

1.30


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 5.—Faeces—continued

 

1718.

Fat, total, quantitative estimation of, one estimation.........................

4.50

1720.

Fat, total, quantitative estimation of, two estimations.........................

9.00

1722.

Fat, total, quantitative estimation of, three or more estimations..................

14.40

1724.

Fat, differential, quantitative estimation of, one estimation.....................

2.10

1726.

Fat, differential, quantitative estimation of, two estimations....................

4.50

1728.

Fat, differential, quantitative estimation of, three or more estimations..............

7.20

1730.

Nitrogen, total, estimation of........................................

4.50

1732.

Occult blood, chemical tests for, other than by reagent stick, strip, tablet or similar.....

1.00

1734.

Porphyrins, qualitative estimation of, other than by reagent stick, strip, tablet or similar..

1.50

1736.

Porphyrins, quantitative estimation of (each substance).......................

10.20

1738.

Reducing substances, qualitative test other than by reagent stick, strip, tablet or similar..

1.30

1741.

Phosphorus, estimation of..........................................

3.30

1744.

Urobilin, urobilinogen, qualitative estimation of, other than by reagent stick, strip, tablet or similar 

1.30

1746.

Urobilinogen, quantitative estimation of, other than by reagent stick, strip, tablet or similar

3.30

1748.

Chemical estimation, quantitative, of any one substance not specified elsewhere, other than by reagent stick, strip, tablet or similar             

3.30

 

Division 6.—Skin, Hair, Nails

 

1761.

Microscopical examination for fungi...................................

1.80

1764.

Microscopical and cultural examination for fungi...........................

3.30

1767.

Chemical examination (qualitative)—each substance........................

1.30

1770.

Chemical examination (quantitative)—each substance........................

3.30

1773.

Skin sensitivity testing for allergens, using one to twenty allergens...............

3.90

1776.

Skin sensitivity testing for allergens, using more than twenty allergens.............

5.70

1779.

Skin sensitivity testing for hydatid disease (Casoni test).......................

1.50

1782.

Skin sensitivity testing for mycobacterial infection (Mantoux, Von Pirquet, Vollmer or similar test) 

1.50

1785.

Skin sensitivity testing for diagnosis of disease not otherwise listed (Schick test, Frei test, Schultz-Charlton test, &c.)             

1.50

 

Division 7.—Gastric and Duodenal Contents

 

 

Gastric and Duodenal Contents—Bacteriology

 

1790.

Microscopical examination for mycobacteria including collection of gastric contents...

2.10

1792.

Cultural examination for mycobacteria..................................

2.10

1794.

Microscopical examination for mycobacteria including collection of gastric contents and cultural examination for mycobacteria             

4.50

1796.

Animal inoculation...............................................

4.50

1798.

Sensitivity testing for mycobacteria—each antibiotic........................

2.10

 

Gastric and Duodenal Contents—Chemistry

 

1800.

Qualitative tests for barbiturate, blood, alcohol, metallic poison or similar substances—each substance 

1.60

1802.

Quantitative determination of acidity, single or multiple specimens, including collection (fractional test meal)             

4.80

1804.

Collection of gastric juice specimens after stimulation by histamine, synthetic gastrin, alcohol or similar substance and quantitative determination of acidity             

7.20

3806.

Quantitative determination of bicarbonate—single determination................

3.30

1808.

Quantitative determinations of bicarbonate—more than one determination..........

7.20

1810.

Quantitative determination of other substances—each substance.................

3.30

1812.

Stomach acid secretion test by ingestion of dye............................

3.30


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 8.—Morbid Anatomy

$

1820.

Histopathological examination of biopsy specimen when one or two pieces of tissue are separately identified, processed and examined             

5.70

1822.

Histopathological examination of biopsy specimen when three or four pieces of tissue are separately identified, processed and examined             

9.00

1824.

Histopathological examination of biopsy specimen when five or more pieces of tissue are separately identified, processed and examined             

12.60

1826.

Immediate frozen section diagnosis and histopathological examination when one or two pieces of tissue are separately identified, processed and examined             

12.60

1828.

Immediate frozen section diagnosis and histopathological examination of biopsy specimen when three or more pieces of tissue are separately identified, processed and examined             

15.60

 

Division 9.—Special Investigations (includes collection of specimens, administration of drugs and all relevant chemical determinations)

 

1840.

ACTH stimulation procedure (including synacthen) using multiple plasma steroid estimation......

18.60

1841.

ACTH stimulation procedure (including synacthen) using multiple urine steroid estimation.......

24.00

1843.

Adrenaline tolerance test...................................................

6.90

1846.

Arginine infusion test.....................................................

4.50

1849.

Basal metabolic rate estimation...............................................

4.50

1850.

Bromsulphthalein retention test...............................................

5.70

1852.

Carbohydrate tolerance test (e.g. glucose, fructose, galactose, lactose, sucrose, or similar) not exceeding two hours 

5.70

1855.

Carbohydrate tolerance test (e.g. glucose, fructose, galactose, lactose, sucrose, or similar) exceeding two hours but not exceeding three hours             

7.20

1858.

Carbohydrate tolerance test (e.g. glucose, fructose, galactose, lactose, sucrose, or similar) exceeding three hours 

9.00

1861.

Congo red test..........................................................

6.30

1863.

Creatinine clearance test...................................................

7.20

1865.

Dexamethazone suppression test..............................................

21.00

1867.

Glucagon tolerance test....................................................

6.90

1869.

Histidine loaded figlu test..................................................

5.70

1871.

Inulin clearance test......................................................

10.20

1873.

Metyropone suppression test................................................

21.00

1875.

Para amino hippuric clearance test.............................................

7.20

1877.

Phenolsulphonphthalein excretion test..........................................

7.20

1879.

Tolbutamide tolerance test..................................................

6.90

1881.

Urea clearance test.......................................................

5.40

1884.

Urea concentration test....................................................

4.50

1887.

Urine acidification test (ammonium chloride or similar)...............................

4.50

1889.

Vasopressin stimulation test.................................................

18.60

1891.

Water elimination or Mosenthal kidney function test.................................

2.10

1893.

Xylose absorption test.....................................................

5.10

 

Division 10.—Cytology

 

1901.

Examination of cervical or vaginal smears for malignant cells...........................

3.30

1903.

Examination of sputum, urine or body fluids including bronchial, cerebrospinal, pericardial, peritoneal, or similar for malignant cells             

4.50

1905.

Examination of colonic or duodenal washings for malignant cells........................

4.50

1907.

Examination of blood for circulating malignant cells.................................

7.20

1909.

Oesophageal cytology including collection of specimen...............................

6.00

1911.

Gastric cytology including collection of specimen..................................

9.00

1913.

Hormonal assessment by cytological examination of vaginal epithelium....................

2.70

1915.

Cytological sex chromatin studies other than from blood film...........................

3.00

 

Division 11.—Chromosome Studies

 

1921.

Chromosome studies—including preparation, count and karyotyping of blood................

9.00

1923.

Chromosome studies—including preparation, count and karyotyping of marrow or other tissue.....

10.80

1925.

Chromosome studies—including preparation, count and karyotyping of skin.................

12.60


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 12.—Radioisotope Studies

 

1941.

Erythrocyte radioactive uptake survival time.....................................

13.20

1943.

Blood volume Cr51.....................................................

4.50

1945.

Radioiodine thyroid uptake.................................................

4.50

1947.

Radioactive T3 test......................................................

5.10

1949.

Radioiodine, urinary estimation..............................................

3.30

1951.

Protein bound radioactive iodine test..........................................

4.50

1953.

Hormonal immunoassay by radioactive techniques, each estimation......................

4.50

1955.

Radioactive B12 absorption test (Schilling test)...................................

5.10

1957.

Cerebral scan..........................................................

9.00

1959.

Spinal cord scan........................................................

9.00

1961.

Parathyroid scan........................................................

7.20

1963.

Thyroid scan..........................................................

4.50

1965.

Mediastinal scan.......................................................

6.90

1967.

Scan of lung or lungs....................................................

6.90

1969.

Heart scan............................................................

6.90

1971.

Liver scan............................................................

10.20

1973.

Pancreas scan.........................................................

9.00

1975.

Spleen scan...........................................................

6.90

1977.

Renal scan...........................................................

7.20

1979.

Differential renal scan....................................................

4.50

1981.

Scan of bone or bones....................................................

7.20

1983.

Scan of region or organ not covered by any other item in this Division....................

7.20

 

Part 8.—Radiological Services

 

 

Division 1.—Radiographic Examination of Extremities and Report (with or without Fluoroscopy)

 

2010.

Digits or phalanges—all or any of either hand or either foot...........................

3.90

2014.

Hand, wrist, forearm, elbow or arm (elbow to shoulder)..............................

4.50

2018.

Hand, wrist and lower forearm; upper forearm and elbow; or elbow and arm (elbow to shoulder)...

4.80

2022.

Foot, ankle, lower leg, upper leg, knee or thigh (femur)..............................

4.50

2026.

Foot, ankle and lower leg; or upper leg and knee...................................

4.50

 

Division 2.—Radiographic Examination of Shoulder or Hip Joint and Report

 

2040.

Shoulder region including clavicle and scapula....................................

4.80

2044.

Hip joint.............................................................

5.10

2048.

Pelvic girdle..........................................................

6.00

2052.

Smith-Petersen nail—insertion or similar procedure................................

10.20

 

Division 3.—Radiographic Examination of Head and Report

 

2060.

Skull, sinuses or mastoids.................................................

5.70

2064.

Maxilla, or orbit, or both..................................................

5.70

2068.

Mandible, malar bones or salivary calculus......................................

5.70

2072.

Nose or eye...........................................................

4.50

2076.

Palate or pharynx, or palate and pharynx, by direct radiography with fluoroscopic screening......

7.20

2081.

Larynx..............................................................

5.10

 

Division 4.—Radiographic Examination of Spine and Report

 

2091.

Spine—any one region...................................................

6.00

2094.

Spine—two regions.....................................................

8.10

2098.

Spine—three or more regions...............................................

14.70

 

Division 5.—Radiographic Examination of Thoracic Region and Report

 

2110.

Chest (lung fields) by direct radiography........................................

4.50

2114.

Chest (lung fields) by direct radiography with fluoroscopic screening.....................

5.10

2119.

Thoracic inlet.........................................................

4.50

2123.

Chest, by miniature radiography.............................................

2.40

2128.

Orthodiagraphy........................................................

5.70

2132.

Teleoroentgenography with cardiac measurements.................................

5.70

2136.

Cardiac examination (including barium swallow)..................................

6.90

2140.

Sternum or one or more ribs of any one side.....................................

4.50

2144.

One or more ribs of both sides..............................................

5.70


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 6.—Radiographic Examination of Urinary Tract and Report

 

2160.

Plain renal only..................................................

5.10

2164.

Drip-infusion pyelography...........................................

17.40

2169.

Intravenous pyelography, including preliminary plain film......................

13.20

2173.

Retrograde pyelography.............................................

7.20

2177.

Cystography, urethrography or vesiculography, as an independent procedure..........

8.10

2181.

Micturating cysto-urethrography, as an independent procedure...................

10.20

2185.

Perirenal insufflations..............................................

5.70

Division 7.—Radiographic Examination of Alimentary Tract and Biliary System (with or without Fluoroscopy) and Report

2200.

Plain abdominal only...............................................

5.10

2205.

Pneumoperitoneum................................................

5.10

2209.

Oesophagus, with or without examination for foreign body or barium swallow.........

6.90

2214.

Barium or other opaque meal of oesophagus, stomach and duodenum, with or without screening of chest 

11.70

2218.

Barium or other opaque meal of oesophagus, stomach, duodenum and follow through to colon, with or without screening of chest             

13.80

2222.

Barium or other opaque meal, small bowel series only.........................

10.20

2226.

Opaque enema...................................................

11.70

2230.

Opaque enema, including air contrast study (two stages).......................

13.20

2234.

Graham’s test (cholecystography)......................................

8.40

2238.

Cholangiography direct, operative or post-operative..........................

9.00

2247.

Cholangiography—intravenous........................................

11.40

 

Division 8.—Radiographic Examination for Localization of Foreign Bodies and Report

 

2250.

Foreign body in eye (special method, Sweet’s or other)........................

8.10

2254.

Foreign body, localization of and report, not covered by any other item in this Part—the amount of Commonwealth benefit payable for the radiographic examination of the area and report, plus             

2.10

 

Division 9.—Radiographic Examination of Breasts and Report

 

2270.

Radiographic examination of both breasts and report..........................

10.20

2274.

Radiographic examination of one breast and report...........................

5.70

 

Division 10.—Radiographic Examination in Connexion with Pregnancy and Report

 

2290.

Pregnant uterus..................................................

5.10

2294.

Pelvimetry or placentography.........................................

10.20

2298.

Control X-rays associated with intrauterine foetal blood transfusion................

8.10

 

Division 11.—Radiographic Examination with Opaque or Contrast Media, and Report

 

 

(Not including any service covered by Division 16 of this Part)

 

2310.

Serial angiocardiography (rapid cassette changing)...........................

10.20

2314.

Serial angiocardiography (single plane—direct roll-film method)..................

14.70

2318.

Serial angiocardiography (bi-plane—direct roll-film method)....................

14.70

2322.

Serial angiocardiography (indirect roll-film method)..........................

14.70

2326.

Discography....................................................

8.10

2330.

Dacryocystography................................................

5.70

2334.

‘Encephalography.................................................

13.80

2338.

Intracranial angiography, one side......................................

10.20

2342.

Cerebral ventriculography...........................................

11.40

2346.

Hysterosalpingography.............................................

6.90

2350.

Bronchography, arteriography, phlebography, aortography or splenography...........

13.20

2354.

Myelography....................................................

15.60

2358.

Sialography or vasoepididymography....................................

6.00

2362.

Sinuses and fistulae—the amount of Commonwealth benefit payable for the radiographic examination of the area and report, plus             

2.40

2367.

Pneumarthrography—the amount of Commonwealth benefit payable for the radiographic examination of the area and report, plus             

2.40

2371.

Lymphangiography, including follow up radiography.........................

8.10


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 12.—Tomography and Report

 

2410.

Tomography, any part and report.......................................

7.20

 

Division 13.—Stereoscopic Examination and Report

 

2420.

Stereoscopic examination and report—the amount of Commonwealth benefit payable for the radiographic examination of the area and report, plus             

1.30

 

Division 14.—Fluoroscopic Examination and Report

 

 

(Fluoroscopic examination and report not covered by any other item in this Part—where radiograph is not taken)

 

2440.

Examination with general anaesthesia....................................

5.10

2444.

Examination without general anaesthesia..................................

3.30

 

Division 15.—Radiotherapy

 

2460.

Radiotherapy, superficial (including treatment by means of X-rays, radium rays or other radio-active substances) not covered by any other item in this Part—each attendance at which treatment is given             

2.40

2464.

Radiotherapy, other than superficial, orthovoltage therapy or megavoltage therapy (including treatment by means of X-rays, radium rays or other radio-active substances) not covered by any other item in this Part—each attendance at which treatment is given             

3.60

2468.

Radiotherapy, orthovoltage therapy or megavoltage therapy under hyperbaric conditions (including treatment by means of X-rays, radium rays or other radio-active substances) not covered by any other item in this Part—each attendance at which treatment is given             

6.90

 

Implantation of Radio-active Substances for Tumour

 

2510.

Globe of eye....................................................

36.00

2514.

Retina.........................................................

36.00

2518.

Lip...........................................................

12.00

2522.

Mouth or tongue or both.............................................

21.00

2526.

Bladder........................................................

48.00

2530.

Prostate........................................................

36.00

2534.

Cervix or corpus uteri..............................................

17.40

2538.

Any region or organ not referred to in a preceding item under this heading, the implantation of which requires a major anaesthetic             

23.40

2542.

Any region or organ referred to in the last preceding item, the implantation of which does not require a major anaesthetic             

8.10

 

Application of Moulds of Radio-active Substances

 

2570.

Alveolus, palate or antrum, each attendance at which a mould is applied.............

17.40

2574.

Scar following radical mastectomy, each attendance at which a mould is applied........

8.10

2578.

Hand or other skin area or mucous membrane, each attendance at which a mould is applied 

8.10

 

Division 16.—Preparation for Radiological Procedure, being the Injection of Opaque or Contrast Media or the Removal of Fluid and its Replacement by Air, Oxygen or Other Contrast Media or Other Similar Preparation, Including the Administration of an Anaesthetic for Radiotherapy

 

2620.

Encephalography.................................................

18.60

2624.

Intracranial angiography—percutaneous..................................

15.60

2628.

Intracranial angioeranhv—open exposure.................................

15.60

2632.

Cerebral ventriculography...........................................

24.00

2636.

Dacryocystography................................................

4.50

2640.

Bronchography...................................................

7.20

2644.

Aortography....................................................

7.20

2648.

Arteriography—peripheral, phlebography or splenography......................

5.70

2652.

Perirenal insufflations..............................................

5.70

2657.

Renal cyst or cysts, aspiration with injection of radio-opaque material...............

7.90

2661.

Pneumarthrography or radiography of pneumoperitoneum......................

6.00

2666.

Drip-infusion pyelography...........................................

3.60

2670.

Hysterosalpingography.............................................

5.70


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 16.—Preparation for Radiological Procedure—continued

 

2674.

Discography............................................................

4.50

2678.

Intraosseous venography....................................................

4.50

2682.

Myelography............................................................

10.20

2686.

Sinus or fistula, injection into.................................................

2.10

2691.

Lymphangiography........................................................

15.60

2696.

Administration of an anaesthetic for radiotherapy under hyperbaric conditions.................

8.10

2700.

Intracavitary administration of radio-active substances.................................

6.90

 

Part 9.—Assistance at Operations

 

2901.

Assistance at any operation or series or combination of operations for which the basic Commonwealth medical benefit does not exceed $24.00             

5.70

2904.

Assistance at any operation or series or combination of operations for which the basic Commonwealth medical benefit exceeds $24.00 but does not exceed $51.00             

7.80

2907.

Assistance at any operation or series or combination of operations for which the basic Commonwealth medical benefit exceeds $51.00 but does not exceed $81.00             

10.20

2910.

Assistance at any operation or series or combination of operations for which the basic Commonwealth medical benefit exceeds $81.00 but does not exceed $117.00             

13.20

2913.

Assistance at any operation or series or combination of operations for which the basic Commonwealth medical benefit exceeds $117.00             

18.60

 

Part 10.—Operations

 

 

Division 1.—General Surgical

 

3000.

Dressing of localised burns (not involving grafting)—each attendance at which the procedure is performed 

1.10

3004.

Dressing of burns, extensive, without anaesthesia (not involving grafting)—each attendance at which the procedure is performed (G)             

2.10

3005.

Dressing of burns, extensive, without anaesthesia (not involving grafting)—each attendance at which the procedure is performed (S)             

3.10

3009.

Dressing of localised burns under general anaesthesia (not involving grafting)—each attendance at which the procedure is performed (G)             

4.10

3011.

Dressing of localised burns under general anaesthesia (not involving grafting)—each attendance at which the procedure is performed (S)             

5.10

3015.

Dressing of burns, extensive, under general anaesthesia (not involving grafting)—each attendance at which the procedure is performed (G)             

8.70

3017.

Dressing of burns, extensive, under general anaesthesia (not involving grafting)—each attendance at which the procedure is performed (S)             

12.00

3021.

Skin and subcutaneous tissue or mucous membrane, repair of recent wound of, other than on face or neck, small (not more than 7 centimetres long), superficial, not covered by any item in Part 2 of this Schedule             

4.40

3025.

Skin and subcutaneous tissue or mucous membrane, repair of recent wound of, other than on face or neck, small (not more than 7 centimetres long), involving deeper tissue, not covered by any item in Part 2 of this Schedule             

8.10

3030.

Skin and subcutaneous tissue or mucous membrane, repair of recent wound of, on face or neck, small (not more than 7 centimetres long), superficial             

7.20

3034.

Skin and subcutaneous tissue or mucous membrane, repair of recent wound of, on face or neck, small (not more than 7 centimetres long), involving deeper tissue             

11.40

3039.

Skin and subcutaneous tissue or mucous membrane, repair of recent wound of, other than on face or neck, large (more than 7 centimetres long), superficial, not covered by any item in Part 2 of this Schedule             

8.10

3043.

Skin and subcutaneous tissue or mucous membrane, repair of recent wound of, other than on face or neck, large (more than 7 centimetres long), involving deeper tissue, not covered by any item in Part 2 of this Schedule (G)             

10.20

3045.

Skin and subcutaneous tissue or mucous membrane, repair of recent wound of, other than on face or neck, large (more than 7 centimetres long), involving deeper tissue, not covered by any item in Part 2 of this Schedule (S)             

14.10

3049.

Skin and subcutaneous tissue or mucous membrane, repair of recent wound or, on face or neck, large (more than 7 centimetres long), superficial (G)             

8.10

3051.

Skin and subcutaneous tissue or mucous membrane, repair of recent wound of, on face or neck, large (more than 7 centimetres long), superficial (S)             

11.40

3055.

Skin and subcutaneous tissue or mucous membrane, repair of recent wound of, on face or neck, large (more than 7 centimetres long), involving deeper tissue (G)             

10.50


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 1.—General Surgical—continued

 

3056.

Skin and subcutaneous tissue or mucous membrane, repair of recent wound of, on face or neck, large (more than 7 centimetres long), involving deeper tissue (S)             

14.70

3061.

Superficial foreign body, removal of, not covered by any other item in this Part........

1.90

3064.

Subcutaneous foreign body, removal of, not covered by any other item in this Part (G)....

4.40

3065.

Subcutaneous foreign body, removal of, not covered by any other item in this Part (S)....

10.20

3069.

Foreign body in muscle, endon or other deep tissue, removal of, not covered by any other item in this Part (G)             

14.70

3070.

Foreign body in muscle, tendon or other deep tissue, removal of, not covered by any other item in this Part (S)             

21.00

3074.

Biopsy of skin or mucous membrane, as an independent procedure.................

4.50

3078.

Biopsy of lymph gland, mtuscle or other deep tissue or organ, as an independent procedure (G) 

8.10

3080.

Biopsy of lymph gland, muscle or other deep tissue or organ, as an independent procedure (S) 

11.40

3084.

Aspiration biopsy of lymph gland, deep tissue or organ, as an independent procedure....

4.50

3089.

Biopsy of bone marrow by trephine or burr-hole.............................

10.20

3093.

Biopsy of bone marrow by aspiration....................................

2.40

3097.

Scalene node biopsy (G)............................................

10.50

3099.

Scalene node biopsy (S).............................................

14.70

3103.

Sinus, excision of, involving superficial tissues only (G).......................

6.00

3104.

Sinus, excision of, involving superficial tissues only (S)........................

8.10

3108.

Sinus, excision of, involving muscle and deep tissue (G).......................

10.50

3110.

Sinus, excision of. involving muscle and deep tissue (S)........................

14.70

3115.

Bursa, incision of.................................................

3.10

3119.

Ganglion or small bursa, excision of (G)..................................

11.40

3121.

Ganglion or small bursa, excision of (S)..................................

18.60

3125.

Bursa (large), including olecranon, calcaneum or patella, excision of (G).............

20.10

3126.

Bursa (large), including olecranon, calcaneum or patella, excision of (S).............

27.00

3131.

Bursa, semimembranosus (Baker’s cyst), excision of (G).......................

24.00

3132.

Bursa, semimembranosus (Baker’s cyst), excision of (S).......................

33.00

3137.

Tumour, cyst or scar, removal of cutaneous, subcutaneous or in mucous membrane, up to 3 centimetres in diameter (G)             

4.50

3138.

Tumour, cyst or scar, removal of cutaneous, subcutaneous or in mucous membrane, up to 3 centimetres in diameter (S)             

10.20

3143.

Tumour, cyst or scar, removal of cutaneous, subcutaneous or in mucous membrane, more than 3 centimetres in diameter (G)             

8.10

3144.

Tumour, cyst or scar, removal of cutaneous, subcutaneous or in mucous membrane, more than 3 centimetres in diameter (S)             

13.20

3149.

Tumour, cyst or scar, removal of, not covered by any other item in this Part, involving muscle, bone or other deep tissue (G)             

17.40

3150.

Tumour, cyst or scar, removal of, not covered by any other item in this Part, involving muscle, bone or other deep tissue (S)             

24.00

3155.

Tumour or deep cyst, removal of, not covered by any other item in this Part, requiring wide excision (G) 

27.00

3156.

Tumour or deep cyst, removal of, not covered by any other item in this Part, requiring wide excision (S) 

33.00

3161.

Tumours, malignant, operation for, not covered by any other item in this Part, requiring wide excision and dissection of glands or involving muscle, bone or viscera (G)             

51.00

3162.

Tumours, malignant, operation for, not covered by any other item in this Part, requiring wide excision and dissection of glands or involving muscle, bone or viscera (S)             

78.00

3166.

Lipectomy for abdominal apron or similar condition..........................

72.00

3170.

Axillary hyperidrosis, wedge excision for.................................

13.20

3174.

Plantar wart, simple removal of........................................

4.40

3178.

Keratoses, warts or similar lesions, electrosurgical destruction or chemotherapy of—each attendance at which the procedure is performed on not more than five lesions (G)             

3.00


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 1.—General Surgical—continued

$

3180.

Keratoses, warts or similar lesions, electrosurgical destruction or chemotherapy of—each attendance at which the procedure is performed on not more than five lesions (S)             

4.50

3184.

Keratoses, warts or similar lesions, electrosurgical destruction or chemotherapy of—each attendance at which the procedure is performed on more than five but not more than ten lesions (G)             

4.40

3185.

Keratoses, warts or similar lesions, electrosurgical destruction or chemotherapy of—each attendance at which the procedure is performed on more than five but not more than ten lesions (S)             

6.30

3190.

Keratoses, warts or similar lesions, electrosurgical destruction or chemotherapy of—each attendance at which the procedure is performed on more than ten but not more than fifteen lesions (G)             

5.10

3191.

Keratoses, warts or similar lesions, electrosurgical destruction or chemotherapy of—each attendance at which the procedure is performed on more than ten but not more than fifteen lesions (S)             

7.80

3196.

Keratoses, warts or similar lesions, electrosurgical destruction or chemotherapy of—each attendance at which the procedure is performed on more than fifteen but not more than twenty lesions (G)             

6.90

3197.

Keratoses, warts or similar lesions, electrosurgical destruction or chemotherapy of—each attendance at which the procedure is performed on more than fifteen but not more than twenty lesions (S)             

8.70

3201.

Keratoses, warts or similar lesions, electrosurgical destruction or chemotherapy of—each attendance at which the procedure is performed on more than twenty lesions (G)             

8.10

3202.

Keratoses, warts or similar lesions, electrosurgical destruction or chemotherapy of—each attendance at which the procedure is performed on more than twenty lesions (S)             

10.20

3206.

Keloid, extensive, multiple injections of hydrocortisone or similar preparation under general anaesthesia (G)             

11.70

3207.

Keloid, extensive, multiple injections of hydrocortisone or similar preparation under general anaesthesia (S)             

15.60

3211.

Haematoma, aspiration of..........................................

2.00

3216.

Haematoma, furuncle, small abscess or similar lesion not requiring a general anaesthetic, incision with drainage of             

2.00

3220.

Large haematoma, abscess, carbuncle, cellulitis or similar lesion requiring a general anaesthetic, incision with drainage of (G)             

8.10

3221.

Large haematoma, abscess, carbuncle, cellulitis or similar lesion requiring a general anaesthetic, incision with drainage of (S)             

13.20

3225.

Muscle, excision of (limited) (G)......................................

8.10

3226.

Muscle, excision of (limited) (S)......................................

11.40

3230.

Muscle, excision of (extensive) (G)....................................

15.90

3232.

Muscle, excision of (extensive) (S)....................................

21.00

3236.

Muscle, ruptured, repair of, not associated with external wound (G)...............

15.90

3238.

Muscle, ruptured, repair of, not associated with external wound (S)...............

21.00

3242.

Fascia, deep, repair of, for herniated muscle (G)............................

8.10

3244.

Fascia, deep, repair of, for herniated muscle (S)............................

11.40

3248.

Anatomical compartment of extremity, extensive exploration of, not involving any other procedure (G) 

8.70

3250.

Anatomical compartment of extremity, extensive exploration of, not involving any other procedure (S) 

12.00

3254.

Bone tumour, innocent, excision of, not covered by any other item in this Part(G).....

26.40

3255.

Bone tumour, innocent, excision of, not covered by any other item in this Part(S)......

36.00

3259.

Styloid process of temporal bone, removal of.............................

36.00

3263.

Parotid gland, total extirpation of.....................................

75.00

3267.

Parotid gland, removal of tumour from (G)...............................

20.10

3269.

Parotid gland, removal of tumour from (S)...............................

27.00

3273.

Parotid gland, superficial lobectomy or removal of tumour from, with exposure of facial nerve (G) 

51.00

3274.

Parotid gland, superficial lobectomy or removal of tumour from, with exposure of facial nerve (S) 

69.00


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 1.—General Surgical—continued

 

3279.

Sublingual or submandibular gland, extirpation of (G)................................

24.00

3280.

Sublingual or submandibular gland, extirpation of (S)................................

33.00

3285.

Salivary gland, incision of, or transoral ligation of salivary duct (G).......................

4.10

3286.

Salivary gland, incision of, or transoral ligation of salivary duct (S).......................

5.10

3291.

Salivary gland, removal of calculus from (G)......................................

10.50

3292.

Salivary gland, removal of calculus from (S)......................................

14.70

3297.

Salivary gland, dilatation or diathermy of duct (G)..................................

3.10

3298.

Salivary gland, dilatation or diathermy of duct (S)..................................

4.40

3303.

Salivary gland, removal of calculus from duct (G)..................................

8.10

3304.

Salivary gland, removal of calculus from duct (S)...................................

11.40

3309.

Salivary gland, repair of cutaneous fistula of......................................

11.40

3313.

Tongue, partial or complete excision of (G).......................................

55.50

3315.

Tongue, partial or complete excision of (S).......................................

75.00

3319.

Tongue tie, repair of......................................................

3.10

3323.

Ranula, removal of (G)....................................................

15.90

3324.

Ranula, removal of (S)....................................................

21.00

3328.

Cut throat, repair of, involving vessels or nerves, or both (G)...........................

20.10

3329.

Cut throat, repair of, involving vessels or nerves, or both (S)...........................

27.00

3334.

Cut throat, repair of, involving vessels and nerves and oesophagus or trachea (G)..............

39.90

3335.

Cut throat, repair of, involving vessels and nerves and oesophagus or trachea (S)..............

54.00

3340.

Neck, malignant tumour of, removal of.........................................

75.00

3344.

Thymectomy...........................................................

129.00

3348.

Branchial cyst or branchial fistula, removal of (G)..................................

28.50

3349.

Branchial cyst or branchial fistula, removal of (S)..................................

39.00

3353.

Cystic hygroma, removal of.................................................

63.00

3357.

Thyroidectomy, total, or removal of parathyroid tumour..............................

93.00

3361.

Thyroidectomy, sub-total (G)................................................

57.00

3362.

Thyroidectomy, sub-total (S)................................................

69.00

3367.

Thyroid, excision of localised tumour of (G)......................................

35.40

3368.

Thyroid, excision of localised tumour of (S)......................................

48.00

3372.

Diverticulum of pharynx or larynx, excision of (G)..................................

39.90

3373.

Diverticulum of pharynx or larynx, excision of (S)..................................

54.00

3377.

Thyroglossal cyst or fistula, removal of (G).......................................

51.00

3378.

Thyroglossal cyst or fistula, removal of (S).......................................

69.00

3383.

Cervical oesophagostomy..................................................

36.00

3387.

Cervical oesophagostomy, closure or plastic repair of................................

27.00

3392.

Tuberculous or neoplastic glands of neck, groin or axilla, limited excision of (G)..............

30.90

3393.

Tuberculous or neoplastic glands of neck, groin or axilla, limited excision of (S)..............

42.00

3397.

Tuberculous or neoplastic glands of neck, groin or axilla, radical excision of.................

69.00

3402.

Operation for lymphoedema by extended indwelling subcutaneous tube or tubes..............

15.60

3406.

Simple mastectomy (G)....................................................

33.00

3408.

Simple mastectomy (S)....................................................

45.00

3412.

Breast, excision of cyst, fibro adenoma or other local lesion or segmental resection for any other reason (G) 

17.40

3414.

Breast, excision of cyst, fibro adenoma or other local lesion or segmental resection for any other reason (S) 

24.00

3418.

Breast, excision of cyst, fibro adenoma or other local lesion or segmental resection for any other reason, where frozen section is performed (G)             

25.80

3419.

Breast, excision of cyst, fibro adenoma or other local lesion or segmental resection for any other reason, where frozen section is performed (S)             

33.00

3423.

Partial mastectomy involving more than one quarter of the breast tissue (G).................

25.80

3424.

Partial mastectomy involving more than one quarter of the breast tissue (S)..................

33.00

3428.

Breast, radical amputation of (G).............................................

69.00

3430.

Breast, radical amputation of (S)..............................................

93.00

3434.

Nipple, inverted, surgical eversion of (G)........................................

8.10

3436.

Nipple, inverted, surgical eversion of (S)........................................

11.40

3440.

Laparotomy (exploratory) where no other procedure is performed (G).....................

36.00

3442.

Laparotomy (exploratory) where no other procedure is performed (S).....................

45.00

3446.

Laparotomy involving operation on abdominal viscera, not covered by any other item in this Part (G) 

45.00

3448.

Laparotomy involving operation on abdominal viscera, not covered by any other item in this Part (S).

57.00


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 1.—General Surgical—continued

$

3452.

Laparotomy, exploratory, followed by enterostomy or colostomy (G)..........................

46.50

3454.

Laparotomy, exploratory, followed by enterostomy or colostomy (S)..........................

63.00

3458.

Subphrenic abscess, drainage of (G)................................................

35.40

3460.

Subphrenic abscess, drainage of (S)................................................

48.00

3464.

Liver tumour, removal of, other than by biopsy........................................

63.00

3469.

Liver, massive resection of, or lobectomy............................................

129.00

3473.

Liver abscess, abdominal drainage of...............................................

48.00

3478.

Liver abscess, transpleural drainage of..............................................

63.00

3482.

Hydatid of liver, peritoneum or viscus, operation for.....................................

63.00

3486.

Cholecystectomy (G)..........................................................

63.00

3487.

Cholecystectomy (S)..........................................................

81.00

3491.

Cholecystostomy (G)..........................................................

35.40

3492.

Cholecystostomy (S)..........................................................

48.00

3497.

Choledochotomy (with or without cholecystectomy) (G)..................................

75.00

3498.

Choledochotomy (with or without cholecystectomy) (S)...................................

93.00

3502.

Reconstruction of bile duct including choledochoduodenostomy, cholecystoduodenostomy, choledochoenterostomy, choledochogastrostomy, cholecystogastrostomy or cholecystenterostomy             

87.00

3506.

Reconstruction of hepatic duct including anastomosis with gallbladder or intestine.................

129.00

3510.

Gastroscopy...............................................................

17.40

3514.

Gastrostomy...............................................................

33.00

3519.

Gastrostomy for fixation of indwelling oesophageal tube..................................

42.00

3523.

Vagotomy.................................................................

69.00

3528.

Gastro-enterostomy or entero-colostomy (G)..........................................

42.00

3529.

Gastro-enterostomy or entero-colostomy (S)..........................................

57.00

3534.

Perforated peptic ulcer, suture of (G)...............................................

35.40

3535.

Perforated peptic ulcer, suture of (S)................................................

48.00

3539.

Partial gastrectomy, with or without gastro-jejunostomy (G)................................

64.50

3541.

Partial gastrectomy, with or without gastro-jejunostomy (S)................................

87.00

3545.

Gastrectomy, complete........................................................

117.00

3550.

Pyloroplasty (G).............................................................

30.90

3551.

Pyloroplasty (S).............................................................

42.00

3556.

Stomach, reconstruction of, by bowel transplant........................................

129.00

3560.

Peritoneal adhesions, separation of, where no other procedure is performed (G)...................

42.00

3561.

Peritoneal adhesions, separation of, where no other procedure is performed (S)....................

57.00

3566.

Enterostomy or colostomy, as an independent procedure (G)................................

42.00

3567.

Enterostomy or colostomy, as an independent procedure (S)................................

57.00

3572.

Enterostomy or colostomy, closure or plastic repair of (G).................................

21.90

3573.

Enterostomy or colostomy, closure or plastic repair of (S).................................

30.00

3577.

Caecostomy (G).............................................................

26.40

3578.

Caecostomy (S).............................................................

36.00

3582.

Bowel, anastomosis of (G)......................................................

69.00

3583.

Bowel, anastomosis of (S)......................................................

93.00

3588.

Intussusception, reduction of, by fluid (G)............................................

17.40

3589.

Intussusception, reduction of, by fluid (S)............................................

23.40

3593.

Intussusception, laparotomy and reduction of (G).......................................

30.90

3594.

Intussusception, laparotomy and reduction of (S).......................................

42.00

3598.

Intussusception, laparotomy and resection of (G).......................................

69.00

3599.

Intussusception, laparotomy and resection of (S)........................................

93.00

3604.

Volvulus, reduction of (G)......................................................

30.90

3605.

Volvulus, reduction of (S)......................................................

42.00

3609.

Meckel’s diverticulum, removal of (G)..............................................

39.00

3610.

Meckel’s diverticulum, removal of (S)..............................................

54.00

3614.

Bowel or viscera, resection of, with or without anastomosis, not covered by any other item in this Part (G).

69.00

3615.

Bowel or viscera, resection of, with or without anastomosis, not covered by any other item in this Part (S)..

93.00

3620.

Enterolysis with intestinal plication, Noble type........................................

69.00

3624.

Appendicectomy (G)..........................................................

36.00

3626.

Appendicectomy (S)..........................................................

42.00

3630.

Drainage of appendiceal abscess, or for ruptured appendix or for peritonitis with or without appendicectomy (G) 

37.50


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 1.—General Surgical—continued

 

3632.

Drainage of appendiceal abscess, or for ruptured appendix or for peritonitis with or without appendicectomy (S)             

51.00

3636.

Small bowel intubation with biopsy....................................

17.40

3640.

Small bowel intubation—as an independent procedure........................

8.10

3645.

Pancreas, partial excision of.........................................

129.00

3649.

Pancreas, drainage of (G)...........................................

30.90

3651.

Pancreas, drainage of (S)...........................................

42.00

3655.

Splenectomy (G)................................................

46.50

3656.

Splenectomy (S).................................................

63.00

3661.

Ruptured viscus (including liver, spleen or kidney), repair of (G).................

46.50

3662.

Ruptured viscus (including liver, spleen or kidney), repair of (S).................

63.00

3667.

Retroperitoneal tumour, removal of....................................

75.00

3671.

Retroperitoneal abscess, drainage of, not involving laparotomy..................

48.00

3675.

Peritoneoscopy..................................................

11.40

3680.

Paracentesis abdominis (G)..........................................

2.70

3681.

Paracentesis abdominis (S)..........................................

3.90

3686.

Abdomino-perineal resection........................................

129.00

3690.

Femoral or inguinal hernia (other than recurrent), repair of (G)..................

36.00

3691.

Femoral or inguinal hernia (other than recurrent), repair of (S)...................

45.00

3696.

Diaphragmatic hernia, traumatic, repair of................................

75.00

3700.

Diaphragmatic hernia, other than traumatic, repair of.........................

105.00

3704.

Umbilical hernia, repair of, in person under ten years of age (G).................

26.40

3705.

Umbilical hernia, repair of, in person under ten years of age (S)..................

36.00

3709.

Umbilical hernia, repair of, in person ten years of age or over (G)................

30.90

3710.

Umbilical hernia, repair of, in person ten years of age or over (S).................

42.00

3714.

Ventral, incisional, lumbar or recurrent hernia, repair of (G)....................

42.00

3716.

Ventral, incisional, lumbar or recurrent hernia, repair of (S)....................

51.00

3720.

Hydrocele, tapping of (G)...........................................

2.10

3721.

Hydrocele, tapping of (S)...........................................

3.10

3726.

Hydrocele, removal of (G)..........................................

21.00

3727.

Hydrocele, removal of (S)..........................................

27.00

3731.

Varicocele, removal of (G)..........................................

21.90

3732.

Varicocele, removal of (S)..........................................

30.00

3736.

Orchidectomy (simple) (G)..........................................

30.90

3737.

Orchidectomy (simple) (S)..........................................

42.00

3741.

Undescended testis, transplantation of, with or without associated hernial repair (G)....

36.00

3742.

Undescended testis, transplantation of, with or without associated hernial repair (S).....

48.00

3746.

Secondary detachment of testis from thigh (G).............................

6.00

3747.

Secondary detachment of testis from thigh (S).............................

8.10

3751.

Circumcision of person under four weeks of age............................

3.30

3755.

Circumcision of person under ten years of age but not less than four weeks of age (G)...

5.10

3756.

Circumcision of person under ten years of age but not less than four weeks of age (S)...

10.20

3760.

Circumcision of person ten years of age or over (G)..........................

10.50

3761.

Circumcision of person ten years of age or over (S)..........................

14.70

3765.

Paraphimosis, reduction of, under anaesthesia, with or without dorsal incision........

4.40

3769.

Sigmoidoscopic examination (G)......................................

3.90

3770.

Sigmoidoscopic examination (S)......................................

4.50

3771.

Sigmoidoscopy with diathermy or resection of rectal tumour or tumours (G).........

14.40

3772.

Sigmoidoscopy with diathermy or resection of rectal tumour or tumours (S)..........

19.20

3773.

Sigmoidoscopic examination followed by removal, ligation or cauterisation of haemorrhoids (G) 

32.40

3774.

Sigmoidoscopic examination followed by removal, ligation or cauterisation of haemorrhoids (S) 

37.00

3776.

Full thickness rectal biopsy..........................................

11.40

3780.

Rectum, radical operation for prolapse of, perineal approach....................

48.00

3784.

Rectum, radical operation for prolapse of, involving laparotomy.................

102.00


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 1.—General Surgical—continued

 

3788.

Rectum, anterior resection of, involving rectosigmoidectomy, not covered by item 3686 or 7594 

117.00

3792.

Rectum, prolapse of, injection into.....................................

3.10

3796.

Rectal polyp, removal of (G).........................................

14.10

3797.

Rectal polyp, removal of (S).........................................

18.60

3801.

Anus, dilatation of, as an independent procedure............................

3.30

3805.

Anal prolapse—circum-anal suture (G)..................................

8.10

3806.

Anal prolapse—circum-anal suture (S)..................................

11.40

3811.

Anal stricture, repair of (G)..........................................

21.90

3812.

Anal stricture, repair of (S)..........................................

30.00

3817.

Haemorrhoids, injection into—each attendance at which an injection is given.........

2.10

3821.

Haemorrhoids, incision of...........................................

5.10

3826.

Haemorrhoidectomy, radical (G)......................................

25.00

3827.

Haemorrhoidectomy, radical (S)......................................

30.00

3832.

Haemorrhoids, external, or anal tags, one or more, removal of...................

7.20

3836.

Fissure in ano, excision of (G)........................................

11.40

3838.

Fissure in ano, excision of (S)........................................

24.00

3842.

Fistula in ano, subcutaneous, excision of (G)..............................

21.90

3844.

Fistula in ano, subcutaneous, excision of (S)...............................

30.00

3848.

Fistula in ano, excision of (involving incision of external sphincter) (G)............

26.40

3850.

Fistula in ano, excision of (involving incision of external sphincter) (S).............

36.00

3854.

Ischio-rectal abscess, incision of (G)....................................

9.60

3856.

Ischio-rectal abscess, incision of (S)....................................

13.20

3860.

Faecal fistula, repair of.............................................

36.00

3865.

Recto-vesical fistula, repair of........................................

63.00

3869.

Pubo-rectalis muscle, division of......................................

33.00

3874.

Disimpaction of faeces under anaesthesia................................

6.30

3878.

Coccyx, excision of (G)............................................

26.40

3880.

Coccyx, excision of (S)............................................

36.00

3883.

Pilonidal cyst or sinus, excision of (G)..................................

30.00

3884.

Pilonidal cyst or sinus, excision of (S)...................................

36.00

3888.

Pilonidal sinus, injection of sclerosant fluid under anaesthesia...................

9.00

 

Blood Vessels

 

3900.

Varicose veins, injection into—each attendance at which an injection is given........

2.10

3904.

Varicose veins—multiple simultaneous injections by continuous compression techniques.

9.00

3908.

Varicose veins, excision or ligation of, not covered by any other item in this Part (G)....

7.20

3909.

Varicose veins, excision or ligation of, not covered by any other item in this Part (S)....

10.20

3914.

Varicose veins, sub-fascial ligation of (G)................................

15.60

3915.

Varicose veins, sub-fascial ligation of (S)................................

21.00

3917.

High ligation of long saphenous vein with excision and sub-fascial ligation of varicose veins (G) 

39.00

3920.

High ligation of long saphenous vein with excision and sub-fascial ligation of varicose veins (S) 

57.00

3921.

Varicose veins, excision of, with ligation of short saphenous vein (G)..............

13.20

3923.

Varicose veins, excision of, with ligation of short saphenous vein (S)..............

17.40

3926.

Varicose veins, excision of, with high ligation of long and short saphenous veins (G)....

36.00

3927.

Varicose veins, excision of, with high ligation of long and short saphenous veins (S)....

51.00

3931.

Varicose veins, excision of, with high ligation of long saphenous vein (G)...........

30.00

3932.

Varicose veins, excision of, with high ligation of long saphenous vein (S)...........

45.00

3936.

Saphenous vein, high ligation of (G)....................................

21.90

3937.

Saphenous vein, high ligation of (S)....................................

30.00

3941.

Saphenous vein, crossed, by-pass......................................

75.00

3945.

Intra-arterial oxygen injection........................................

4.50

3949.

Vein or small artery, ligation of (G)....................................

2.60

3951.

Vein or small artery, ligation of (S).....................................

3.80

3955.

Medium artery, ligation of (G)........................................

6.90


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 1.—General Surgical—continued

 

3957.

Medium artery, ligation of (S)........................................

9.30

3961.

Artery or vein, ligation of—involving deep dissection (G)......................

21.90

3963.

Artery or vein, ligation of—involving deep dissection (S)......................

30.00

3967.

Great vessel (including carotid, jugular, subclavian, axillary, iliac or femoral vessel), ligation of, involving gradual occlusion of vessel by mechanical device             

42.00

3971.

Great vessel (including carotid, jugular, subclavian, axillary, iliac or femoral vessel), ligation of 

48.00

3975.

Major artery of neck or extremity, repair of wound of, with restoration of continuity....

69.00

3979.

Major artery of trunk, repair of wound of, with restoration of continuity.............

87.00

3983.

Arteriovenous fistula, dissection and repair of..............................

129.00

3987.

Artery of neck or extremities, endarterectomy of............................

117.00

3991.

Innominate, subclavian, carotid or any intra-thoracic artery, endarterectomy of........

129.00

3995.

Inferior vena cava, plication of........................................

63.00

3999.

Repositioning of internal carotid artery..................................

63.00

4004.

Arterial or venous graft or by-pass.....................................

147.00

4008.

Arterial anastomosis..............................................

129.00

4013.

Portal hypertension, lienorenal anastomosis for.............................

129.00

4017.

Portal vein anastomosis............................................

129.00

4022.

Embolus, removal of, from artery of neck or extremities.......................

63.00

4026.

Embolus, removal of, from artery of trunk................................

75.00

4031.

Thrombus, removal of, from femoral, iliac or other similar large vein..............

48.00

4035.

Carotid body or carotid body tumour, removal of, without arterial anastomosis........

48.00

4040.

Arteriovenous shunt, external, insertion of................................

24.00

 

Operations for Acute Osteomyelitis

 

4050.

Operation on terminal phalanx of finger or toe (G)...........................

3.90

4051.

Operation on terminal phalanx of finger or toe (S)...........................

5.10

4055.

Operation on phalanx other than terminal, metacarpus or metatarsus—one bone (G).....

8.70

4056.

Operation on phalanx other than terminal, metacarpus or metatarsus—one bone (S).....

12.00

4060.

Operation on sternum, clavicle, rib, ulna, radius, carpus, tibia, fibula, tarsus, mandible or maxilla (other than alveolar margins)—one bone (G)             

15.90

4061.

Operation on sternum, clavicle, rib, ulna, radius, carpus, tibia, fibula, tarsus, mandible or maxilla (other than alveolar margins)—one bone (S)             

21.00

4065.

Operation on humerus or femur—one bone (G).............................

26.40

4066.

Operation on humerus or femur—one bone (S).............................

36.00

4070.

Operation on skull (G).............................................

21.90

4071.

Operation on skull (S).............................................

30.00

4075.

Operation on spine or pelvic bones—one bone (G)...........................

26.40

4076.

Operation on spine or pelvic bones—one bone (S)...........................

36.00

 

Operations for Chronic Osteomyelitis

 

4090.

Operation on nasal bones (G).........................................

8.70

4091.

Operation on nasal bones (S).........................................

12.00

4095.

Operation on scapula, sternum, clavicle, rib, ulna, radius, metacarpus, carpus, phalanx, tibia, fibula, metatarsus, tarsus, mandible or maxilla (other than alveolar margins)—one bone (G)             

26.40

4096.

Operation on scapula, sternum, clavicle, rib, ulna, radius, metacarpus, carpus, phalanx, tibia, fibula, metatarsus, tarsus, mandible or maxilla (other than alveolar margins)—one bone (S)             

36.00

4101.

Operation on humerus or femur—one bone (G).............................

26.40

4102.

Operation on humerus or femur—one bone (S).............................

36.00

4107.

Operation on spine or pelvic bones—one bone (G)...........................

46.50

4108.

Operation on spine or pelvic bones—one bone (S)...........................

63.00

4113.

Operation on skull (G).............................................

35.40

4114.

Operation on skull (S).............................................

48.00

4119.

Operation on any combination of bones referred to in item 4095 (G)...............

26.40

4120.

Operation on any combination of bones referred to in item 4096 (S)...............

36.00

4125.

Operation on any combination of bones not covered by item 4119 (G)..............

46.50

4126.

Operation on any combination of bones not covered by item 4120 (S)..............

63.00


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 2.—Amputation or Disarticulation of Limb

 

4150.

One finger or thumb (G)..................................................

15.60

4151.

One finger or thumb (S)...................................................

21.00

4156.

Additional ringer or thumb—each (G).........................................

2.10

4157.

Additional finger or thumb—each (S).........................................

2.70

4161.

Finger or thumb, including metacarpal or part of metacarpal—each digit (G)................

13.20

4162.

Finger or thumb, including metacarpal or part of metacarpal—each digit (S)................

17.40

4166.

Hand, midcarpal or transmetacarpal (G)........................................

21.90

4167.

Hand, midcarpal or transmetacarpal (S)........................................

30.00

4171.

Hand, forearm or through arm (G)............................................

26.40

4172.

Hand, forearm or through arm (S)............................................

36.00

4176.

At shoulder (G)........................................................

46.50

4177.

At shoulder (S)........................................................

63.00

4182.

Interscapulothoracic (G)..................................................

96.00

4183.

Interscapulothoracic (S)...................................................

129.00

4188.

One toe or great toe (G)...................................................

7.20

4189.

One toe or great toe (S)...................................................

10.20

4194.

Additional toe or great toe—each (G)..........................................

2.10

4195.

Additional toe or great toe—each (S)..........................................

3.00

4200

Toe, including metatarsal or part of metatarsal—each toe (G)..........................

10.50

4201.

Toe, including metatarsal or part of metatarsal—each toe (S)..........................

14.70

4206.

Foot at ankle (Syme, Pirogoff types) (G)........................................

26.40

4207.

Foot at ankle (Syme, Pirogoff types) (S)........................................

36.00

4212.

Foot, midtarsal or transmetatarsal (G)..........................................

21.90

4213.

Foot, midtarsal or transmetatarsal (S)..........................................

30.00

4218.

Through leg or at knee (G).................................................

35.40

4219.

Through leg or at knee (S).................................................

48.00

4224.

Through thigh (G)......................................................

51.00

4225.

Through thigh (S).......................................................

69.00

4230.

At hip (G)............................................................

57.90

4231.

At hip (S)............................................................

78.00

4236.

Hindquarter...........................................................

162.00

 

Division 3.—Ear, Nose and Throat

 

4300.

Ear, removal of foreign body in, otherwise than by simple syringing.....................

7.20

4304.

Aural polyp, removal of (G)................................................

9.60

4305.

Aural polyp, removal of (S)................................................

13.20

4309.

External auditory meatus, surgical removal of keratosis obturans from, not covered by item 4315 or 4320 (G) 

11.70

4311.

External auditory meatus, surgical removal of keratosis obturans from, not covered by item 4315 or 4320 (S) 

15.60

4315.

External auditory meatus, surgical removal of exostoses in............................

102.00

4320.

Tympanoplasty, including preliminary mastoidectomy..............................

102.00

4324.

Mastoidectomy (cortical)..................................................

57.00

4328.

Mastoidectomy (radical or modified radical).....................................

117.00

4333.

Mastoidectomy for decompression of facial nerve..................................

75.00

4337.

Labyrinthotomy or destruction of labyrinth......................................

114.00

4342.

Fenestration operation—each ear.............................................

129.00

4346.

Venous graft to fenestration cavity............................................

63.00

4350.

Stapedectomy.........................................................

117.00

4355.

Stapes mobilization.....................................................

75.00

4359.

Abscess or inflammation of middle ear, operation for (G).............................

4.50

4360.

Abscess or inflammation of middle ear, operation for (S).............................

7.20

4364.

Middle ear, exploration of.................................................

45.00

4368.

Middle ear, insertion of tube for drainage of.....................................

24.00

4372.

Perforation of tympanum, cauterisation or diathermy of..............................

4.40

4376.

Cholesteatoma, removal of, by suction ear toilet...................................

10.20

4381.

Examination of nasal cavity or post-nasal space, or nasal cavity and post-nasal space, under general anaesthesia, as an independent procedure             

4.50

4385.

Nose, removal of foreign body in, other than by simple probing........................

7.20

4389.

Nasal polyp or polypi (simple), removal of (G)...................................

5.40

4390.

Nasal polyp or polypi (simple), removal of (S)....................................

7.20

4394.

Nasal polyp or polypi (requiring admission to hospital), removal of (G)...................

15.60


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 3.—Ear, Nose and Throat—continued

 

4395.

Nasal polyp or polypi (requiring admission to hospital), removal of (S).............

21.00

4399.

Nasal septum, septoplasty or submucous resection of, as an independent procedure.....

45.00

4400.

Nasal septum, septoplasty or submucous resection of, with cauterisation or diathermy of any one or more of septum or turbinates or pharynx (G)             

46.70

4401.

Nasal septum, septoplasty or submucous resection of, with cauterisation or diathermy of any one or more of septum or turbinates or pharynx (S)             

49.50

4402.

Nasal septum, septoplasty or submucous resection of, with turbinectomy or dislocation of turbinate 

52.50

4403.

Cauterisation or diathermy of septum or turbinates or pharynx—any one or more—each attendance at which the procedure is performed (G)             

2.40

4404.

Cauterisation or diathermy of septum or turbinates or pharynx—any one or more—each attendance at which the procedure is performed (S)             

7.20

4408.

Cryotherapy to nose in the treatment of nasal haemorrhage.....................

15.60

4412.

Turbinectomy or dislocation of turbinate.................................

13.20

4416.

Turbinates, submucous resection of....................................

17.40

4420.

Maxillary antrum, proof puncture and lavage of............................

2.70

4424.

Maxillary antrum, lavage of—each attendance.............................

2.50

4428.

Antrostomy (radical)..............................................

45.00

4432.

Antrostomy (radical) with transantral ethmoidectomy........................

69.00

4436.

Antrum, intranasal operation on, or removal of foreign body from................

27.00

4440.

Antrum, drainage of, through tooth socket................................

11.40

4444.

Oro-antral fistula, plastic closure of....................................

63.00

4448.

Frontal sinus, external operation on....................................

63.00

4450.

Frontal sinus or ethmoidal sinuses, intranasal operation on.....................

39.00

4452.

Frontal sinus, catheterisation of.......................................

5.10

4456.

Ethmoidal sinuses, external operation on.................................

66.00

4460.

Sphenoidal sinus, proof puncture of....................................

5.10

4464.

Sphenoidal sinus, intranasal operation on.................................

30.00

4468.

Transantral Vidian neurectomy.......................................

63.00

4472.

Trans-sphenoidal hypophysectomy.....................................

96.00

4476.

Eustachian tube, catheterisation of.....................................

3.60

4480.

Division of pharyngeal adhesions......................................

11.40

4484.

Post-nasal space, direct examination of, with biopsy.........................

7.20

4488.

Nasopharyngeal tumour, operation for removal of—involving hard palate...........

63.00

4492.

Pharyngeal pouch, removal of........................................

75.00

4496.

Pharyngotomy (lateral)............................................

75.00

4498.

Tonsils or tonsils and adenoids, removal of, in a person aged less than twelve years (G)..

12.00

4499.

Tonsils or tonsils and adenoids, removal of, in a person aged less than twelve years (S)..

24.00

4501.

Tonsils or tonsils and adenoids in a person aged less than twelve years, removal of, with operation for abscess or inflammation of middle ear (G)             

14.70

4502.

Tonsils or tonsils and adenoids in a person aged less than twelve years, removal of, with operation for abscess or inflammation of middle ear (S)             

30.50

4504.

Tonsils or tonsils and adenoids in a person aged less than twelve years, removal of, with cauterisation and diathermy of any one or more of septum or turbinates or pharynx (G)             

13.70

4505.

Tonsils or tonsils and adenoids in a person aged less than twelve years, removal of with cauterisation and diathermy of any one or more of septum or turbinates or pharynx (S)             

30.50

4507.

Tonsils or tonsils and adenoids, removal of, in a person twelve years of age or over (G)..

17.40

4508.

Tonsils or tonsils and adenoids, removal of, in a person twelve years of age or over (S)..

39.00

4513.

Tonsils or tonsils and adenoids, arrest of haemorrhage requiring general anaesthesia, following removal of (G)             

4.10

4514.

Tonsils or tonsils and adenoids, arrest of haemorrhage requiring general anaesthesia, following removal of (S)             

5.10

4519.

Adenoids, removal of (G)...........................................

8.10

4520.

Adenoids, removal of (S)...........................................

13.20


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 3.—Ear, Nose and Throat—continued

$

4525.

Adenoids, removal of, with operation for abscess or inflammation of middle ear (G)....

10.80

4526.

Adenoids, removal of, with operation for abscess or inflammation of middle ear (S)....

20.10

4528.

Lingual tonsil or lateral pharyngeal bands, removal of........................

8.10

4529.

Peritonsillar abscess (quinsy), incision of.................................

6.30

4533.

Uvulotomy....................................................

3.10

4538.

Vallecular or pharyngeal cysts, removal of................................

36.00

4542.

Oesophagoscopy.................................................

24.00

4545.

Oesophagoscopy with insertion of Souttar’s tubes or first dilatation of oesophagus.....

37.20

4547.

Oesophagoscopy with biopsy........................................

30.00

4551.

Oesophagus, removal of foreign body in.................................

36.00

4555.

Insertion of Souttar’s tubes or dilatation of oesophagus—first dilatation............

23.40

4559.

Insertion of Souttar’s tubes or dilatation of oesophagus—subsequent dilatation........

17.40

4563.

Laryngectomy (total)..............................................

96.00

4567.

Larynx, direct examination of, as an independent procedure....................

18.60

4571.

Larynx, direct examination of, with biopsy...............................

21.00

4575.

Larynx, direct examination of, with removal of tumour.......................

23.40

4579.

Microlaryngoscopy...............................................

18.60

4583.

Microlaryngoscopy with removal of tumour...............................

42.00

4587.

Larynx, fractured, operation for.......................................

63.00

4591.

Larynx, external operation on, or laryngofissure............................

63.00

4595.

Arytenoid cartilages, fixation of.......................................

78.00

4599.

Arytenoid cartilage, removal of.......................................

63.00

4604.

Tracheotomy (G)................................................

18.00

4605.

Tracheotomy (S).................................................

24.00

4610.

Trachea, removal of foreign body in....................................

17.40

4614.

Bronchoscopy, as an independent procedure (G)............................

13.20

4616.

Bronchoscopy, as an independent procedure (S)............................

17.40

4620.

Bronchoscopy, with biopsy..........................................

23.40

4625.

Bronchus, removal of foreign body in (G)................................

26.40

4626.

Bronchus, removal of foreign body in (S)................................

36.00

 

Division 4.—Urological

 

4710.

Adrenal gland, biopsy of...........................................

63.00

4714.

Adrenal gland, removal of..........................................

63.00

4719.

Renal transplant.................................................

162.00

4723.

Nephrectomy for malignant disease, complete or partial.......................

117.00

4727.

Nephrectomy (complete or partial) other than for malignant disease (G)............

78.00

4728.

Nephrectomy (complete or partial) other than for malignant disease (S).............

105.00

4732.

Nephro-ureterectomy, complete, with bladder repair.........................

117.00

4735.

Kidney, fused, symphysiotomy for.....................................

75.00

4739.

Kidney, exploration of, with division of aberrant artery or other procedure not covered by any other item 

57.00

4743.

Nephrolithotomy, pyelolithotomy or ureterolithotomy........................

87.00

4747.

Nephrostomy...................................................

63.00

4751.

Nephropexy, as an independent procedure................................

63.00

4755.

Pyonephrosis, drainage of...........................................

36.00

4759.

Perinephric abscess, drainage of......................................

36.00

4763.

Pelvi-ureteric junction, plastic procedures to..............................

87.00

4767.

Divided ureter, repair of............................................

63.00

4771.

Ureterectomy, complete, with bladder repair, as an independent procedure...........

60.00

4775.

Ureter, transplantation of, into skin.....................................

48.00

4779.

Ureter, transplantation of, into bladder..................................

72.00

4783.

Ureter, transplantation of, into intestine..................................

96.00

4787.

Ureter, transplantation of, into isolated intestinal loop........................

114.00

 

Operations on the Bladder (Closed)

 

4810.

Bladder, catheterisation of—where no other surgical procedure is performed.........

2.40

4814.

Cystoscopy, with or without urethral dilatation.............................

14.70

4819.

Cystoscopy, with ureteric catheterisation, with or without introduction of opaque medium.

17.40


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 4.—Urological—continued

 

4823.

Cystometrography...............................................

5.10

4827.

Cystoscopic removal of foreign body...................................

23.40

4831.

Cystoscopy, with biopsy of bladder tumours..............................

21.00

4835.

Cystoscopy, with diathermy or resection of bladder tumours....................

30.00

4839.

Cystoscopy, with ureteric meatotomy...................................

27.00

4843.

Cystoscopy, with diathermy of ureteric orifices.............................

21.00

4847.

Cystoscopy, with endoscopic bladder neck resection.........................

36.00

4851.

Cystoscopy, with endoscopic removal or manipulation of ureteric calculus..........

36.00

4855.

Litholapaxy, with or without cystoscopy.................................

33.00

 

Operations on the Bladder (Open)

 

4910.

Bladder, repair of rupture of (G)......................................

35.40

4911.

Bladder, repair of rupture of (S).......................................

48.00

4916.

Cystostomy or cystotomy, suprapubic (G)................................

20.10

4917.

Cystostomy or cystotomy, suprapubic, (S)................................

27.00

4922.

Bladder, partial excision or plastic repair of...............................

75.00

4926.

Bladder, excision of, with ureteric transplantation...........................

129.00

4931.

Bladder neck contracture, operation for..................................

63.00

4935.

Bladder tumours, suprapubic diathermy of................................

63.00

4939.

Diverticulum of bladder, excision or obliteration of..........................

84.00

4944.

Vesical fistula, cutaneous, operation for.................................

36.00

 

Operations on the Prostate

 

5010.

Prostatectomy (suprapubic, perineal or retropubic)..........................

117.00

5014.

Prostatectomy (endoscopic), with or without cystoscopy.......................

75.00

5019.

Median bar, endoscopic resection of, with or without cystoscopy.................

51.00

5023.

Prostate, total excision of...........................................

129.00

5028.

Prostate, biopsy of, perineal.........................................

30.00

5032.

Prostate, biopsy of, endoscopic, with or without cystoscopy....................

45.00

5037.

Prostate, needle biopsy of, or injection into...............................

4.50

5041.

Prostatic abscess, retropubic drainage of.................................

30.00

 

Operations on Urethra, Penis or Scrotum

 

5110.

Urethral sounds, passage of, as an independent procedure......................

3.90

5114.

Urethral stricture, dilatation of........................................

7.20

5118.

Urethra, repair of rupture of (G).......................................

46.50

5120.

Urethra, repair of rupture of (S).......................................

63.00

5124.

Urethral fistula, closure of..........................................

14.70

5128.

Urethroscopy, as an independent procedure...............................

14.70

5132.

Urethroscopy with removal of stone or foreign body.........................

17.40

5136.

Urethral meatotomy..............................................

7.20

5140.

Urethrotomy (external), with excision of stricture...........................

63.00

5145.

Urethrotomy, perineal (external), as an independent procedure..................

30.00

5149.

Urethrotomy (internal).............................................

27.00

5153.

Urethroplasty not covered by any other item in this Part.......................

63.00

5157.

Urethrectomy, partial or complete, for removal of tumour......................

51.00

5161.

Urethral stricture, plastic repair of.....................................

75.00

5165.

Hypospadias, correction of chordee....................................

36.00

5170.

Hypospadias, urethral reconstruction for.................................

57.00

5174.

Hypospadias, secondary correction of...................................

23.40

5178.

Epispadias, repair of, not involving sphincter..............................

63.00

5182.

Epispadias, repair of, including bladder neck closure.........................

78.00

5186.

Urethra, diathermy of.............................................

15.60

5190.

Priapism, decompression operation for, under general anaesthesia................

7.20

5194.

Penis, partial amputation of..........................................

36.00

5198.

Penis, complete or radical amputation of.................................

75.00

5202.

Penis, amputation of, with excision of glands..............................

96.00

5206.

Scrotum, partial excision of.........................................

30.00


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 4.—Urological—continued

 

 

Operations on Testes, Vasa or Seminal Vesicles

 

5220.

Testicular biopsy......................................................

14.70

5223.

Spermatocele, excision of (G)..............................................

20.10

5224.

Spermatocele, excision of (S)..............................................

27.00

5228.

Testis, exposure of, with or without fixation.....................................

21.00

5232.

Orchidectomy, with excision of retroperitoneal glands or seminal vesicles.................

96.00

5236.

Orchidoplasty........................................................

36.00

5240.

Epididymectomy......................................................

33.00

5244.

Vasoepididymostomy...................................................

63.00

5248.

Vasoepididymography and vasovesiculography as an independent operative procedure, preparation for, by open operation             

15.60

5252.

Vasectomy (simple)....................................................

21.00

5256.

Vasectomy (radical) including seminal vesicles..................................

75.00

5260.

Vasotomy or vasectomy (bilateral) (G)........................................

18.00

5261.

Vasotomy or vasectomy (bilateral) (S)........................................

24.00

 

Division 5.—Gynaecological

 

5310.

Gynaecological examination under anaesthesia not performed in association with any service covered by any other item in this Part (G)             

4.20

5311.

Gynaecological examination under anaesthesia not performed in association with any service covered by any other item in this Part (S)             

7.20

5316.

Simple tumour of vagina or vulva, removal of (G).................................

6.00

5317.

Simple tumour of vagina or vulva, removal of (S).................................

8.10

5322.

Hymenectomy (G).....................................................

6.00

5323.

Hymenectomy (S)......................................................

8.10

5328.

Bartholin’s cyst, excision of (G)............................................

14.10

5329.

Bartholin’s cyst, excision of (S).............................................

18.60

5334.

Bartholin’s cyst or gland, marsupialisation or cautery destruction of (G)..................

10.50

5335.

Bartholin’s cyst or gland, marsupialisation or cautery destruction of (S)..................

14.70

5340.

Bartholin’s abscess, incision of (G)..........................................

4.10

5341.

Bartholin’s abscess, incision of (S)...........................................

5.10

5346.

Skene’s duct, incision of, or removal of calculus from..............................

8.10

5350.

Urethra or urethral caruncle, cauterisation of (G).................................

4.10

5352.

Urethra or urethral caruncle, cauterisation of (S)..................................

5.10

5356.

Urethral caruncle, excision of (G)...........................................

10.50

5358.

Urethral caruncle, excision of (S)............................................

14.70

5362.

Clitoris, amputation of...................................................

27.00

5367.

Vulvectomy (simple)....................................................

36.00

5371.

Vulvectomy (radical)....................................................

96.00

5376.

Pelvic lymph glands, excision of (radical)......................................

75.00

5380.

Vagina, dilatation of, as an independent procedure—each attendance at which dilatation is performed 

4.00

5385.

Vagina, complete removal of..............................................

75.00

5387.

Vaginal reconstruction in congenital absence or gynatresia...........................

75.00

5394.

Vaginal septum, excision of, for correction of double vagina..........................

42.00

5398.

Plastic repair to enlarge vaginal orifice (G).....................................

11.70

5399.

Plastic repair to enlarge vaginal orifice (S)......................................

15.60

5403.

Colpotomy or colporrhaphy, not covered by any other item in this Part (G)................

8.70

5404.

Colpotomy or colporrhaphy, not covered by any other item in this Part (S)................

12.00

5408.

Cystocele or rectocele, repair of, not covered by item 5414 or 5419 (G)..................

33.00

5410.

Cystocele or rectocele, repair of, not covered by item 5416 or 5420 (S)...................

45.00

5414.

Cystocele and rectocele, repair of, not covered by item 5419 (G).......................

42.00

5416.

Cystocele and rectocele, repair of, not covered by item 5420 (S).......................

57.00

5419.

Colpoplasty, Donald-Fothergill or Manchester operation (operation for genital prolapse) (G)....

51.00

5420.

Colpoplasty, Donald-Fothergill or Manchester operation (operation for genital prolapse) (S).....

63.00

5422.

Colpoplasty, Donald-Fothergill or Manchester operation (operation for genital prolapse) and curettage of uterus, with or without dilatation (G)             

57.90

5423.

Colpoplasty, Donald-Fothergill or Manchester operation (operation for genital prolapse) and curettage of uterus, with or without dilatation (S)             

72.00


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 5.—Gynaecological—continued

$

5425.

Urethrocele, operation for................................................

17.40

5429.

Fistula between genital and urinary or alimentary tracts, repair of......................

75.00

5434.

Stress incontinence, sling operation for, as an independent procedure....................

72.00

5438.

Cervix, cauterisation, ionisation or diathermy of (G)...............................

3.90

5439.

Cervix, cauterisation, ionisation or diathermy of (S)...............................

4.50

5443.

Cervix, removal of polyp from (G)..........................................

4.50

5444.

Cervix, removal of polyp from (S)...........................................

5.10

5448.

Examination of the uterine cervix by a magnifying colposcope of the Hinselmann type or similar instrument 

6.30

5451.

Cervix, cone biopsy of (G)................................................

15.60

5452.

Cervix, cone biopsy of (S)................................................

21.00

5453.

Cone biopsy of cervix, and curettage of uterus with or without dilatation(G)...............

21.90

5454.

Cone biopsy of cervix, and curettage of uterus with or without dilatation (S)...............

30.00

5457.

Cervix, amputation or repair of, not covered by item 5419 (G)........................

13.20

5458.

Cervix, amputation or repair of, not covered by item 5420 (S).........................

17.40

5462.

Cervix, dilatation of, not covered by item 5471 (G)................................

6.00

5463.

Cervix, dilatation of, not covered by item 5472 (S)................................

7.80

5467.

Culdoscopy..........................................................

10.20

5471.

Uterus, curettage of, with or without dilatation (G)................................

12.00

5472.

Uterus, curettage of, with or without dilatation (S)................................

15.60

5475.

Uterus, curettage of, with or without dilatation; and cauterisation, ionisation or diathermy of cervix (G) 

14.40

5477.

Uterus, curettage of, with or without dilatation; and cauterisation, ionisation or diathermy of cervix (S) 

18.60

5481.

Uterus, curettage of, with or without dilatation and removal of polyp from cervix (G).........

14.70

5483.

Uterus, curettage of, with or without dilatation and removal of polyp from cervix (S).........

18.90

5487.

Uterus, curettage of, with or without dilatation, with removal of polyp from cervix and cauterisation, ionisation or diathermy of cervix (G)             

15.90

5489.

Uterus, curettage of, with or without dilatation, with removal of polyp from cervix and cauterisation, ionisation or diathermy of cervix (S)             

20.40

5493.

Hysterotomy (G)......................................................

21.90

5495.

Hysterotomy (S).......................................................

30.00

5499.

Hysterectomy (other than vaginal)—subtotal (G).................................

51.00

5501.

Hysterectomy (other than vaginal)—subtotal (S).................................

69.00

5505.

Hysterectomy (other than vaginal)—total (G)...................................

51.00

5507.

Hysterectomy (other than vaginal)—total (S)....................................

69.00

5511.

Hysterectomy (other than vaginal)—total, with curettage of uterus, with or without dilatation (G).

57.90

5512.

Hysterectomy (other than vaginal)—total, with curettage of uterus, with or without dilatation (S).

78.00

5513.

Hysterectomy (total) with abdominal urethroplexy................................

81.00

5515.

Hysterectomy and dissection of pelvic glands...................................

117.00

5518.

Hysterectomy (other than vaginal)—total, with appendicectomy (G)....................

70.50

5519.

Hysterectomy (other than vaginal)—total, with appendicectomy (S).....................

91.50

5523.

Colpoplasty with vaginal hysterectomy (G).....................................

69.00

5525.

Colpoplasty with vaginal hysterectomy (S).....................................

87.00

5529.

Ectopic gestation, removal of (G)...........................................

42.00

5531.

Ectopic gestation, removal of (S)............................................

57.00

5535.

Myomectomy (G)......................................................

42.00

5537.

Myomectomy (S)......................................................

57.00

5541.

Round ligaments, shortening of (G)..........................................

36.00

5543.

Round ligaments, shortening of (S)..........................................

42.00

5547.

Bicornuate uterus, plastic reconstruction for....................................

36.00

5551.

Uterus, suspension or fixation of (G).........................................

30.90

5553.

Uterus, suspension or fixation of (S).........................................

42.00

5557.

Rubin test for patency...................................................

5.70

5561.

Fallopian tube or tubes, implantation of, into uterus...............................

48.00

5565.

Fallopian tubes, hydrotubation of, as an isolated procedure...........................

5.70

5569.

Fallopian tubes, hydrotubation of, as a repetitive post-operative procedure................

3.90


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 5.—Gynaecological—continued

$

5573.

Oophorectomy, salpingectomy, salpingo-oophorectomy or ligation of Fallopian tubes, not associated with hysterectomy (G)             

33.00

5574.

Oophorectomy, salpingectomy, salpingo-oophorectomy or ligation of Fallopian tubes, not associated with hysterectomy (S)             

42.00

5577.

Oophorectomy, salpingectomy, salpingo-oophorectomy or ligation of Fallopian tubes, not associated with hysterectomy in addition to curettage of uterus, with or without dilatation (G)             

39.90

5579.

Oophorectomy, salpingectomy, salpingo-oophorectomy or ligation of Fallopian tubes, not associated with hysterectomy in addition to curettage of uterus, with or without dilatation (S)             

51.00

5583.

Appendicectomy with oophorectomy, salpingectomy, salpingo-oophorectomy, or ligation of Fallopian tubes, not associated with hysterectomy (G)             

54.00

5585.

Appendicectomy with oophorectomy, salpingectomy, salpingo-oophorectomy, or ligation of Fallopian tubes, not associated with hysterectomy (S)             

64.50

5589.

Salpingostomy or salpingolysis, or both.........................................

48.00

5593.

Ovarian, parovarian, fimbrial or broad ligament cyst, excision of, not covered by any other item in this Part (G) 

39.00

5594.

Ovarian, parovarian, fimbrial or broad ligament cyst, excision of, not covered by any other item in this Part (S) 

57.00

5596.

Pelvic abscess, suprapubic drainage of (G)........................................

35.40

5597.

Pelvic abscess, suprapubic drainage of (S)........................................

48.00

 

Division 6.—Ophthalmological

 

5610.

Ophthalmological examination under general anaesthesia as an independent procedure..........

4.50

5614.

Eye, enucleation of (G)....................................................

26.40

5616.

Eye, enucleation of (S).....................................................

36.00

5620.

Eye, enucleation of, and insertion of ball.........................................

66.00

5625.

Globe, evisceration of.....................................................

36.00

5631.

Orbitotomy, lateral.......................................................

69.00

5635.

Orbit, exenteration of, including skin grafting......................................

63.00

5640.

Orbital cyst or tumour, excision of, requiring preparation of bone flap......................

69.00

5644.

Orbital cyst or tumour, excision of, not requiring preparation of bone flap...................

42.00

5649.

Perforating wound of globe, repair of, with or without iris prolapsed.......................

87.00

5653.

Perforating wound of globe involving the lens, repair of...............................

69.00

5658.

Intraocular foreign body, removal of............................................

75.00

5662.

Abscess (intraorbital), drainage of.............................................

11.40

5667.

Tarsal cyst, extirpation of (G)................................................

4.50

5668.

Tarsal cyst, extirpation of (S)................................................

5.10

5673.

Tarsal cartilage, excision of.................................................

21.00

5677.

Canthoplasty or tarsorrhaphy.................................................

27.00

5681.

Lacrimal sac, excision of, or operation on........................................

30.00

5685.

Dacryocystorrhinostomy...................................................

63.00

5689.

Parotid duct, transplantation of, into conjunctival sac.................................

69.00

5693.

Lacrimal canaliculus, reconstruction of..........................................

63.00

5697.

Lacrimal canaliculus, immediate repair of........................................

42.00

5701.

Lacrimal passages, probing or dilatation of, for obstruction (G)..........................

6.00

5702.

Lacrimal passages, probing or dilatation of, for obstruction (S)..........................

10.20

5706.

Conjunctival peritomy.....................................................

11.40

5710.

Trachoma, crushing operation for..............................................

12.00

5714.

Cornea or sclera, removal of superficial foreign body from.............................

1.10

5718.

Cornea or sclera, removal of foreign body, involving deeper layers (G).....................

4.10

5719.

Cornea or sclera, removal of foreign body, involving deeper layers (S).....................

5.10

5723.

Corneal scars, excision of, or partial keratectomy...................................

19.20

5727.

Cornea, tattooing of.......................................................

23.40

5731.

Cornea, epithelial debridement for dendritic ulcer...................................

5.10

5735.

Cornea, transplantation of, including collection of implant.............................

147.00

5739.

Keratoplasty, superficial....................................................

96.00

5742.

Keratoplasty—corneal transplant, lamellar........................................

87.00

5746.

Conjunctiva, cautery of, for treatment of pannus—each attendance at which treatment is given.....

5.40


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 6.—Ophthalmological—continued

$

5750.

Pterygium or Pinguecula, removal of..................................

24.00

5754.

Limbic tumour, removal of.........................................

27.00

5758.

Lens extraction, including initial and subsequent needlings....................

129.00

5762.

Insertion of artificial lens..........................................

63.00

5766.

Cataract, juvenile, removal of, including subsequent needlings..................

129.00

5770.

Capsulectomy..................................................

51.00

5774.

Secondary cataract, needling of—each stage..............................

27.00

5778.

Paracentesis in relation to eye.......................................

30.00

5782.

Glaucoma, filtering and allied operations for.............................

105.00

5786.

Goniotomy...................................................

51.00

5790.

Iridectomy or iridotomy...........................................

57.00

5794.

Tumour involving iris or ciliary body, or iris and ciliary body, excision of..........

69.00

5798.

Cyclodiathermy................................................

30.00

5802.

Detached retina, diathermy operation for................................

96.00

5806.

Detached retina, resection or buckling operation for.........................

129.00

5810.

Re-attachment of retina, revision operation for............................

51.00

5814.

Detached retina, light coagulation for..................................

36.00

5818.

Detached retina, removal of encircling silicone band from.....................

15.60

5822.

Detached retina, removal of encircling silicone band from, with excision of sclera.....

24.00

5826.

Cryopexy, without scleral resection or scleral infolding, for treatment of detached retina or pre-detachment disease of retina             

63.00

5830.

Cryopexy, with scleral resection or scleral infolding, for treatment of detached retina or pre-detachment disease of retina             

96.00

5834.

Retrobulbar transillumination.......................................

8.10

5838.

Retrobulbar injection of alcohol......................................

6.30

5842.

Squint, operation for.............................................

57.00

5846.

Muscle transplant (Hummelsheim type, etc.) for squint.......................

42.00

5850.

Re-attachment of ruptured medial palpebral ligament........................

42.00

5854.

Torn ocular muscle, repair of........................................

39.00

5858.

Suprachoroidal implantation of ocular muscle.............................

39.00

 

Division 7.—Thoracic

 

5910.

Thoracic cavity, aspiration or paracentesis of, or both (G).....................

2.70

5911.

Thoracic cavity, aspiration or paracentesis of, or both (S).....................

3.90

5915.

Artificial pneumothorax—induction...................................

7.80

5920.

Artificial pneumothorax—each filling subsequent to induction..................

4.00

5924.

Intercostal drain, insertion of, not involving resection of rib (G).................

10.50

5926.

Intercostal drain, insertion of, not involving resection of rib (S).................

14.70

5930.

Empyema, radical operation for, involving resection of rib (G)..................

35.40

5931.

Empyema, radical operation for, involving resection of rib (S)..................

48.00

5936.

Thoracotomy without pneumolysis....................................

96.00

5940.

Thoracotomy with pneumolysis......................................

96.00

5945.

Thoracotomy with pulmonary decortications.............................

102.00

5949.

Thoracoplasty (complete)..........................................

129.00

5954.

Thoracoplasty (in stages)—each stage..................................

75.00

5958.

Pectus excavatum or pectus carinatum in person under five years of age, correction of..

42.00

5963.

Pectus excavatum or pectus carinatum in person five years of age or over, correction of.

105.00

5967.

Thoracoscopy..................................................

23.40

5971.

Thoracoscopy with division of pleural adhesions...........................

39.00

5976.

Thoracic duct cannulisation.........................................

8.10

5980.

Phrenic avulsion or crush..........................................

17.40

5985.

Pneumonectomy or lobectomy.......................................

129.00

5989.

Hydatid cysts of lungs, removal of....................................

78.00

5994.

Oesophagectomy or operation for atresia of oesophagus......................

114.00

5998.

Oesophagus, reconstruction of, or replacement by bowel transplant...............

129.00

6003.

Mediastinal abscess, drainage of.....................................

63.00

6007.

Mediastinum, cervical exploration of, with or without biopsy..................

42.00

6012.

Left ventricular puncture..........................................

30.00

6016.

Pericardium, drainage of, by open operation..............................

75.00


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 7.—Thoracic—continued

$

6021.

Bronchoscopy with left atrial puncture.........................................

48.00

6025.

Intrathoracic operation on heart, lungs, great vessels, bronchial tree, oesophagus or mediastinum, or on more than one of those organs, not covered by any other item in this Part             

147.00

6029.

Cardiac catheterisation with or without fluoroscopy................................

17.40

6034.

Cardiac catheterisation with oximetry..........................................

25.20

6038.

Atrial balloon septostomy including preliminary cardiac catheterisation with oximetry..........

60.00

6042.

Implantation of cardiac pacemaker—extrathoracic.................................

23.40

 

Division 8.—Neuro-Surgical

 

6100.

Local infiltration around nerve or in muscle with alcohol, novocaine or similar preparation—each attendance at which an injection is given             

1.10

6104.

Nerve blocking with alcohol or other agent following localization by electrical stimulator.......

4.50

6108.

Sympathetic trunk, injection into.............................................

5.10

6112.

Injection of intracranial ganglion, or primary branch of trigeminal nerve, with alcohol or similar substance 

12.00

6116.

Lumbar puncture.......................................................

4.20

6120.

Cisternal puncture......................................................

5.10

6124.

Spinal or epidural injection for neurological diagnosis or for therapeutic reasons.............

6.30

6128.

Ventricular puncture.....................................................

17.40

6132.

Cutaneous or digital nerve, primary suture of (G)..................................

10.50

6133.

Cutaneous or digital nerve, primary suture of (S)..................................

14.70

6137.

Repair of divided digital nerve to thumb or finger (G)...............................

18.00

6138.

Repair of divided digital nerve to thumb or finger (S)...............................

24.00

6142.

Nerve trunk, primary suture of (G)............................................

30.60

6143.

Nerve trunk, primary suture of (S)............................................

42.00

6147.

Nerve trunk, secondary suture of.............................................

48.00

6151.

Nerve, graft or anastomosis of...............................................

75.00

6155.

Neuro-anastomosis, involving cranial nerves.....................................

87.00

6159.

Nerve, transposition of (G).................................................

24.00

6160.

Nerve, transposition of (S).................................................

33.00

6164.

Neurectomy, neurotomy, or removal of tumour from peripheral nerve (G)..................

15.60

6165.

Neurectomy, neurotomy, or removal of tumour from peripheral nerve (S)..................

21.00

6169.

Neurectomy, periarterial..................................................

75.00

6173.

Neurectomy, intracranial or radical as in tic douloureux..............................

96.00

6177.

Exploration of brachial plexus not covered by any other item in this Part...................

36.00

6181.

Neurolysis by open operation, with or without transposition (G)........................

21.00

6182.

Neurolysis by open operation, with or without transposition (S).........................

24.00

6186.

Craniotomy, burr-hole (G).................................................

15.60

6187.

Craniotomy, burr-hole (S).................................................

21.00

6191.

Intracranial haemorrhage, burr-hole craniotomy for (G)..............................

26.40

6192.

Intracranial haemorrhage, burr-hole craniotomy for (S)..............................

36.00

6196.

Intracranial cyst, needling and drainage of.......................................

23.40

6197.

Fracture of skull, depressed or comminuted, operation for (G)..........................

46.50

6198.

Fracture of skull, depressed or comminuted, operation for (S)..........................

63.00

6202.

Compound or complicated fracture or fractures of skull, operation for (G)..................

64.50

6203.

Compound or complicated fracture or fractures of skull, operation for (S)..................

87.00

6207.

Reconstructive cranioplasty................................................

96.00

6211.

Chronic subdural haematoma, operation for......................................

87.00

6215.

Craniotomy involving osteoplastic flap

81.00

6219.

Aneurysm, intracranial, operation for..........................................

162.00

6223.

Craniotomy and tumour removal.............................................

147.00

6227.

Transfrontal orbitotomy for tumours or other lesions................................

129.00

6231.

Intracranial abscess, excision of.............................................

129.00

6235.

Intracranial infection, drainage of............................................

75.00

6239.

Leucotomy or lobotomy for psychiatric causes....................................

96.00

6243.

Hemispherectomy.......................................................

162.00

6247.

Temporal lobectomy.....................................................

129.00

6251.

Chemopallidectomy, or other stereotatic procedure.................................

96.00

6255.

Laminectomy for cordotomy, removal of tumour or for treatment or removal of intervertebral disc lesion 

105.00

6259.

Spinal rhizolysis with or without laminectomy....................................

96.00

6263.

Sympathectomy (cervical, lumbar, thoracic, sacral or presacral).........................

63.00


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 9.—Treatment of Dislocations

$

 

Dislocations not requiring Open Operation

 

6310.

Mandible—first or second dislocation.........................................

4.40

6314.

Mandible—third or subsequent dislocation......................................

2.50

6318.

Clavicle (G)..........................................................

4.80

6320.

Clavicle (S)..........................................................

6.90

6324.

Shoulder—first or second dislocation.........................................

8.10

6328.

Shoulder—third or subsequent dislocation—requiring anaesthesia......................

6.90

6333.

Shoulder—third or subsequent dislocation—not requiring anaesthesia....................

5.10

6337.

Elbow (G)...........................................................

7.20

6338.

Elbow (S)...........................................................

10.20

6343.

Carpus (G)...........................................................

4.50

6344.

Carpus (S)...........................................................

6.30

6349.

Carpus on radius and ulna (G)..............................................

13.20

6350.

Carpus on radius and ulna (S)..............................................

17.40

6354.

Finger (G)...........................................................

1.90

6355.

Finger (S)...........................................................

2.50

6359.

Metacarpo-phalangeal joint of thumb (G).......................................

6.00

6360.

Metacarpo-phalangeal joint of thumb (S).......................................

8.10

6365.

Hip (G).............................................................

21.90

6366.

Hip (S).............................................................

30.00

6371.

Knee (G)............................................................

15.90

6372.

Knee (S)............................................................

21.00

6377.

Patella (G)...........................................................

4.50

6378.

Patella (S)...........................................................

6.30

6382.

Ankle (G)...........................................................

8.10

6383.

Ankle (S)............................................................

11.40

6387.

Toe (G).............................................................

2.10

6388.

Toe (S).............................................................

3.10

6392.

Tarsus (G)...........................................................

6.00

6393.

Tarsus (S)...........................................................

8.10

6397.

Spine (cervical), without fracture (G).........................................

20.10

6398.

Spine (cervical), without fracture (S)..........................................

27.00

6402.

Spine (lumbar), without fracture (G)..........................................

20.10

6404.

Spine (lumbar), without fracture (S)..........................................

27.00

 

Dislocations requiring Open Operation

 

6414.

Treatment of a dislocation requiring open operation, being a dislocation referred to in an item under the last preceding heading

The amount shown in this column in the item in which the dislocation concerned is referred to, plus one-half of that amount

 

Division 10.—Treatment of Fractures

 

 

Simple and Uncomplicated Fractures not requiring Open Operation

 

6420.

Terminal phalanx of finger or thumb..........................................

4.40

6425.

Proximal phalanx of finger or thumb (G).......................................

8.10

6426.

Proximal phalanx of finger or thumb (S)

13.20

6431.

Middle phalanx of finger (G)...............................................

4.40

6432.

Middle phalanx of finger (S)...............................................

5.40

6437.

One or more metacarpals, not involving base of first carpometacarpal joint (G)..............

8.10

6438.

One or more metacarpals, not involving base of first carpometacarpal joint (S)..............

18.60

6442.

First metacarpal involving carpometacarpal joint (Bennett’s fracture) (G)..................

10.20


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 10.—Treatment of Fractures—continued

$

6443.

First metacarpal involving carpometacarpal joint (Bennett’s fracture) (S)..................

21.00

6447.

Carpus (excluding navicular) (G)............................................

5.00

6448.

Carpus (excluding navicular) (S)............................................

6.30

6453.

Navicular or carpal scaphoid (G)............................................

10.50

6454.

Navicular or carpal scaphoid (S)............................................

14.70

6458.

Colles’ fracture of wrist (G)...............................................

11.40

6459.

Colles’ fracture of wrist (S)................................................

24.00

6463.

Distal end of radius or ulna, involving wrist.....................................

11.40

6467.

Radius (G)...........................................................

11.40

6468.

Radius (S)...........................................................

18.60

6472.

Ulna(G)............................................................

8.10

6473.

Ulna(S).............................................................

11.40

6477.

Both shafts of forearm (G)................................................

17.40

6478.

Both shafts of forearm (S)................................................

33.00

6482.

Humerus (G).........................................................

15.60

6483.

Humerus (S).........................................................

33.00

6487.

Clavicle or sternum (G)..................................................

8.10

6489.

Clavicle or sternum (S)..................................................

13.20

6493.

Scapula (G)..........................................................

8.10

6494.

Scapula (S)..........................................................

11.40

6498.

One or more ribs—each attendance (G)........................................

1.10

6499.

One or more ribs—each attendance (S)........................................

2.00

6503.

Pelvis (excluding symphysis pubis) or sacrum (G).................................

17.40

6505.

Pelvis (excluding symphysis pubis) or sacrum (S).................................

23.40

6509.

Symphysis pubis (G)....................................................

13.20

6510.

Symphysis pubis (S)....................................................

17.40

6515.

Femur (G)...........................................................

42.00

6516.

Femur (S)...........................................................

57.00

6521.

Fibula or tarsus (excepting os calcis or os talus) (G)................................

8.10

6522.

Fibula or tarsus (excepting os calcis or os talus) (S)................................

14.10

6525.

Tibia or patella (G).....................................................

14.70

6527.

Tibia or patella (S).....................................................

21.00

6531.

Both shafts of leg (G)...................................................

26.40

6532.

Both shafts of leg (S)....................................................

36.00

6537.

Ankle (Pott’s fracture), with or without dislocation of ankle (G)........................

26.40

6538.

Ankle (Pott’s fracture), with or without dislocation of ankle (S)........................

36.00

6543.

Os calcis (calcaneus) or os talus (G)..........................................

26.40

6544.

Os calcis (calcaneus) or os talus (S)..........................................

36.00

6549.

Metatarsals—one or more (G)..............................................

8.10

6550.

Metatarsals—one or more (S)..............................................

13.20

6555.

Phalanx of toe (other than great toe)..........................................

4.40

6559.

More than one phalanx of toe (other than great toe)................................

5.10

6564.

Distal phalanx of great toe................................................

4.70

6568.

Proximal phalanx of great toe (G)...........................................

4.40

6569.

Proximal phalanx of great toe (S)............................................

5.70

6574.

Skull, not requiring operation—each attendance (G)...............................

1.10

6575.

Skull, not requiring operation—each attendance (S)................................

2.00

6578.

Nasal bones, not requiring reduction—each attendance (G)...........................

1.10

6580.

Nasal bones, not requiring reduction—each attendance (S)...........................

2.00

6584.

Nasal bones, requiring reduction (G)..........................................

11.70

6586.

Nasal bones, requiring reduction (S)..........................................

21.00

6590.

Maxilla—not requiring splinting (G)..........................................

10.50

6592.

Maxilla—not requiring splinting (S)..........................................

14.70

6596.

Maxilla—with wiring of teeth or internal fixation.................................

33.00

6601.

Maxilla—with external fixation.............................................

36.00

6605.

Mandible—not requiring splinting (G)........................................

13.20

6606.

Mandible—not requiring splinting (S).........................................

17.40

6610.

Mandible—with wiring of teeth or internal fixation................................

45.00

6614.

Mandible—skeletal pinning with external fixation.................................

48.00

6618.

Zygoma (G)..........................................................

11.70

6619.

Zygoma (S)..........................................................

15.60

6623.

Spine (excluding sacrum), transverse process or bone other than vertebral body, not requiring immobilisation in plaster—each attendance (G)             

1.10


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 10.—Treatment of Fractures—continued

$

6624.

Spine (excluding sacrum), transverse process or bone other than vertebral body, not requiring immobilisation in plaster—each attendance (S)             

2.40

6628.

Spine (excluding sacrum), vertebral body, without involvement of cord, not requiring immobilisation in plaster—each attendance (G)             

1.10

6629.

Spine (excluding sacrum), vertebral body, without involvement of cord, not requiring immobilisation in plaster—each attendance (S)             

2.00

6633.

Spine (excluding sacrum), transverse process or bone other than vertebral body requiring immobilisation in plaster or traction by skull calipers (G)             

15.90

6634.

Spine (excluding sacrum), transverse process or bone other than vertebral body requiring immobilisation in plaster or traction by skull calipers (S)             

21.00

6638.

Spine (excluding sacrum), vertebral body, without involvement of cord, requiring immobilisation in plaster or traction by skull calipers (G)             

26.40

6639.

Spine (excluding sacrum), vertebral body, without involvement of cord, requiring immobilisation in plaster or traction by skull calipers (S)             

36.00

6643.

Spine (excluding sacrum), vertebral body, with involvement of cord.....................

96.00

 

Simple and Uncomplicated Fractures requiring Open Operation

 

6647.

Treatment of a simple and uncomplicated fracture requiring open operation, being a fracture referred to in an item under the last preceding heading             

The amount shown in this column in the item in which the fracture concerned is referred to, plus one-third of that amount

 

Compound Fractures requiring Open Operation

 

6651.

Treatment of a compound fracture requiring open operation, being a fracture referred to in an item under the first heading in this Division             

The amount shown in this column in the item in which the fracture concerned is referred to, plus one-half of that amount

 

Complicated Fractures requiring Open Operation

 

6655.

Treatment of a complicated fracture involving viscera, blood vessels or nerves and requiring open operation, being a fracture referred to in an item under the first heading in this Division             

The amount shown in this column in the


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 10.—Treatment of Fractures—continued

 

6655

continued

item in which the fracture concerned is referred to, plus three-quarters of that amount

 

General

 

6659.

Initial reduction (without full post-operative treatment) in a series of two or more reductions of a fracture, being a reduction that would, but for this item, be covered by an item under a preceding heading in this Division             

One-half of the amount shown in this column in the item that would, but for this item, apply to the reduction concerned

6663.

Each subsequent reduction (without full post-operative treatment) in the series (other than the final reduction), being a reduction that would, but for this item, be covered by an item under a preceding heading in this Division             

One-half of the amount shown in this column in the item that would, but for this item, apply to the reduction concerned

6667

Final reduction (including full post-operative treatment) in the series, being a reduction that would, but for this item, be covered by an item under a preceding heading in this Division             

The amount shown in this column in the item that would, but for this item, apply to the reduction concerned


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 10.—Treatment of Fractures—continued

$

6671.

Treatment of avulsion of epiphysis of any part....................................

The amount shown in this column in the item that would apply in the case of a simple and uncomplicated fracture of the part concerned

 

Division 11.—Orthopaedic

 

7010.

Accessory or sesamoid bone, removal of........................................

27.00

7014.

Epicondylitis, open operation for (G)..........................................

14.10

7016.

Epicondylitis, open operation for (S)..........................................

18.60

7020.

Digital nail, removal of...................................................

3.00

7025.

Incision of pulp space, paronychia or other acute infection of hands or feet, not covered by any other item in this Part 

2.50

7029.

Middle palmar, thenar or hypothenar spaces, drainage of (G)..........................

5.00

7031.

Middle palmar, thenar or hypothenar spaces, drainage of (S)...........................

6.30

7035.

Ingrowing toenail, excision of nail bed (G)......................................

8.10

7037.

Ingrowing toenail, excision of nail bed (S).......................................

16.00

7041.

Insertion of orthopaedic pin or wire where no other surgical procedure is performed (G)........

8.10

7043.

Insertion of orthopaedic pin or wire where no other surgical procedure is performed (S).........

11.40

7047.

Osteosynthesis by Smith-Petersen nail.........................................

105.00

7051.

Temporo-mandibular meniscectomy..........................................

36.00

7055.

Joint (other than spine), manipulation of, under general anaesthesia (G)...................

9.60

7056.

Joint (other than spine), manipulation of, under general anaesthesia (S)....................

13.20

7060.

Spine, manipulation of, under general anaesthesia (G)...............................

13.20

7061.

Spine, manipulation of, under general anaesthesia (S)...............................

18.60

7065.

Spine, application of plaster jacket............................................

17.40

7069.

Risser jacket, localiser or turn-buckle jacket, application of, body only....................

15.60

7074.

Risser jacket, localiser or turn-buckle jacket, application of, body and head.................

19.20

7078.

Scoliosis, spinal fusion for.................................................

162.00

7082.

Scoliosis, re-exploration for adjustment or removal of Harrington rods or similar devices........

51.00

7087.

Application of halo for spinal fusion in the treatment of scoliosis, as an independent procedure....

33.00

7091.

Bone graft to spine, posterior, not covered by item 7095, 7100 or 7104....................

75.00

7095.

Bone graft to spine, postero-lateral for spondylolisthesis.............................

135.00

7100.

Bone graft to spine with interbody spinal fusion...................................

135.00

7104.

Bone graft to spine with laminectomy and posterior interbody fusion.....................

117.00

7108.

Bone graft not covered by any other item in this Part................................

57.00

7113.

Shoulder—removal of calcium deposit from cuff (G)...............................

20.10

7114.

Shoulder—removal of calcium deposit from cuff (S)................................

27.00

7118.

Shoulder—arthrotomy....................................................

30.00

7122.

Shoulder—arthroplasty or plastic reconstruction...................................

81.00

7126.

Shoulder—arthrodesis or arthrectomy..........................................

96.00

7130.

Finger or other small joint—arthrodesis, arthrectomy or arthroplasty.....................

33.00

7135.

Small joint—arthrotomy (G)................................................

6.00

7136.

Small joint—arthrotomy (S)................................................

8.10


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 11.—Orthopaedic—continued

$

7141.

Zygapopbyseal joints, arthrectomy of.........................................

48.00

7145.

Sacro-iliac joint—arthrodesis..............................................

54.00

7149.

Other large joint—arthrodesis, arthrectomy, arthroplasty or total synovectomy of............

48.00

7154.

Other large joint—arthrotomy (G)...........................................

24.00

7155.

Other large joint—arthrotomy (S)...........................................

33.00

7159.

Hip—arthrodesis, arthrectomy or arthroplasty...................................

129.00

7163.

Hip—arthrotomy......................................................

63.00

7167.

Knee—arthrodesis, arthrectomy, arthroplasty or total synovectomy of...................

87.00

7171.

Knee—arthrotomy.....................................................

42.00

7176.

Knee—operation for internal derangement.....................................

48.00

7180.

Knee—reconstruction of cruciate ligaments.....................................

63.00

7184.

Knee—reconstruction of capsular ligaments....................................

48.00

7189.

Knee—excision of patella (G).............................................

42.00

7190.

Knee—excision of patella (S)..............................................

57.00

7195.

Knee—operation for recurrent dislocation of patella...............................

48.00

7199.

Joint, aspiration of, or intra-articular injection into, or both of those services (G)............

2.10

7200.

Joint, aspiration of, or intra-articular injection into, or both of those services (S).............

2.70

7205.

Synovial cavity, aspiration of, or intra-synovial injection of, or both of those services (G)......

2.10

7206.

Synovial cavity, aspiration of, or intra-synovial injection of, or both of those services (S).......

2.70

7210.

Joint, repair of capsule or ligament of.........................................

17.40

7214.

Foot or ankle region—triple arthrodesis.......................................

63.00

7218.

Calcanean spur, removal of...............................................

36.00

7221.

Hallux valgus, correction of (G)............................................

30.00

7222.

Hallux valgus, correction of (S)............................................

39.00

7224.

Hallux valgus, correction of, with osteotomy or osteectomy of phalanx, metacarpal or metatarsal (G) 

40.50

7225.

Hallux valgus, correction of, with osteotomy or osteectomy of phalanx, metacarpal or metatarsal (S) 

60.00

7227.

Hallux valgus and hammer toe, correction of, with subcutaneous tenotomy, one or more tendons (G) 

44.30

7228.

Hallux valgus and hammer toe, correction of, with subcutaneous tenotomy, one or more tendons (S) 

57.00

7230.

Hallux rigidus, correction of...............................................

30.00

7233.

Hammer toe, correction of (G).............................................

20.10

7234.

Hammer toe, correction of (S).............................................

27.00

7238.

Cervical rib. removal of..................................................

63.00

7242.

Scalenotomy.........................................................

21.00

7246.

Acromion or coraco-acromion ligament, removal of...............................

36.00

7250.

Excision of exostosis of small bone (G).......................................

20.10

7252.

Excision of exostosis of small bone (S).......................................

27.00

7256.

Excision of exostosis of large bone (G).......................................

24.00

7257.

Excision of exostosis of large bone (S)........................................

33.00

7261.

Osteotomy or osteectomy of phalanx, metacarpal or metatarsal (G).....................

18.60

7262.

Osteotomy or osteectomy of phalanx, metacarpal or metatarsal (S).....................

33.00

7266.

Osteotomy of phalanx, metacarpal or metatarsal, with internal fixation...................

30.00

7271.

Osteotomy or osteectomy of fibula, radius, ulna, clavicle, scapula (other than acromion), rib, tarsus or carpus 

30.00

7275.

Osteotomy of fibula, radius, ulna, clavicle, scapula (other than acromion), rib, tarsus or carpus, with internal fixation 

36.00

7280.

Osteotomy or osteectomy of tibia or humerus...................................

42.00

7284.

Osteotomy or osteectomy of femur or pelvic bone................................

69.00

7289.

Osteotomy of tibia, humerus, femur or pelvic bone, with internal fixation.................

105.00

7293.

Osteotomy of spines—sub-trochanteric.......................................

69.00

7297.

Osteectomy of vertebral bodies.............................................

66.00

7301.

Osteotomy and distraction for lengthening of limb................................

69.00

7305.

Removal of distracting apparatus from limb, without internal fixation...................

15.60

7309.

Removal of distracting apparatus from limb, with internal fixation......................

33.00

7313.

Flexor tendon of hand, primary suture of (G)....................................

13.20

7314.

Flexor tendon of hand, primary suture of (S)....................................

17.40

7318.

Flexor tendon of hand, secondary suture of (G)..................................

30.90


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 11.—Orthopaedic—continued

$

7319.

Flexor tendon of hand, secondary suture of (S)..................................

42.00

7323.

Extensor tendon of hand, primary suture of (G)..................................

16.20

7324.

Extensor tendon of hand, primary suture of (S)..................................

21.60

7328.

Extensor tendon of hand, secondary suture of (G)................................

20.10

7329.

Extensor tendon of hand, secondary suture of (S).................................

27.00

7333.

Achilles tendon or other large tendon, suture of (G)...............................

33.00

7334.

Achilles tendon or other large tendon, suture of (S)...............................

45.00

7338.

Tendon of foot, primary suture of (G)........................................

8.10

7339.

Tendon of foot, primary suture of (S)........................................

11.40

7343.

Tendon of foot, secondary suture of (G).......................................

13.20

7344.

Tendon of foot, secondary suture of (S).......................................

17.40

7348.

Tenotomy, subcutaneous, one or more tendons..................................

10.20

7352.

Tenotomy, open, with or without tenoplasty....................................

27.00

7356.

Tendon or ligament transplantation not covered by any other item......................

51.00

7360.

Iliopsoas tendon, transplantation of, to greater trochanter............................

87.00

7364.

Tendon graft.........................................................

42.00

7368.

Achilles tendon or other large tendon—operation for lengthening......................

30.00

7372.

Tendon sheath, incision of (G).............................................

8.10

7373.

Tendon sheath, incision of (S).............................................

11.40

7377.

Stenosing tendovaginitis, open operation for (G).................................

15.60

7378.

Stenosing tendovaginitis, open operation for (S).................................

21.00

7382.

Tendon sheath of finger or thumb, synovectomy of...............................

23.40

7386.

Cicatricial flexion contracture of joint, correction of, involving tissues deeper than skin and subcutaneous tissue 

36.00

7390.

Dupuytren’s contracture, subcutaneous fasciotomy (G).............................

13.20

7391.

Dupuytren’s contracture, subcutaneous fasciotomy (S).............................

17.40

7395.

Dupuytren’s contracture, radical operation for (G)................................

33.00

7396.

Dupuytren’s contracture, radical operation for (S)................................

45.00

7400.

Volkmann’s contracture, operation for........................................

42.00

 

Division 12.—Paediatric

 

 

Manipulations and Plaster Work for correction of Congenital Abnormalities

 

7450.

Congenital dislocation of hip—manipulation and plaster (one hip).....................

18.60

7454.

Talipes equinovarus—manipulation under general anaesthesia........................

4.40

7458.

Talipes equinovarus—manipulation and plaster under general anaesthesia................

4.50

7462.

Calcaneus valgus—manipulation under general anaesthesia..........................

4.40

7466.

Calcaneus valgus—manipulation and plaster under general anaesthesia..................

5.10

7470.

Pes planus—manipulation under general anaesthesia..............................

4.40

7474.

Pes planus—manipulation and plaster under general anaesthesia.......................

6.30

7478.

Genu varum or genu valgum—manipulation under general anaesthesia..................

4.40

7482.

Genu varum or genu valgum—manipulation and plaster under general anaesthesia...........

8.10

7486.

Genu varum or genu valgum—manipulation and plaster with osteoclasis.................

23.40

7490.

Contractures, manipulation under general anaesthesia not covered by any other item in this Part..

4.40

7494.

Contractures, manipulation and plaster under general anaesthesia, not covered by any other item in this Part 

6.30

7498.

Spastic paralysis—manipulation and plaster (one limb).............................

6.30

 

Operations for correction of Congenital Abnormalities

 

7510.

Subdural haemorrhage, tap for, each tap.......................................

4.40

7514.

Subdural haemorrhage, osteoplastic flap and excision of............................

75.00

7519.

Hydrocephalus—suboccipital decompression, third ventriculostomy or Torkildsen’s operation...

96.00

7523.

Ventriculo-jugular shunt.................................................

96.00

7528.

Ventriculo-atrial shunt for hydrocephalus......................................

96.00

7532.

Ventriculo-atrial shunt for hydrocephalus, revision or removal of......................

48.00

7537.

Hydrocephalus, spino-ureteral, spino-peritoneal or spino-pleural anastomosis of, or ventricular cable shunt for 

75.00

7541.

Craniostenosis, operation for..............................................

75.00

7545.

Arachnoidal cyst, operation for............................................

96.00


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

Division 12.—Paediatric—continued

$

7549.

Hypertelorism, correction of...............................................

96.00

7553.

Choanal atresia, repair of—transpalatine.......................................

63.00

7557.

Choanal atresia, repair of—intranasal.........................................

21.00

7561.

Macrocheilia, macroglossia or macrostomia, operation for...........................

48.00

7565.

Torticollis, operation for..................................................

36.00

7569.

Oesophagus, radical correction of congenital stenosis of.............................

114.00

7573.

Tracheo-oesophageal fistula, correction of......................................

114.00

7577.

Duodenal obstruction (congenital)—anastomosis or resection of.......................

75.00

7581.

Hypertrophic pyloric stenosis, operation for (G)..................................

37.50

7582.

Hypertrophic pyloric stenosis, operation for (S)..................................

51.00

7586.

Congenital volvulus of the small intestine, correction of.............................

63.00

7590.

Intestinal atresia or stenosis—excision or anastomosis (or both)........................

75.00

7594.

Hirschsprung’s disease, rectosigmoidectomy for..................................

96.00

7598.

Exomphalos, operation for................................................

48.00

7602.

Exomphalos, operation for, by plastic flap......................................

63.00

7607.

Imperforate anus, abdominoperineal correction of.................................

96.00

7611.

Imperforate anus, correction of (other than abdomino-perineal)........................

36.00

7616.

Contracted bladder neck (congenital), wedge excision or perurethral resection of............

63.00

7620.

Urachal fistula, operation for...............................................

36.00

7625.

Ectopic bladder—‘turning-in’ operation.......................................

96.00

7629.

Pinhole urinary meatus—meatotomy (G).......................................

8.10

7631.

Pinhole urinary meatus—meatotomy (S).......................................

11.40

7635.

Urethral valves, open removal of............................................

75.00

7640.

Incontinence of urine (congenital)—plastic operation to sphincter......................

54.00

7644.

Lymphangiectasis of limb (Milroy’s disease)—excision of...........................

48.00

 

Operations for Excision of Congenital Abnormalities

 

7649.

Abnormal limb, amputation of..............................................

27.00

7653.

Extra digit, amputation of (G)..............................................

8.10

7655.

Extra digit, amputation of (S)..............................................

11.40

7659.

Dermoid, periorbital, excision of (G).........................................

9.60

7661.

Dermoid, periorbital, excision of (S)..........................................

13.20

7665.

Dermoid, orbital, excision of...............................................

48.00

7670.

Dermoid of nose, superficial, excision of (G)....................................

8.10

7671.

Dermoid of nose, superficial, excision of (S)....................................

11.40

7676.

Dermoid of nose, excision of, with intranasal extension.............................

30.00

7680.

Sacrococcygeal dermoid or teratoma other than pilonidal sinus, excision of................

54.00

7685.

Myelomeningocele—excision of sac..........................................

48.00

 

Operations for Acquired Conditions

 

7700.

Megacolon, colectomy...................................................

75.00

7704.

Epiphysitis (Perthes’, Calve’s or Scheuermann’s) plaster for..........................

8.10

7708.

Epiphysitis (Sever’s, Kohler’s, Kienboch’s or Schlatter’s), plaster for....................

4.50

 

Division 13.—Plastic and Reconstructive

 

 

Meticulous Plastic Repair designed to obtain maximal Functional or Cosmetic Results including the preparation of the Defect requiring Repair

 

 

 

7750.

Derma-fat fascia graft (including transplant or muscle flap)...........................

36.00

7754.

Abrasive therapy, limited area..............................................

17.40

7758.

Abrasive therapy, extensive area............................................

30.00

7762.

Electrolysis epilation, each treatment.........................................

4.50

7767.

Angioma, cauterisation of or injection into, under general anaesthesia....................

4.40

7771.

Angioma of skin and subcutaneous tissue or mucous surface, small, excision and repair of......

13.20

7775.

Angioma of skin and subcutaneous tissue or mucous surface, large, excision and repair of......

15.60

7779.

Angioma involving deeper tissue, small, excision and repair of........................

21.00

7783.

Angioma involving deeper tissue, large, excision and repair of........................

33.00

7787.

Haemangioma of neck, deep-seated, excision of..................................

60.00

7791.

Major excision and grafting for lymph-oedema...................................

63.00

7795.

Foreign implants for contour reconstruction.....................................

30.00


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 13.—Plastic and Reconstructive—continued

 

 

Meticulous Plastic Repair of Limb (above Hand or Foot) or of Trunk designed to obtain maximal Functional or Cosmetic Results including the preparation of the Defect requiring Repair

 

7850.

Single stage local flap repair, simple, small......................................

21.00

7854.

Single stage local flap repair, complicated or large.................................

27.00

7858.

Direct flap repair (cross leg or similar), first stage.................................

21.00

7862.

Direct flap repair (cross leg or similar), second stage...............................

11.40

7866.

Direct flap repair, small, first stage...........................................

14.70

7870.

Direct flap repair, small, second stage.........................................

6.30

7874.

Indirect flap or tubed pedicle, formation of.....................................

23.40

7877.

Indirect flap or tubed pedicle, delay, intermediate transfer or detachment of................

14.70

7881.

Indirect flap or tubed pedicle, preparation of site and attachment to site...................

36.00

7885.

Indirect flap or tubed pedicle, spreading of pedicle, as a separate procedure................

21.00

7889.

Direct, indirect or local flap repair, revision of graft................................

14.70

7893.

Free grafts (split skin or pinch grafts) on granulating areas, small.......................

8.10

7897.

Free grafts (split skin) on granulating areas, extensive..............................

24.00

7901.

Free grafts (split skin) to extensive burns.......................................

36.00

7905.

Free grafts (split skin) including elective dissection, small...........................

16.20

7909.

Free grafts (split skin) including elective dissection, extensive.........................

36.00

7913.

Free full thickness grafts.................................................

30.00

7917.

Cineplasty for amputation stump............................................

48.00

7921.

Mammaplasty, reduction or repositioning (unilateral)...............................

96.00

7925.

Mammaplasty, augmentation, prosthetic (unilateral)...............................

81.00

7929.

Mammaplasty, derma-fat fascia (unilateral).....................................

96.00

 

Meticulous Plastic Repair of Hands, Feet, Scalp, Face or Neck designed to obtain maximal Functional or Cosmetic Results including the preparation of the Defect requiring Repair

 

7950.

Single stage local flap repair, simple, small.....................................

21.00

7952.

Single stage local flap repair following removal of tumour, cyst or scar, cutaneous, subcutaneous or in mucous membrane, up to 3 centimetres in diameter (G)             

24.00

7953.

Single stage local flap repair following removal of tumour, cyst or scar, cutaneous, subcutaneous or in mucous membrane, up to 3 centimetres in diameter (S)             

28.50

7954.

Single stage local flap repair, complicated or large................................

36.00

7958.

Direct flap repair, small (cross finger or similar), first stage...........................

21.00

7962.

Direct flap repair, small (cross finger or similar), second stage.........................

11.40

7966.

Indirect flap or tubed pedicle, formation of.....................................

30.00

7970.

Indirect flap or tubed pedicle, delay, intermediate transfer or detachment of ................

21.00

7974.

Indirect flap or tubed pedicle, preparation of site and attachment to site...................

48.00

7978.

Indirect flap or tubed pedicle, spreading of pedicle, as a separate procedure................

30.00

7982.

Direct, indirect or local flap repair, revision of graft................................

21.00

7986.

Hair transplants, multiple punch or similar technique, complete procedure.................

51.00

7990.

Hair transplants, multiple punch or similar technique, staged procedure involving more than fifteen transplants—each stage             

15.60

7994.

Free grafts (split skin or pinch grafts) on granulating areas, small.......................

11.40

7998.

Free grafts (split skin) on granulating areas, extensive..............................

33.00

8002.

Free grafts (split skin) to extensive burns.......................................

54.00

8007.

Free grafts (split skin) including elective dissection, small...........................

27.00

8011.

Free grafts (split skin) including elective dissection, extensive.........................

42.00

8015.

Free full thickness grafts.................................................

42.00

8020.

Digit, transplantation of—complete procedure...................................

75.00

8024.

Macrodactyly, plastic reduction of, each finger...................................

24.00

8029.

Face, operations involving supportive grafts.....................................

75.00

8033.

Suspension operation for facial paralysis.......................................

54.00

8037.

Melonoplasty.........................................................

147.00

8042.

Orbital cavity, reconstruction of floor or roof of..................................

51.00

8046.

Maxilla, resection of....................................................

96.00

8050.

Mandible, resection of...................................................

75.00

8054.

Mandible, segmental resection of, for tumours...................................

63.00

8058.

Mandible, section—fixation for prognathism or retrognathism.........................

63.00

8062.

Mandible, condylectomy.................................................

36.00


First Schedule—continued

Item No.

Medical service

Basic Commonwealth benefit

 

 

$

 

Division 13.—Plastic and Reconstructive—continued

 

8066.

Osteotomy or osteectomy of mandible (other than alveolar margins) for congenital malformation not covered by any other item in this Part             

30.00

8070.

Osteotomy or osteectomy of maxilla (other than alveolar margins) for congenital malformation not covered by any other item in this Part             

36.00

 

Meticulous Plastic Repair of Eyelids, Nose, Ears, Lips, Palate or Pharynx designed to obtain maximal Functional or Cosmetic Results including the preparation of the Defect requiring Repair

 

8110.

Single stage local flap repair, simple, small.....................................

27.00

8114.

Single stage local flap repair, complicated or large................................

42.00

8119.

Direct flap repair, first stage...............................................

48.00

8123.

Direct flap repair, second stage.............................................

27.00

8128.

Indirect flap or tubed pedicle, formation of.....................................

48.00

8132.

Indirect flap or tubed pedicle, delay, intermediate transfer or detachment of................

27.00

8136.

Indirect flap or tubed pedicle, preparation of site and attachment to site...................

63.00

8141.

Indirect flap or tubed pedicle, spreading of pedicle, as a separate procedure................

48.00

8145.

Direct, indirect or local flap repair, revision of graft................................

30.00

8150.

Free grafts (split skin or pinch grafts) on granulating areas, small.......................

17.40

8154

Free grafts (split skin) on granulating areas, extensive..............................

36.00

8159.

Free grafts (split skin) to extensive burns.......................................

75.00

8163.

Free grafts (split skin) including elective dissection, small...........................

36.00

8167

Free grafts (split skin) including elective dissection, extensive.........................

75.00

8172.

Free full thickness grafts.................................................

42.00

8176.

Whole thickness repair of eyelid............................................

63.00

8180.

Partial reconstruction of eyelid or socket.......................................

14.70

8184.

Correction of ptosis (unilateral).............................................

69.00

8188.

Ectropion or entropion, correction of (unilateral)..................................

33.00

8192.

Reduction of eyelid or eyelids of one eye.......................................

33.00

8196

Symblepharon, grafting for................................................

36.00

8200.

Rhinoplasty involving correction of bony or cartilaginous vault of the nose................

63.00

8204

Rhinoseptoplasty......................................................

75.00

8208.

Rhinoplasty, cosmetic, not covered by item 6584 or 6586............................

105.00

8212.

Rhinoplasty, secondary revision of...........................................

14.70

8216.

Rhinophyma. correction of................................................

36.00

8220.

Composite graft to nose or ear..............................................

27.00

8224.

Lop ear. bat ear or similar deformity, correction of................................

57.00

8228.

Pinna, amputation of, complete.............................................

19.20

8232.

Congenital atresia, reconstruction of external auditory canal..........................

63.00

8236.

Full thickness lip reconstruction, other than simple suture—complete procedure.............

42.00

8240.

Cleft lip, complete primary repair, unilateral....................................

69.00

8244.

Cleft lip, complete primary repair, one stage, bilateral..............................

93.00

8248.

Cleft lip, incomplete primary repair, unilateral...................................

36.00

8252.

Cleft lip, secondary correction, partial or incomplete...............................

27.00

8256.

Cleft lip, secondary correction, complete revision.................................

54.00

8260.

Cleft lip, secondary correction, Abbè flap......................................

129.00

8264.

Cleft lip, secondary correction of nostril or nasal tip...............................

21.60

8268.

Cleft palate, primary repair, partial cleft.......................................

69.00

8272.

Cleft palate, primary repair, complete cleft......................................

87.00

8276.

Cleft palate, secondary repair, incomplete......................................

36.00

8280.

Cleft palate, secondary repair, lengthening procedure...............................

63.00

8284

Cleft palate, partial repair, complex cleft.......................................

63.00

8288.

Pharyngeal flap or pharyngoplasty...........................................

75.00


SECOND SCHEDULE  Section 13.

TABLE OF FUND MEDICAL BENEFITS IN RESPECT OF NEW SOUTH WALES

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

2

1.60

0.80

355

11.60

4.00

3

2.15

1.20

357

16.00

5.00

9

4.25

2.50

370

4.40

2.50

11

6.50

3.00

371

5.00

3.00

13

2.00

1.50

375

5.40

3.00

15

9.00

3.00

376

6.60

3.00

17

12.00

3.00

378

7.80

3.00

18

3.75

1.50

379

9.40

3.00

24

1.10

3.30

381

8.20

3.00

37

8.50

3.00

382

9.80

3.00

38

13.00

4.00

384

13.00

4.00

39

17.50

5.00

386

17.40

5.00

40

22.50

5.00

388

10.00

3.00

43

1.60

0.80

389

11.20

4.00

45

1.50

1.50

391

10.40

3.00

203

1.60

0.80

392

11.60

4.00

206

12.40

4.00

394

14.80

5.00

209

11.60

4.00

396

11.80

4.00

210

36.00

5.00

397

13.40

4.00

220

12.80

4.00

399

12.20

4.00

223

21.00

5.00

400

13.80

4.00

224

56.00

5.00

402

17.00

5.00

226

22.40

5.00

430

2.60

1.50

227

55.00

5.00

435

4.20

2.50

230

29.00

5.00

436

5.00

3.00

231

56.50

5.00

451

5.40

3.00

235

36.00

5.00

455

3.60

2.50

236

58.00

5.00

456

4.80

3.00

243

1.00

0.80

501

3.80

2.50

247

1.00

0.80

601

2.20

1.50

251

7.80

3.00

611

2.90

1.50

252

10.40

4.00

616

4.60

2.50

255

2.60

1.50

621

11.60

4.00

256

3.40

2.50

625

10.40

4.00

259

1.00

0.80

631

3.40

2.50

263

3.40

2.50

641

5.40

3.00

267

2.60

1.50

651

8.40

3.00

268

3.40

2.50

661

11.60

4.00

271

3.40

2.50

681

2.70

1.50

275

15.60

5.00

691

2.00

1.50

279

5.40

3.00

701

3.00

2.50

283

17.20

5.00

703

1.80

1.50

287

2.60

1.50

705

6.00

3.00

288

3.40

2.50

707

2.20

1.50

291

7.60

3.00

708

1.40

1.50

301

2.00

1.50

715

2.40

1.50

302

2.80

1.50

721

2.50

1.50

305

3.00

1.50

731

9.80

3.00

306

3.40

2.50

741

3.40

2.50

309

5.40

3.00

751

5.00

3.00

310

6.80

3.00

761

28.00

5.00

313

7.60

3.00

771

42.00

5.00

317

11.60

4.00

781

32.00

5.00

321

1.20

0.80

791

7.60

3.00

323

3.80

2.50

801

6.20

3.00

341

3.00

2.50

831

1.60

1.50

342

3.80

2.50

841

3.00

1.50

344

4.20

2.50

851

2.80

1.50

345

5.20

3.00

861

4.60

2.50

347

6.40

3.00

866

7.60

3.00

348

8.00

3.00

871

5.40

3.00

351

6.80

3.00

881

3.40

2.50

352

8.40

3.00

891

14.00

4.00


Second Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

901

11.60

4.00

1106

1.40

1.50

906

14.00

4.00

1108

2.00

1.50

911

2.70

1.50

1110

4.80

3.00

915

6.80

3.00

1112

0.70

0.80

921

0.90

0.80

1114

1.20

0.80

931

0.60

0.80

1116

4.60

2.50

941

1.00

0.80

1118

1.40

1.50

943

1.20

1.00

1120

3.80

2.50

945

1.80

1.50

1122

2.20

1.50

951

2.90

1.50

1124

1.40

1.50

961

1.60

1.50

1126

1.80

1.50

971

7.60

3.00

1128

1.20

0.80

976

15.60

5.00

1130

2.60

1.50

981

3.00

2.50

1132

1.40

1.50

985

3.80

2.50

1134

2.60

1.50

1000

0.70

0.80

1136

3.80

2.50

1002

1.20

0.80

1138

1.40

1.50

1004

1.50

1.00

1140

2.20

1.50

1006

0.90

0.80

1142

2.40

1.50

1008

0.70

0.80

1144

1.40

1.50

1010

1.40

1.00

1146

1.40

1.50

1012

3.00

2.50

1148

2.20

1.50

1014

2.40

1.50

1150

3.80

2.50

1016

2.60

1.50

1152

2.20

1.50

1018

3.80

2.50

1154

1.80

1.50

1020

8.20

3.00

1156

1.80

1.50

1022

0.70

0.80

1160

2.20

1.50

1024

2.00

1.00

1162

2.60

1.50

1026

1.20

0.80

1164

3.00

1.50

1028

2.70

1.50

1166

3.00

1.50

1030

2.60

1.50

1168

3.00

2.50

1032

2.70

1.50

1170

3.40

2.50

1034

1.40

1.50

1172

0.90

0.80

1036

2.20

1.50

1174

1.40

1.50

1038

2.60

1.50

1176

1.80

1.50

1040

2.60

1.50

1180

1.40

1.50

1042

2.20

1.50

1182

2.00

1.00

1044

3.00

2.50

1184

2.20

1.50

1046

1.20

1.00

1186

0.70

0.80

1048

4.60

2.50

1188

1.40

1.50

1050

3.00

2.50

1190

2.20

1.50

1052

8.80

3.00

1192

2.20

1.50

1054

1.50

1.00

1194

2.20

1.50

1060

0.70

0.80

1196

2.20

1.50

1062

1.40

1.00

1198

2.20

1.50

1064

0.70

0.80

1200

2.00

1.00

1066

1.80

1.50

1202

2.40

1.50

1068

2.00

1.50

1204

1.40

1.00

1070

1.80

1.50

1206

2.60

1.50

1072

2.20

1.50

1208

2.20

1.50

1074

7.60

3.00

1210

2.20

1.50

1076

0.90

0.80

1212

3.00

1.50

1080

1.20

0.80

1214

2.00

1.00

1082

1.80

1.50

1216

1.60

1.50

1084

8.80

3.00

1218

3.00

1.50

1090

1.40

1.50

1220

4.00

2.50

1092

1.40

1.50

1222

4.00

2.50

1094

1.40

1.50

1224

6.80

3.00

1096

1.20

1.00

1226

8.80

3.00

1098

1.60

1.50

1228

3.00

1.50

1100

2.00

1.50

1230

4.00

2.50

1102

3.00

2.50

1232

2.20

1.50

1104

1.50

1.00

1234

3.80

2.50


Second Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

1236

4.80

3.00

1397

2.40

1.50

1238

6.00

3.00

1399

0.70

0.80

1240

1.40

1.50

1401

1.40

1.50

1242

2.60

1.50

1404

1.20

0.80

1244

4.20

2.50

1407

2.20

1.50

1246

4.00

2.50

1410

1.40

1.50

1248

1.20

0.80

1413

1.40

1.50

1250

2.20

1.50

1416

2.60

1.50

1252

3.80

2.50

1419

1.40

1.50

1254

5.20

3.00

1421

1.80

1.50

1256

6.80

3.00

1423

1.80

1.50

1258

8.40

3.00

1425

3.00

2.50

1260

2.20

1.50

1428

1.80

1.50

1262

3.40

2.50

1430

4.00

2.50

1264

2.20

1.50

1432

8.80

3.00

1266

3.80

2.50

1434

2.20

1.50

1268

5.20

3.00

1436

2.60

1.50

1270

6.80

3.00

1438

8.80

3.00

1272

3.00

1.50

1441

2.80

1.50

1274

8.80

3.00

1444

2.20

1.50

1276

4.80

3.00

1447

4.00

2.50

1278

2.20

1.50

1450

3.40

2.50

1280

3.80

2.50

1453

2.20

1.50

1282

5.20

3.00

1456

3.00

1.50

1284

6.80

3.00

1459

2.20

1.50

1286

8.40

3.00

1461

3.80

2.50

1288

3.00

2.50

1463

5.20

3.00

1290

4.60

2.50

1466

6.80

3.00

1292

4.60

2.50

1468

2.00

1.50

1294

2.20

1.50

1470

2.20

1.50

1296

1.40

1.50

1472

3.00

2.50

1298

3.80

2.50

1474

8.80

3.00

1301

2.20

1.50

1476

3.20

2.50

1302

3.80

2.50

1478

2.80

1.50

1304

5.20

3.00

1481

2.80

1.50

1305

6.80

3.00

1484

6.80

3.00

1307

8.40

3.00

1487

3.20

2.50

1310

2.20

1.50

1490

3.20

2.50

1313

1.40

1.50

1491

2.00

1.50

1316

2.20

1.50

1493

6.80

3.00

1319

3.60

2.50

1494

8.80

3.00

1322

1.50

1.00

1495

0.90

0.80

1325

0.90

0.80

1496

1.40

1.50

1328

1.40

1.50

1497

3.40

2.50

1331

4.00

2.50

1499

3.00

2.50

1334

2.60

1.50

1500

0.70

0.80

1337

4.20

2.50

1502

1.20

0.80

1340

6.00

3.00

1504

1.20

0.80

1343

4.20

2.50

1506

1.80

1.50

1346

6.80

3.00

1508

1.50

1.00

1349

2.80

1.50

1511

1.40

1.50

1352

3.00

1.50

1513

1.40

1.00

1355

3.00

1.50

1515

2.40

1.50

1358

1.80

1.50

1517

3.20

2.50

1380

1.70

0.80

1519

4.00

2.50

1382

1.50

1.00

1521

5.00

3.00

1385

2.20

1.50

1523

5.00

3.00

1388

3.80

2.50

1525

2.40

1.50

1389

4.80

3.00

1527

3.00

2.50

1391

3.00

2.50

1529

1.80

1.50

1392

4.80

3.00

1531

3.40

2.50

1394

6.00

3.00

1534

1.40

1.50

1395

0.90

0.80

1537

2.60

1.50


Second Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

1539

1.80

1.50

1714

2.20

1.50

1541

1.40

1.50

1716

0.90

0.80

1543

1.80

1.50

1718

3.00

1.50

1545

0.70

0.80

1720

6.00

3.00

1546

3.00

2.50

1722

9.60

3.00

1548

4.80

3.00

1724

1.40

1.50

1551

3.00

2.50

1726

3.00

2.50

1554

5.40

3.00

1728

4.80

3.00

1557

8.00

3.00

1730

3.00

2.50

1560

5.40

3.00

1732

1.20

0.80

1562

4.80

3.00

1734

2.00

1.50

1564

7.40

3.00

1736

6.80

3.00

1566

6.40

3.00

1738

0.90

0.80

1568

9.00

3.00

1741

2.20

1.50

1571

2.80

1.50

1744

0.90

0.80

1580

1.40

1.50

1746

2.20

1.50

1582

1.60

1.50

1748

2.20

1.50

1584

3.00

2.50

1761

1.20

1.00

1586

2.00

1.00

1764

2.20

1.50

1588

2.20

1.50

1767

0.90

0.80

1590

2.20

1.50

1770

2.20

1.50

1601

2.20

1.50

1773

2.60

1.50

1604

3.80

2.50

1776

3.80

2.50

1607

5.20

3.00

1779

2.00

1.00

1609

6.80

3.00

1782

2.00

1.00

1611

2.00

1.50

1785

2.00

1.00

1613

2.80

1.50

1790

1.40

1.50

1615

3.00

1.50

1792

1.40

1.50

1616

3.00

2.50

1794

3.00

2.50

1621

0.90

0.80

1796

3.00

2.50

1623

1.80

1.50

1798

1.40

1.50

1625

1.10

0.80

1800

1.10

0.80

1627

2.20

1.50

1802

3.20

2.50

1629

1.80

1.50

1804

4.80

3.00

1631

1.40

1.50

1806

2.20

1.50

1640

4.60

2.50

1808

4.80

3.00

1643

2.40

1.50

1810

2.20

1.50

1645

2.40

1.50

1812

2.20

1.50

1647

8.80

3.00

1820

3.80

2.50

1649

6.00

3.00

1822

6.00

3.00

1651

8.80

3.00

1824

8.40

3.00

1653

3.00

2.50

1826

8.40

3.00

1661

2.00

1.00

1828

10.40

4.00

1664

4.80

3.00

1840

12.40

4.00

1667

2.20

1.50

1841

16.00

5.00

1670

2.20

1.50

1843

4.60

2.50

1673

3.00

1.50

1846

3.00

2.50

1680

0.70

0.80

1849

3.00

2.50

1682

1.20

0.80

1850

3.80

2.50

1684

0.90

0.80

1852

3.80

2.50

1686

1.10

0.80

1855

4.80

3.00

1688

1.40

1.50

1858

6.00

3.00

1691

1.40

1.50

1861

4.20

2.50

1694

1.80

1.50

1863

4.80

3.00

1697

2.80

1.50

1865

14.00

5.00

1698

3.80

2.50

1867

4.60

2.50

1700

1.40

1.50

1869

3.80

2.50

1701

5.60

3.00

1871

6.80

3.00

1703

1.40

1.50

1873

14.00

5.00

1706

1.40

1.50

1875

4.80

3.00

1707

2.60

1.50

1877

4.80

3.00

1710

0.70

0.80

1879

4.60

2.50

1712

2.20

1.50

1881

3.60

2.50


Second Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

1884

3.00

2.50

2144

3.80

2.50

1887

3.00

2.50

2160

3.40

2.50

1889

12.40

4.00

2164

11.60

4.00

1891

1.40

1.50

2169

8.80

3.00

1893

3.40

2.50

2173

4.80

3.00

1901

2.20

1.50

2177

5.40

3.00

1903

3.00

2.50

2181

6.80

3.00

1905

3.00

2.50

2185

3.80

2.50

1907

4.80

3.00

2200

3.40

2.50

1909

4.00

2.50

2205

3.40

2.50

1911

6.00

3.00

2209

4.60

2.50

1913

1.80

1.50

2214

7.80

3.00

1915

2.00

1.50

2218

9.20

3.00

1921

6.00

3.00

2222

6.80

3.00

1923

7.20

3.00

2226

7.80

3.00

1925

8.40

3.00

2230

8.80

3.00

1941

8.80

3.00

2234

5.60

3.00

1943

3.00

2.50

2238

6.00

3.00

1945

3.00

2.50

2247

7.60

3.00

1947

3.40

2.50

2250

5.40

3.00

1949

2.20

1.50

2254

1.40

1.50

1951

3.00

2.50

2270

6.80

3.00

1953

3.00

2.50

2274

3.80

2.50

1955

3.40

2.50

2290

3.40

2.50

1957

6.00

3.00

2294

6.80

3.00

1959

6.00

3.00

2298

5.40

3.00

1961

4.80

3.00

2310

6.80

3.00

1963

3.00

2.50

2314

9.80

3.00

1965

4.60

2.50

2318

9.80

3.00

1967

4.60

2.50

2322

9.80

3.00

1969

4.60

2.50

2326

5.40

3.00

1971

6.80

3.00

2330

3.80

2.50

1973

6.00

3.00

2334

9.20

3.00

1975

4.60

2.50

2338

6.80

3.00

1977

4.80

3.00

2342

7.60

3.00

1979

3.00

2.50

2346

4.60

2.50

1981

4.80

3.00

2350

8.80

3.00

1983

4.80

3.00

2354

10.40

4.00

2010

2.60

1.50

2358

4.00

2.50

2014

3.00

1.50

2362

1.60

1.50

2018

3.20

1.50

2367

1.60

1.50

2022

3.00

2.50

2371

5.40

3.00

2026

3.00

2.50

2410

4.80

3.00

2040

3.20

2.50

2420

0.90

0.80

2044

3.40

2.50

2440

3.40

2.50

2048

4.00

2.50

2444

2.20

1.50

2052

6.80

3.00

2460

1.60

1.50

2060

3.80

2.50

2464

2.40

1.50

2064

3.80

2.50

2468

4.60

2.50

2068

3.80

2.50

2510

24.00

5.00

2072

3.00

2.50

2514

24.00

5.00

2076

4.80

3.00

2518

8.00

3.00

2081

3.40

2.50

2522

14.00

4.00

2091

4.00

2.50

2526

32.00

5.00

2094

5.40

3.00

2530

24.00

5.00

2098

9.80

3.00

2534

11.60

4.00

2110

3.00

2.50

2538

15.60

5.00

2114

3.40

2.50

2542

5.40

3.00

2119

3.00

2.50

2570

11.60

4.00

2123

1.60

1.50

2574

2578

2620

2624

5.40

5.40

12.40

10.40

3.00

3.00

4.00

4.00

2128

3.80

2.50

2132

3.80

2.50

2136

4.60

2.50

2140

3.00

2.50


Second Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

2628

10.40

4.00

3131

16.00

5.00

2632

16.00

5.00

3132

22.00

5.00

2636

3.00

2.50

3137

3.00

2.50

2640

4.80

3.00

3138

11.80

3.00

2644

4.80

3.00

3143

5.40

3.00

2648

3.80

2.50

3144

8.80

3.00

2652

3.80

2.50

3149

11.60

4.00

2657

4.80

3.00

3150

16.00

5.00

2661

4.00

2.50

3155

18.00

5.00

2666

2.40

1.50

3156

22.00

5.00

2670

3.80

2.50

3161

34.00

5.00

2674

3.00

2.50

3162

52.00

5.00

2678

3.00

2.50

3166

48.00

5.00

2682

6.80

3.00

3170

8.80

3.00

2686

1.40

1.50

3174

2.90

1.50

2691

10.40

4.00

3178

2.00

1.50

2696

5.40

3.00

3180

3.00

2.50

2700

4.60

2.50

3184

2.90

1.50

2901

3.80

2.50

3185

4.20

2.50

2904

5.20

3.00

3190

3.40

2.50

2907

6.80

3.00

3191

5.20

3.00

2910

8.80

3.00

3196

4.60

2.50

2913

12.40

4.00

3197

5.80

3.00

3000

1.60

0.80

3201

5.40

3.00

3004

1.40

1.50

3202

6.80

3.00

3005

2.00

1.50

3206

7.80

3.00

3009

2.65

1.50

3207

10.40

4.00

3011

3.40

2.50

3211

1.40

1.00

3015

5.80

3.00

3216

1.40

1.00

3017

8.00

3.00

3220

5.40

3.00

3021

2.90

1.50

3221

12.80

4.00

3025

5.40

3.00

3225

5.40

3.00

3030

4.80

3.00

3226

7.60

3.00

3034

7.60

3.00

3230

10.60

3.00

3039

5.40

3.00

3232

14.00

4.00

3043

6.80

3.00

3236

10.60

3.00

3045

9.40

3.00

3238

14.00

4.00

3049

5.40

3.00

3242

5.40

3.00

3051

7.60

3.00

3244

7.60

3.00

3055

7.00

3.00

3248

5.80

3.00

3056

9.80

3.00

3250

8.00

3.00

3061

1.50

1.00

3254

17.60

5.00

3064

2.90

1.50

3255

24.00

5.00

3065

6.80

3.00

3259

24.00

5.00

3069

9.80

3.00

3263

50.00

5.00

3070

14.00

5.00

3267

13.40

4.00

3074

3.00

2.50

3269

18.00

5.00

3078

5.40

3.00

3273

34.00

5.00

3080

7.60

3.00

3274

46.00

5.00

3084

3.00

1.50

3279

16.00

5.00

3089

6.80

3.00

3280

22.00

5.00

3093

1.60

1.50

3285

2.65

1.50

3097

7.00

3.00

3286

3.40

2.50

3099

9.80

3.00

3291

7.00

3.00

3103

4.00

2.50

3292

9.80

3.00

3104

5.40

3.00

3297

2.00

1.50

3108

7.00

3.00

3298

2.90

1.50

3110

9.80

3.00

3303

5.40

3.00

3115

2.00

1.50

3304

7.60

3.00

3119

7.60

3.00

3309

7.60

3.00

3121

16.40

5.00

3313

37.00

5.00

3125

27.40

5.00

3315

50.00

5.00

3126

38.00

5.00

3319

2.00

1.50


Second Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

3323

10.60

3.00

3528

28.00

5.00

3324

14.00

4.00

3529

38.00

5.00

3328

13.40

4.00

3534

23.60

5.00

3329

18.00

5.00

3535

32.00

5.00

3334

26.60

5.00

3539

43.00

5.00

3335

36.00

5.00

3541

58.00

5.00

3340

50.00

5.00

3545

78.00

5.00

3344

86.00

5.00

3550

20.60

5.00

3348

19.00

5.00

3551

28.00

5.00

3349

26.00

5.00

3556

86.00

5.00

3353

42.00

5.00

3560

28.00

5.00

3357

62.00

5.00

3561

38.00

5.00

3361

38.00

5.00

3566

28.00

5.00

3362

46.00

5.00

3567

38.00

5.00

3367

23.60

5.00

3572

14.60

5.00

3368

32.00

5.00

3573

20.00

5.00

3372

26.60

5.00

3577

17.60

5.00

3373

36.00

5.00

3578

24.00

5.00

3377

34.00

5.00

3582

46.00

5.00

3378

46.00

5.00

3583

62.00

5.00

3383

24.00

5.00

3588

11.60

4.00

3387

18.00

5.00

3589

15.60

5.00

3392

20.60

5.00

3593

20.60

5.00

3393

28.00

5.00

3594

28.00

5.00

3397

46.00

5.00

3598

46.00

5.00

3402

10.40

4.00

3599

62.00

5.00

3406

22.00

5.00

3604

20.60

5.00

3408

30.00

5.00

3605

28.00

5.00

3412

11.60

4.00

3609

26.60

5.00

3414

21.00

5.00

3610

36.00

5.00

3418

17.20

5.00

3614

46.00

5.00

3419

22.00

5.00

3615

62.00

5.00

3423

17.20

5.00

3620

46.00

5.00

3424

22.00

5.00

3624

24.00

5.00

3428

46.00

5.00

3626

28.00

5.00

3430

62.00

5.00

3630

25.00

5.00

3434

5.40

3.00

3632

34.00

5.00

3436

7.60

3.00

3636

11.60

4.00

3440

24.00

5.00

3640

5.40

3.00

3442

30.00

5.00

3645

86.00

5.00

3446

30.00

5.00

3649

20.60

5.00

3448

38.00

5.00

3651

28.00

5.00

3452

31.00

5.00

3655

31.00

5.00

3454

42.00

5.00

3656

42.00

5.00

3458

23.60

5.00

3661

31.00

5.00

3460

32.00

5.00

3662

42.00

5.00

3464

42.00

5.00

3667

50.00

5.00

3469

86.00

5.00

3671

32.00

5.00

3473

32.00

5.00

3675

7.60

3.00

3478

42.00

5.00

3680

1.80

1.50

3482

42.00

5.00

3681

2.60

1.50

3486

42.00

5.00

3686

86.00

5.00

3487

54.00

5.00

3690

24.00

5.00

3491

23.60

5.00

3691

30.00

5.00

3492

32.00

5.00

3696

50.00

5.00

3497

50.00

5.00

3700

70.00

5.00

3498

62.00

5.00

3704

17.60

5.00

3502

58.00

5.00

3705

24.00

5.00

3506

86.00

5.00

3709

20.60

5.00

3510

11.60

4.00

3710

28.00

5.00

3514

22.00

5.00

3714

28.00

5.00

3519

28.00

5.00

3716

34.00

5.00

3523

46.00

5.00

3720

1.40

1.50


Second Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

3721

2.00

1.50

3917

26.00

5.00

3726

14.00

5.00

3920

38.00

5.00

3727

18.00

5.00

3921

8.80

3.00

3731

14.60

5.00

3923

11.60

4.00

3732

20.00

5.00

3926

24.00

5.00

3736

20.60

5.00

3927

34.00

5.00

3737

28.00

5.00

3931

20.00

5.00

3741

24.00

5.00

3932

30.00

5.00

3742

32.00

5.00

3936

14.60

5.00

3746

4.00

2.50

3937

20.00

5.00

3747

5.40

3.00

3941

50.00

5.00

3751

2.20

1.50

3945

3.00

1.50

3755

3.40

2.50

3949

1.75

1.50

3756

6.80

3.00

3951

2.50

1.50

3760

7.00

3.00

3955

4.60

2.50

3761

9.80

3.00

3957

6.20

3.00

3765

2.90

1.50

3961

14.60

5.00

3769

2.60

1.50

3963

20.00

5.00

3770

3.00

2.50

3967

28.00

5.00

3771

9.60

3.00

3971

32.00

5.00

3772

12.80

4.00

3975

46.00

5.00

3773

21.60

5.00

3979

58.00

5.00

3774

33.00

5.00

3983

86.00

5.00

3776

7.60

3.00

3987

78.00

5.00

3780

32.00

5.00

3991

86.00

5.00

3784

68.00

5.00

3995

42.00

5.00

3788

78.00

5.00

3999

42.00

5.00

3792

2.00

1.50

4004

98.00

5.00

3796

9.40

3.00

4008

86.00

5.00

3797

12.40

4.00

4013

86.00

5.00

3801

2.20

1.50

4017

86.00

5.00

3805

5.40

3.00

4022

42.00

5.00

3806

7.60

3.00

4026

50.00

5.00

3811

14.60

5.00

4031

32.00

5.00

3812

20.00

5.00

4035

32.00

5.00

3817

1.40

1.50

4040

16.00

5.00

3821

3.40

2.50

4050

2.60

1.50

3826

25.00

5.00

4051

3.40

2.50

3827

35.00

5.00

4055

5.80

3.00

3832

4.80

3.00

4056

8.00

3.00

3836

7.60

3.00

4060

10.60

3.00

3838

16.00

5.00

4061

14.00

4.00

3842

14.60

5.00

4065

17.60

5.00

3844

20.00

5.00

4066

24.00

5.00

3848

17.60

5.00

4070

14.60

5.00

3850

24.00

5.00

4071

20.00

5.00

3854

6.40

3.00

4075

17.60

5.00

3856

8.80

3.00

4076

24.00

5.00

3860

24.00

5.00

4090

5.80

3.00

3865

42.00

5.00

4091

8.00

3.00

3869

22.00

5.00

4095

17.60

5.00

3874

4.20

2.50

4096

24.00

5.00

3878

17.60

5.00

4101

17.60

5.00

3880

24.00

5.00

4102

24.00

5.00

3883

20.00

5.00

4107

31.00

5.00

3884

24.00

5.00

4108

42.00

5.00

3888

6.00

3.00

4113

23.60

5.00

3900

1.40

1.50

4114

32.00

5.00

3904

6.00

3.00

4119

17.60

5.00

3908

4.80

3.00

4120

24.00

5.00

3909

6.80

3.00

4125

31.00

5.00

3914

10.40

4.00

4126

42.00

5.00

3915

14.00

5.00

4150

10.40

4.00


Second Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

4151

14.00

5.00

4408

10.40

4.00

4156

1.40

1.00

4412

8.80

3.00

4157

1.80

1.50

4416

11.60

4.00

4161

8.80

3.00

4420

1.80

1.50

4162

11.60

4.00

4424

1.60

1.50

4166

14.60

5.00

4428

30.00

5.00

4167

20.00

5.00

4432

46.00

5.00

4171

17.60

5.00

4436

18.00

5.00

4172

24.00

5.00

4440

7.60

3.00

4176

31.00

5.00

4444

42.00

5.00

4177

42.00

5.00

4448

42.00

5.00

4182

64.00

5.00

4450

26.00

5.00

4183

86.00

5.00

4452

3.40

2.50

4188

4.80

3.00

4456

44.00

5.00

4189

6.80

3.00

4460

3.40

2.50

4194

1.40

1.50

4464

20.00

5.00

4195

2.00

1.50

4468

42.00

5.00

4200

7.00

3.00

4472

64.00

5.00

4201

9.80

3.00

4476

2.40

1.50

4206

17.60

5.00

4480

7.60

3.00

4207

24.00

5.00

4484

4.80

3.00

4212

14.60

5.00

4488

42.00

5.00

4213

20.00

5.00

4492

50.00

5.00

4218

23.60

5.00

4496

50.00

5.00

4219

32.00

5.00

4498

8.00

3.00

4224

34.00

5.00

4499

26.00

5.00

4225

46.00

5.00

4501

9.80

3.00

4230

38.60

5.00

4502

27.00

5.00

4231

52.00

5.00

4504

9.05

3.00

4236

108.00

5.00

4505

27.00

5.00

4300

4.80

3.00

4507

11.60

4.00

4304

6.40

3.00

4508

26.00

5.00

4305

8.80

3.00

4513

2.65

1.50

4309

7.80

3.00

4514

3.40

2.50

4311

10.40

4.00

4519

5.40

3.00

4315

68.00

5.00

4520

12.80

4.00

4320

68.00

5.00

4525

7.20

3.00

4324

38.00

5.00

4526

13.40

4.00

4328

78.00

5.00

4528

5.40

3.00

4333

50.00

5.00

4529

4.20

2.50

4337

76.00

5.00

4533

2.00

1.50

4342

86.00

5.00

4538

24.00

5.00

4346

42.00

5.00

4542

16.00

5.00

4350

78.00

5.00

4545

24.80

5.00

4355

50.00

5.00

4547

20.00

5.00

4359

3.00

1.50

4551

24.00

5.00

4360

4.80

3.00

4555

15.60

5.00

4364

30.00

5.00

4559

11.60

4.00

4368

16.00

5.00

4563

64.00

5.00

4372

2.90

1.50

4567

12.40

4.00

4376

6.80

3.00

4571

14.00

5.00

4381

3.00

2.50

4575

15.60

5.00

4385

4.80

2.50

4579

12.40

4.00

4389

3.60

2.50

4583

28.00

5.00

4390

4.80

3.00

4587

42.00

5.00

4394

10.40

4.00

4591

42.00

5.00

4395

14.00

5.00

4595

52.00

5.00

4399

30.00

5.00

4599

42.00

5.00

4400

31.05

5.00

4604

12.00

4.00

4401

33.00

5.00

4605

16.00

5.00

4402

35.00

5.00

4610

11.60

4.00

4403

1.60

1.50

4614

8.80

3.00

4404

4.80

3.00

4616

11.60

4.00


Second Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

 

$

 

$

$

4620

15.60

5.00

5149

18.00

5.00

4625

17.60

5.00

5153

42.00

5.00

4626

24.00

5.00

5157

34.00

5.00

4710

42.00

5.00

5161

50.00

5.00

4714

42.00

5.00

5165

24.00

5.00

4719

108.00

5.00

5170

38.00

5.00

4723

78.00

5.00

5174

15.60

5.00

4727

52.00

5.00

5178

42.00

5.00

4728

70.00

5.00

5182

52.00

5.00

4732

78.00

5.00

5186

10.40

4.00

4735

50.00

5.00

5190

4.80

3.00

4739

38.00

5.00

5194

24.00

5.00

4743

83.00

5.00

5198

50.00

5.00

4747

42.00

5.00

5202

64.00

5.00

4751

42.00

5.00

5206

20.00

5.00

4755

24.00

5.00

5220

9.80

3.00

4759

24.00

5.00

5223

13.40

4.00

4763

58.00

5.00

5224

18.00

5.00

4767

42.00

5.00

5228

14.00

5.00

4771

40.00

5.00

5232

64.00

5.00

4775

32.00

5.00

5236

24.00

5.00

4779

48.00

5.00

5240

22.00

5.00

4783

64.00

5.00

5244

42.00

5.00

4787

76.00

5.00

5248

10.40

4.00

4810

1.60

1.50

5252

14.00

4.00

4814

9.80

3.00

5256

50.00

5.00

4819

11.60

4.00

5260

12.00

4.00

4823

3.40

2.50

5261

16.00

5.00

4827

15.60

5.00

5310

2.80

1.50

4831

14.00

5.00

5311

4.80

3.00

4835

20.00

5.00

5316

4.00

2.50

4839

18.00

5.00

5317

5.40

3.00

4843

14.00

5.00

5322

4.00

2.50

4847

24.00

5.00

5323

5.40

3.00

4851

24.00

5.00

5328

9.40

3.00

4855

22.00

5.00

5329

12.40

4.00

4910

23.60

5.00

5334

7.00

3.00

4911

32.00

5.00

5335

9.80

3.00

4916

13.40

4.00

5340

2.65

1.50

4917

18.00

5.00

5341

3.40

2.50

4922

50.00

5.00

5346

5.40

3.00

4926

86.00

5.00

5350

2.65

1.50

4931

42.00

5.00

5352

3.40

2.50

4935

42.00

5.00

5356

7.00

3.00

4939

56.00

5.00

5358

9.80

3.00

4944

24.00

5.00

5362

18.00

5.00

5010

78.00

5.00

5367

24.00

5.00

5014

100.00

5.00

5371

64.00

5.00

5019

34.00

5.00

5376

50.00

5.00

5023

86.00

5.00

5380

2.70

1.50

5028

20.00

5.00

5385

50.00

5.00

5032

30.00

5.00

5387

50.00

5.00

5037

3.00

2.50

5394

28.00

5.00

5041

20.00

5.00

5398

7.80

3.00

5110

2.60

1.50

5399

10.40

4.00

5114

4.80

3.00

5403

5.80

3.00

5118

31.00

5.00

5404

8.00

3.00

5120

42.00

5.00

5408

22.00

5.00

5124

9.80

3.00

5410

30.00

5.00

5128

9.80

3.00

5414

28.00

5.00

5132

11.60

4.00

5416

38.00

5.00

5136

4.80

3.00

5419

34.00

5.00

5140

42.00

5.00

5420

42.00

5.00

5145

20.00

5.00

5422

38.60

5.00


Second Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

5423

48.00

5.00

5610

3.00

2.50

5425

11.60

4.00

5614

17.60

5.00

5429

50.00

5.00

5616

24.00

5.00

5434

48.00

5.00

5620

44.00

5.00

5438

2.60

1.50

5625

24.00

5.00

5439

3.00

2.50

5631

46.00

5.00

5443

3.00

1.50

5635

42.00

5.00

5444

3.40

2.50

5640

46.00

5.00

5448

4.20

2.50

5644

28.00

5.00

5451

10.40

4.00

5649

58.00

5.00

5452

14.00

5.00

5653

46.00

5.00

5453

14.60

5.00

5658

50.00

5.00

5454

20.00

5.00

5662

7.60

3.00

5457

8.80

3.00

5667

3.00

1.50

5458

11.60

4.00

5668

3.40

2.50

5462

4.00

2.50

5673

14.00

4.00

5463

9.20

3.00

5677

18.00

5.00

5467

6.80

3.00

5681

20.00

5.00

5471

8.00

3.00

5685

42.00

5.00

5472

10.40

4.00

5689

46.00

5.00

5475

9.60

3.00

5693

42.00

5.00

5477

12.40

4.00

5697

28.00

5.00

5481

9.80

3.00

5701

4.00

2.50

5483

12.60

4.00

5702

11.80

3.00

5487

10.60

3.00

5706

7.60

3.00

5489

13.60

4.00

5710

8.00

3.00

5493

14.60

5.00

5714

1.60

0.80

5495

20.00

5.00

5718

2.65

1.50

5499

34.00

5.00

5719

3.40

2.50

5501

46.00

5.00

5723

12.80

4.00

5505

34.00

5.00

5727

15.60

5.00

5507

46.00

5.00

5731

3.40

2.50

5511

38.60

5.00

5735

98.00

5.00

5512

52.00

5.00

5739

64.00

5.00

5513

54.00

5.00

5742

58.00

5.00

5515

78.00

5.00

5746

3.60

2.50

5518

47.00

5.00

5750

16.00

5.00

5519

61.00

5.00

5754

18.00

5.00

5523

46.00

5.00

5758

86.00

5.00

5525

58.00

5.00

5762

42.00

5.00

5529

28.00

5.00

5766

86.00

5.00

5531

38.00

5.00

5770

34.00

5.00

5535

28.00

5.00

5774

18.00

5.00

5537

38.00

5.00

5778

20.00

5.00

5541

24.00

5.00

5782

70.00

5.00

5543

28.00

5.00

5786

34.00

5.00

5547

24.00

5.00

5790

38.00

5.00

5551

20.60

5.00

5794

46.00

5.00

5553

28.00

5.00

5798

20.00

5.00

5557

3.80

2.50

5802

64.00

5.00

5561

32.00

5.00

5806

86.00

5.00

5565

3.80

2.50

5810

34.00

5.00

5569

2.60

1.50

5814

24.00

5.00

5573

22.00

5.00

5818

10.40

4.00

5574

28.00

5.00

5822

16.00

5.00

5577

26.60

5.00

5826

42.00

5.00

5579

34.00

5.00

5830

64.00

5.00

5583

36.00

5.00

5834

5.40

3.00

5585

43.00

5.00

5838

4.20

2.50

5589

32.00

5.00

5842

38.00

5.00

5593

26.00

5.00

5846

28.00

5.00

5594

38.00

5.00

5850

28.00

5.00

5596

23.60

5.00

5854

26.00

5.00

5597

32.00

5.00

5858

26.00

5.00


Second Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

5910

1.80

1.50

6198

42.00

5.00

5911

2.60

1.50

6202

43.00

5.00

5915

5.20

3.00

6203

58.00

5.00

5920

2.70

1.50

6207

64.00

5.00

5924

7.00

3.00

6211

58.00

5.00

5926

9.80

3.00

6215

54.00

5.00

5930

23.60

5.00

6219

108.00

5.00

5931

32.00

5.00

6223

98.00

5.00

5936

64.00

5.00

6227

86.00

5.00

5940

64.00

5.00

6231

86.00

5.00

5945

68.00

5.00

6235

50.00

5.00

5949

86.00

5.00

6239

64.00

5.00

5954

50.00

5.00

6243

108.00

5.00

5958

28.00

5.00

6247

86.00

5.00

5963

70.00

5.00

6251

64.00

5.00

5967

15.60

5.00

6255

70.00

5.00

5971

26.00

5.00

6259

64.00

5.00

5976

5.40

3.00

6263

42.00

5.00

5980

11.60

4.00

6310

2.90

1.50

5985

86.00

5.00

6314

1.60

1.50

5989

52.00

5.00

6318

3.20

2.50

5994

76.00

5.00

6320

4.60

2.50

5998

86.00

5.00

6324

5.40

3.00

6003

42.00

5.00

6328

4.60

2.50

6007

28.00

5.00

6333

3.40

2.50

6012

20.00

5.00

6337

4.80

3.00

6016

50.00

5.00

6338

6.80

3.00

6021

32.00

5.00

6343

3.00

2.50

6025

98.00

5.00

6344

4.20

2.50

6029

11.60

4.00

6349

8.80

3.00

6034

16.80

5.00

6350

11.60

4.00

6038

40.00

5.00

6354

1.30

1.00

6042

15.60

5.00

6355

1.60

1.50

6100

1.60

0.80

6359

4.00

2.50

6104

3.00

2.50

6360

5.40

3.00

6108

3.40

2.50

6365

14.60

5.00

6112

8.00

3.00

6366

20.00

5.00

6116

2.80

1.50

6371

10.60

3.00

6120

3.40

2.50

6372

14.00

4.00

6124

4.20

2.50

6377

3.00

2.50

6128

11.60

4.00

6378

4.20

2.50

6132

7.00

3.00

6382

5.40

3.00

6133

9.80

3 00

6383

7.60

3.00

6137

12.00

4.00

6387

1.40

1.50

6138

16.00

5.00

6388

2.00

1.50

6142

20.40

5.00

6392

4.00

2.50

6143

28.00

5.00

6393

5.40

3.00

6147

32.00

5.00

6397

13.40

4.00

6151

50.00

5.00

6398

18.00

5.00

6155

58.00

5.00

6402

13.40

4.00

6159

16.00

5.00

6404

18.00

5.00

6160

22.00

5.00

6414

The amount shown in this column in the item relating to the dislocation concerned, plus one-half of that amount

The amount shown in this column in the item relating to the dislocation concerned, plus one-half of that amount

6164

10.40

4.00

 

6165

14.00

5.00

 

6169

50.00

5.00

 

6173

64.00

5.00

 

6177

24.00

5.00

 

6181

14.00

5.00

 

6182

31.00

5.00

 

6186

10.40

4.00

 

6187

14.00

5.00

 

6191

17.60

5.00

6420

2.90

1.50

6192

24.00

5.00

6196

15.60

5.00

6425

5.40

3.00

6197

31.00

5.00

6426

8.80

3.00


Second Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

6431

2.90

1.50

6618

7.80

3.00

6432

3.60

2.50

6619

10.40

4.00

6437

5.40

3.00

6623

1.60

0.80

6438

12.40

4.00

6624

1.60

1.50

6442

6.80

3.00

6628

1.60

0.80

6443

14.00

5.00

6629

2.00

1.50

6447

3.40

1.50

6633

10.60

3.00

6448

4.20

2.50

6634

14.00

4.00

6453

7.00

3.00

6638

17.60

5.00

6454

9.80

3.00

6639

24.00

5.00

6458

7.60

3.00

6643

64.00

5.00

6459

16.00

5.00

6647

The amount shown in this column in the item relating to the fracture concerned, plus one-third of that amount

The amount shown in this column in the item relating to the fracture concerned, plus one-third of that amount

6463

7.60

3.00

 

6467

7.60

3.00

 

6468

12.40

4.00

 

6472

5.40

3.00

 

6473

7.60

3.00

 

6477

11.60

4.00

 

6478

22.00

5.00

 

6482

10.40

4.00

 

6483

22.00

5.00

6651

The amount shown in this column in the item relating to the fracture concerned, plus one-half of that amount

The amount shown in this column in the item relating to the fracture concerned, plus one-half of that amount

6487

5.40

3.00

 

6489

8.80

3.00

 

6493

5.40

3.00

 

6494

7.60

3.00

 

6498

1.60

0.80

 

6499

2.00

1.50

 

6503

11.60

4.00

 

6505

15.60

5.00

 

6509

8.80

3.00

6655

The amount shown in this column in the item relating to the fracture concerned, plus three-quarters of that amount

The amount shown in this column in the item relating to the fracture concerned, plus three-quarters of that amount

6510

11.60

4.00

 

6515

28.00

5.00

 

6516

38.00

5.00

 

6521

5.40

3.00

 

6522

9.40

3.00

 

6525

9.80

3.00

 

6527

14.00

5.00

 

6531

17.60

5.00

 

6532

24.00

5.00

 

6537

17.60

5.00

6659

One-half of the amount shown in this column in the item that would, but for item 6659 in the First Schedule to this Act, apply to the reduction concerned

One-half of the amount shown in this column in the item that would, but for item 6659 in the First Schedule to this Act, apply to the reduction concerned

6538

24.00

5.00

 

6543

17.60

5.00

 

6544

24.00

5.00

 

6549

5.40

3.00

 

6550

8.80

3.00

 

6555

2.90

1.50

 

6559

3.40

2.50

 

6564

3.20

1.50

 

6568

2.95

1.50

 

6569

3.80

2.50

 

6574

1.60

0.80

 

6575

2.00

1.50

 

6578

1.60

0.80

6663

One-half of the amount shown in this column in the item that would, but for item 6663 in the First Schedule to this Act, apply to the reduction concerned

One-half of the amount shown in this column in the item that would, but for item 6663 in the First Schedule to this Act, apply to the reduction concerned

6580

2.00

1.50

 

6584

7.80

3.00

 

6586

19.00

5.00

 

6590

7.00

3.00

 

6592

9.80

3.00

 

6596

22.00

5.00

 

6601

24.00

5.00

 

6605

8.80

3.00

 

6606

11.60

4.00

 

 

6610

30.00

5.00

 

6614

32.00

5.00

 


Second Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

6667

The amount shown in this column in the item that would, but for item 6667 in the First Schedule to this Act, apply to the reduction concerned

The amount shown in this column in the item that would, but for item 6667 in the First Schedule to this Act, apply to the reduction concerned

7155

22.00

5.00

7159

86.00

5.00

7163

42.00

5.00

7167

58.00

5.00

7171

28.00

5.00

7176

32.00

5.00

7180

42.00

5.00

7184

32.00

5.00

7189

28.00

5.00

7190

38.00

5.00

7195

32.00

5.00

7199

1.40

1.50

6671

The amount shown in this column in the item that would apply in the case of a simple and uncomplicated fracture of the part concerned

The amount shown in this column in the item that would apply in the case of a simple and uncomplicated fracture of the part concerned

7200

1.80

1.50

7205

1.40

1.00

7206

1.80

1.50

7210

11.60

4.00

7214

42.00

5.00

7218

24.00

5.00

7221

20.00

5.00

7222

26.00

5.00

7224

27.00

5.00

7225

40.00

5.00

7227

29.45

5.00

7228

38.00

5.00

7230

20.00

5.00

7010

18.00

5.00

7233

13.40

4.00

7014

9.40

3.00

7234

18.00

5.00

7016

12.40

4.00

7238

42.00

5.00

7020

2.00

1.50

7242

14.00

4.00

7025

1.60

1.50

7246

24.00

5.00

7029

3.40

1.50

7250

13.40

4.00

7031

4.20

2.50

7252

18.00

5.00

7035

5.40

3.00

7256

16.00

5.00

7037

19.00

5.00

7257

22.00

5.00

7041

5.40

3.00

7261

12.40

4.00

7043

7.60

3.00

7262

32.00

5.00

7047

70.00

5.00

7266

20.00

5.00

7051

24.00

5.00

7271

20.00

5.00

7055

6.40

3.00

7275

24.00

5.00

7056

8.80

3.00

7280

28.00

5.00

7060

8.80

3.00

7284

46.00

5.00

7061

12.40

4.00

7289

70.00

5.00

7065

11.60

4.00

7293

46.00

5.00

7069

10.40

4.00

7297

44.00

5.00

7074

12.80

4.00

7301

46.00

5.00

7078

108.00

5.00

7305

10.40

4.00

7082

34.00

5.00

7309

22.00

5.00

7087

22.00

5.00

7313

8.80

3.00

7091

50.00

5.00

7314

11.60

4.00

7095

90.00

5.00

7318

20.60

5.00

7100

90.00

5.00

7319

28.00

5.00

7104

78.00

5.00

7323

10.80

4.00

7108

38.00

5.00

7324

14.40

5.00

7113

13.40

4.00

7328

13.40

4.00

7114

18.00

5.00

7329

18.00

5.00

7118

20.00

5.00

7333

22.00

5.00

7122

54.00

5.00

7334

30.00

5.00

7126

64.00

5.00

7338

5.40

3.00

7130

22.00

5.00

7339

7.60

3.00

7135

4.00

2.50

7343

8.80

3.00

7136

5.40

3.00

7344

11.60

4.00

7141

32.00

5.00

7348

6.80

3.00

7145

36.00

5.00

7352

18.00

5.00

7149

32.00

5.00

7356

34.00

5.00

7154

16.00

5.00

7360

58.00

5.00


Second Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

7364

28.00

5.00

7659

6.40

3.00

7368

20.00

5.00

7661

8.80

3.00

7372

5.40

3.00

7665

32.00

5.00

7373

7.60

3.00

7670

5.40

3.00

7377

10.40

4.00

7671

7.60

3.00

7378

14.00

5.00

7676

20.00

5.00

7382

15.60

5.00

7680

36.00

5.00

7386

24.00

5.00

7685

32.00

5.00

7390

8.80

3.00

7700

50.00

5.00

7391

11.60

4.00

7704

5.40

3.00

7395

22.00

5.00

7708

3.00

2.50

7396

30.00

5.00

7750

24.00

5.00

7400

28.00

5.00

7754

11.60

4.00

7450

12.40

4.00

7758

20.00

5.00

7454

2.90

1.50

7762

3.00

2.50

7458

3.00

2.50

7767

2.90

1.50

7462

2.90

1.50

7771

8.80

3.00

7466

3.40

2.50

7775

10.40

4.00

7470

2.90

1.50

7779

14.00

5.00

7474

4.20

2.50

7783

22.00

5.00

7478

2.90

1.50

7787

40.00

5.00

7482

5.40

3.00

7791

42.00

5.00

7486

15.60

5.00

7795

20.00

5.00

7490

2.90

1.50

7850

14.00

5.00

7494

4.20

2.50

7854

18.00

5.00

7498

4.20

2.50

7858

14.00

4.00

7510

2.90

1.50

7862

7.60

3.00

7514

50.00

5.00

7866

9.80

3.00

7519

64.00

5.00

7870

4.20

2.50

7523

64.00

5.00

7874

15.60

5.00

7528

64.00

5.00

7877

9.80

3.00

7532

32.00

5.00

7881

24.00

5.00

7537

50.00

5.00

7885

14.00

4.00

7541

50.00

5.00

7889

9.80

3.00

7545

64.00

5.00

7893

5.40

3.00

7549

64.00

5.00

7897

16.00

5.00

7553

42.00

5.00

7901

24.00

5.00

7557

14.00

4.00

7905

10.80

4.00

7561

32.00

5.00

7909

24.00

5.00

7565

24.00

5.00

7913

20.00

5.00

7569

76.00

5.00

7917

32.00

5.00

7573

76.00

5.00

7921

64.00

5.00

7577

50.00

5.00

7925

54.00

5.00

7581

25.00

5.00

7929

64.00

5.00

7582

34.00

5.00

7950

14.00

5.00

7586

42.00

5.00

7952

16.00

5.00

7590

50.00

5.00

7953

19.00

5.00

7594

64.00

5.00

7954

24.00

5.00

7598

32.00

5.00

7958

14.00

5.00

7602

42.00

5.00

7962

7.60

3.00

7607

64.00

5.00

7966

20.00

5.00

7611

24.00

5.00

7970

14.00

4.00

7616

42.00

5.00

7974

32.00

5.00

7620

24.00

5.00

7978

20.00

5.00

7625

64.00

5.00

7982

14.00

4.00

7629

5.40

3.00

7986

34.00

5.00

7631

7.60

3.00

7990

10.40

4.00

7635

50.00

5.00

7994

7.60

3.00

7640

36.00

5.00

7998

22.00

5.00

7644

32.00

5.00

8002

36.00

5.00

7649

18.00

5.00

8007

18.00

5.00

7653

5.40

3.00

8011

28.00

5.00

7655

7.60

3.00

8015

28.00

5.00


Second Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

8020

50.00

5.00

8180

9.80

3.00

8024

16.00

5.00

8184

46.00

5.00

8029

50.00

5.00

8188

22.00

5.00

8033

36.00

5.00

8192

22.00

5.00

8037

98.00

5.00

8196

24.00

5.00

8042

34.00

5.00

8200

42.00

5.00

8046

64.00

5.00

8204

50.00

5.00

8050

50.00

5.00

8208

70.00

5.00

8054

42.00

5.00

8212

9.80

3.00

8058

42.00

5.00

8216

24.00

5.00

8062

24.00

5.00

8220

18.00

5.00

8066

20.00

5.00

8224

38.00

5.00

8070

24.00

5.00

8228

12.80

4.00

8110

18.00

5.00

8232

42.00

5.00

8114

28.00

5.00

8236

28.00

5.00

8119

32.00

5.00

8240

46.00

5.00

8123

18.00

5.00

8244

62.00

5.00

8128

32.00

5.00

8248

24.00

5.00

8132

18.00

5.00

8252

18.00

5.00

8136

42.00

5.00

8256

36.00

5.00

8141

32.00

5.00

8260

86.00

5.00

8145

20.00

5.00

8264

14.40

5.00

8150

11.60

4.00

8268

46.00

5.00

8154

24.00

5.00

8272

58.00

5.00

8159

50.00

5.00

8276

24.00

5.00

8163

24.00

5.00

8280

42.00

5.00

8167

50.00

5.00

8284

42.00

5.00

8172

28.00

5.00

8288

50.00

5.00

8176

42.00

5.00

 

 

 


THIRD SCHEDULE Section 13.

TABLE OF FUND MEDICAL BENEFITS IN RESPECT OF VICTORIA

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

2

1.30

0.80

351

8.80

3.00

3

1.65

1.20

352

10.40

3.00

9

4.25

1.50

355

13.60

4.00

11

6.50

2.00

357

16.00

5.00

13

2.50

1.00

370

4.90

1.50

15

8.00

2.00

371

5.50

2.00

17

10.00

3.00

375

5.40

2.00

18

3.25

1.00

376

6.10

2.00

24

1.60

2.30

378

8.30

3.00

37

8.50

3.00

379

9.90

3.00

38

13.00

4.00

381

9.70

3.00

39

17.50

5.00

382

11.30

3.00

40

22.50

5.00

384

14.50

4.00

43

1.30

0.80

386

16.90

5.00

45

1.70

0.80

388

10.00

3.00

203

1.30

0.80

389

11.20

4.00

206

9.40

4.00

391

10.40

4.00

209

8.60

4.00

392

12.60

4.00

210

16.00

5.00

394

15.80

5.00

220

8.80

3.00

396

13.30

4.00

223

16.00

5.00

397

14.90

4.00

224

21.00

5.00

399

14.70

4.00

226

16.40

5.00

400

15.30

5.00

227

19.00

5.00

402

19.50

5.00

230

21.50

5.00

430

3.10

1.00

231

19.00

5.00

435

6.70

2.00

235

36.00

5.00

436

8.50

2.00

236

38.00

5.00

451

4.90

2.00

243

0.20

0.80

455

4.60

1.50

247

0.20

0.80

456

5.80

2.00

251

7.80

3.00

501

4.80

1.50

252

10.40

4.00

601

3.70

1.00

255

3.10

1.00

611

3.10

1.00

256

4.40

1.50

616

5.60

1.50

259

0.20

0.80

621

11.60

4.00

263

4.40

1.50

625

10.40

4.00

267

3.10

1.00

631

4.40

1.50

268

4.40

1.50

641

5.90

2.00

271

3.40

1.50

651

8.40

3.00

275

15.60

5.00

661

11.60

4.00

279

2.40

1.50

681

3.20

1.00

283

17.20

5.00

691

2.50

1.00

287

3.10

1.00

701

1.50

1.00

288

4.40

1.50

703

2.30

1.00

291

5.60

3.00

705

7.00

2.00

301

4.00

1.00

707

2.70

1.00

302

4.30

1.00

708

1.90

1.00

305

4.00

1.50

715

2.90

1.00

306

5.40

1.50

721

2.70

1.00

309

5.90

2.00

731

9.80

3.00

310

6.80

2.00

741

3.40

1.50

313

7.60

3.00

751

6.00

2.00

317

11.60

4.00

761

28.00

5.00

321

0.70

0.80

771

42.00

5.00

323

4.80

1.50

781

32.00

5.00

341

4.00

1.50

791

7.60

3.00

342

4.80

1.50

801

7.20

2.00

344

4.70

1.50

831

1.60

1.00

345

5.20

2.00

841

2.50

1.00

347

7.40

3.00

851

3.30

1.00

348

9.00

3.00

861

5.60

1.50


Third Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

866

7.60

3.00

1098

1.30

0.80

871

6.40

2.00

1100

1.50

1.00

881

5.40

1.50

1102

3.50

1.00

891

14.00

4.00

1104

0.70

0.80

901

11.60

4.00

1106

0.60

0.80

906

14.00

4.00

1108

1.50

1.00

911

3.20

1.00

1110

5.80

2.00

915

6.80

3.00

1112

0.70

0.80

921

0.90

0.80

1114

1.20

0.80

931

0.90

0.80

1116

4.60

1.50

941

1.00

0.80

1118

1.90

1.00

943

1.40

0.80

1120

4.80

1.50

945

2.30

1.00

1122

2.70

1.00

951

3.40

1.00

1124

1.90

1.00

961

2.10

1.00

1126

2.30

1.00

971

7.60

3.00

1128

1.40

0.80

976

15.60

5.00

1130

3.10

1.00

981

4.00

1.50

1132

1.90

1.00

985

4.80

1.50

1134

3.10

1.00

1000

1.20

0.80

1136

4.80

1.50

1002

1.20

0.80

1138

1.60

0.80

1004

1.70

0.80

1140

3.20

1.00

1006

0.90

0.80

1142

1.40

1.00

1008

0.70

0.80

1144

1.90

1.00

1010

1.90

1.00

1146

1.90

1.00

1012

5.00

1.50

1148

2.70

1.00

1014

2.40

1.00

1150

4.80

1.50

1016

3.60

1.00

1152

2.70

1.00

1018

5.80

1.50

1154

2.30

1.00

1020

4.70

3.00

1156

2.30

1.00

1022

0.70

0.80

1160

3.70

1.00

1024

2.20

0.80

1162

3.10

1.00

1026

0.70

0.80

1164

4.00

1.50

1028

3.20

1.00

1166

4.00

1.50

1030

3.10

1.00

1168

5.00

1.50

1032

3.20

1.00

1170

4.40

1.50

1034

1.90

1.00

1172

0.90

0.80

1036

2.70

1.00

1174

2.40

1.00

1038

3.10

1.00

1176

1.80

1.00

1040

3.10

1.00

1180

1.90

1.00

1042

3.20

1.00

1182

2.20

0.80

1044

4.00

1.50

1184

3.70

1.00

1046

1.40

0.80

1186

0.70

0.80

1048

5.60

1.50

1188

1.90

1.00

1050

4.00

1.50

1190

2.70

1.00

1052

8.80

3.00

1192

2.70

1.00

1054

0.70

0.80

1194

3.20

1.00

1060

1.20

0.80

1196

2.70

1.00

1062

1.60

0.80

1198

1.70

1.00

1064

1.20

0.80

1200

1.20

0.80

1066

2.30

1.00

1202

2.90

1.00

1068

2.50

1.00

1204

0.60

0.80

1070

2.30

1.00

1206

3.10

1.00

1072

2.70

1.00

1208

3.70

1.00

1074

7.60

3.00

1210

2.70

1.00

1076

0.90

0.80

1212

3.50

1.00

1080

1.20

0.80

1214

2.20

0.80

1082

2.30

1.00

1216

2.10

1.00

1084

8.80

3.00

1218

3.50

1.00

1090

1.90

1.00

1220

5.00

1.50

1092

1.90

1.00

1222

5.00

1.50

1094

1.60

0.80

1224

6.80

3.00

1096

0.90

0.80

1226

8.80

3.00


Third Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

1228

3.50

1.00

1391

4.00

1.50

1230

5.00

1.50

1392

6.30

2.00

1232

2.70

1.00

1394

7.50

2.00

1234

4.80

1.50

1395

0.90

0.80

1236

5.80

2.00

1397

2.90

1.00

1238

7.00

2.00

1399

0.70

0.80

1240

1.90

1.00

1401

1.90

1.00

1242

3.10

1.00

1404

1.20

0.80

1244

5.20

1.50

1407

2.70

1.00

1246

5.00

1.50

1410

1.90

1.00

1248

0.20

0.80

1413

2.40

1.00

1250

2.70

1.00

1416

3.60

1.00

1252

4.80

1.50

1419

1.90

1.00

1254

6.20

2.00

1421

2.30

1.00

1256

6.80

3.00

1423

2.30

1.00

1258

8.40

3.00

1425

4.00

1.50

1260

2.70

1.00

1428

2.30

1.00

1262

4.40

1.50

1430

5.00

1.50

1264

2.70

1.00

1432

8.80

3.00

1266

4.80

1.50

1434

2.70

1.00

1268

6.20

2.00

1436

3.10

1.00

1270

6.80

3.00

1438

8.80

3.00

1272

4.00

1.50

1441

3.30

1.00

1274

8.80

3.00

1444

2.70

1.00

1276

5.80

2.00

1447

5.00

1.50

1278

2.70

1.00

1450

4.40

1.50

1280

4.80

1.50

1453

2.70

1.00

1282

6.20

2.00

1456

3.50

1.00

1284

6.80

3.00

1459

2.70

1.00

1286

8.40

3.00

1461

4.80

1.50

1288

4.00

1.50

1463

6.20

2.00

1290

5.60

1.50

1466

6.80

3.00

1292

5.60

1.50

1468

2.50

1.00

1294

2.70

1.00

1470

2.20

1.00

1296

1.90

1.00

1472

4.00

1.50

1298

4.80

1.50

1474

8.80

3.00

1301

2.70

1.00

1476

4.20

1.50

1302

4.80

1.50

1478

3.30

1.00

1304

6.20

2.00

1481

3.30

1.00

1305

6.80

3.00

1484

6.80

3.00

1307

8.40

3.00

1487

4.20

1.50

1310

2.70

1.00

1490

4.20

1.50

1313

1.90

1.00

1491

2.50

1.00

1316

2.70

1.00

1493

6.80

3.00

1319

5.10

1.50

1494

8.80

3.00

1322

1.70

0.80

1495

0.90

0.80

1325

0.90

0.80

1496

2.40

1.00

1328

2.40

1.00

1497

4.40

1.50

1331

5.00

1.50

1499

4.00

1.50

1334

3.10

1.00

1500

0.70

0.80

1337

5.20

1.50

1502

1.20

0.80

1340

7.00

2.00

1504

1.20

0.80

1343

5.20

1.50

1506

2.30

1.00

1346

6.80

3.00

1508

1.70

0.80

1349

3.30

1.00

1511

1.90

1.00

1352

3.50

1.00

1513

1.60

0.80

1355

4.00

1.50

1515

2.90

1.00

1358

2.30

1.00

1517

4.20

1.50

1380

1.70

0.80

1519

5.00

1.50

1382

1.70

0.80

1521

6.00

2.00

1385

2.70

1.00

1523

6.00

2.00

1388

4.80

1.50

1525

2.90

1.00

1389

5.80

2.00

1527

4.00

1.50


Third Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

1529

2.30

1.00

1706

1.90

1.00

1531

4.40

1.50

1707

3.10

1.00

1534

1.90

1.00

1710

0.70

0.80

1537

3.10

1.00

1712

2.70

1.00

1539

2.30

1.00

1714

2.70

1.00

1541

1.90

1.00

1716

0.90

0.80

1543

2.30

1.00

1718

3.50

1.00

1545

0.70

0.80

1720

7.00

2.00

1546

4.00

1.50

1722

9.60

3.00

1548

5.80

2.00

1724

1.90

1.00

1551

4.00

1.50

1726

4.00

1.50

1554

6.40

2.00

1728

5.80

2.00

1557

8.00

3.00

1730

4.00

1.50

1560

6.40

2.00

1732

0.70

0.80

1562

5.80

2.00

1734

2.50

1.00

1564

7.40

3.00

1736

6.80

3.00

1566

7.40

2.00

1738

0.90

0.80

1568

9.00

3.00

1741

2.70

1.00

1571

3.30

1.00

1744

0.90

0.80

1580

1.90

1.00

1746

2.70

1.00

1582

1.60

1.00

1748

2.70

1.00

1584

3.50

1.00

1761

1.40

0.80

1586

1.70

0.80

1764

2.70

1.00

1588

2.70

1.00

1767

0.90

0.80

1590

2.70

1.00

1770

2.70

1.00

1601

2.70

1.00

1773

3.10

1.00

1604

4.80

1.50

1776

4.80

1.50

1607

6.20

2.00

1779

1.70

0.80

1609

6.80

3.00

1782

1.70

0.80

1611

2.50

1.00

1785

1.70

0.80

1613

3.30

1.00

1790

1.90

1.00

1615

3.50

1.00

1792

1.90

1.00

1616

4.00

1.50

1794

4.00

1.50

1621

0.90

0.80

1796

4.00

1.50

1623

2.30

1.00

1798

1.90

1.00

1625

1.10

0.80

1800

1.10

0.80

1627

2.70

1.00

1802

4.20

1.50

1629

2.30

1.00

1804

5.80

2.00

1631

1.90

1.00

1806

2.70

1.00

1640

5.60

1.50

1808

5.80

2.00

1643

2.90

1.00

1810

2.70

1.00

1645

2.90

1.00

1812

2.70

1.00

1647

8.80

3.00

1820

4.80

1.50

1649

7.00

2.00

1822

7.00

2.00

1651

8.80

3.00

1824

8.40

3.00

1653

4.00

1.50

1826

8.40

3.00

1661

1.20

0.80

1828

10.40

4.00

1664

5.80

2.00

1840

12.40

4.00

1667

2.70

1.00

1841

16.00

5.00

1670

2.70

1.00

1843

5.60

1.50

1673

3.50

1.00

1846

4.00

1.50

1680

1.70

0.80

1849

4.00

1.50

1682

1.20

0.80

1850

4.80

1.50

1684

0.90

0.80

1852

4.80

1.50

1686

1.10

0.80

1855

5.80

2.00

1688

1.90

1.00

1858

7.00

2.00

1691

1.90

1.00

1861

5.20

1.50

1694

1.30

1.00

1863

5.80

2.00

1697

3.30

1.00

1865

14.00

5.00

1698

4.80

1.50

1867

5.60

1.50

1700

1.90

1.00

1869

4.80

1.50

1701

6.60

2.00

1871

6.80

3.00

1703

1.90

1.00

1873

14.00

5.00


Third Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

1875

5.80

2.00

2123

2.10

1.00

1877

5.80

2.00

2128

4.80

1.50

1879

5.60

1.50

2132

4.80

1.50

1881

4.60

1.50

2136

6.10

2.00

1884

4.00

1.50

2140

4.00

1.50

1887

4.00

1.50

2144

4.80

1.50

1889

12.40

4.00

2160

5.40

1.50

1891

1.90

1.00

2164

11.60

4.00

1893

4.40

1.50

2169

8.80

3.00

1901

2.70

1.00

2173

6.80

2.00

1903

4.00

1.50

2177

6.40

2.00

1905

4.00

1.50

2181

6.80

3.00

1907

5.80

2.00

2185

5.80

1.50

1909

5.00

1.50

2200

4.40

1.50

1911

7.00

2.00

2205

4.40

1.50

1913

2.30

1.00

2209

6.60

2.00

1915

2.50

1.00

2214

7.30

3.00

1921

7.00

2.00

2218

7.20

3.00

1923

7.20

3.00

2222

6.80

3.00

1925

8.40

3.00

2226

7.80

3.00

1941

8.80

3.00

2230

8.80

3.00

1943

4.00

1.50

2234

7.60

2.00

1945

4.00

1.50

2238

8.50

2.00

1947

3.40

1.50

2247

10.60

3.00

1949

2.70

1.00

2250

6.40

2.00

1951

4.00

1.50

2254

1.90

1.00

1953

4.00

1.50

2270

6.80

3.00

1955

4.40

1.50

2274

4.80

1.50

1957

7.00

2.00

2290

4.90

1.50

1959

7.00

2.00

2294

8.80

3.00

1961

5.80

2.00

2298

6.40

2.00

1963

4.00

1.50

2310

6.80

3.00

1965

5.60

1.50

2314

9.80

3.00

1967

5.60

1.50

2318

9.80

3.00

1969

5.60

1.50

2322

9.80

3.00

1971

6.80

3.00

2326

7.90

2.00

1973

7.00

2.00

2330

4.80

1.50

1975

5.60

1.50

2334

9.20

3.00

1977

5.80

2.00

2338

6.80

3.00

1979

4.00

1.50

2342

7.60

3.00

1981

5.80

2.00

2346

7.10

2.00

1983

5.80

2.00

2350

8.80

3.00

2010

3.10

1.00

2354

10.40

4.00

2014

3.50

1.00

2358

5.00

1.50

2018

3.20

1.00

2362

2.10

1.00

2022

4.00

1.00

2367

2.10

1.00

2026

4.00

1.50

2371

6.40

2.00

2040

3.70

1.50

2410

5.80

2.00

2044

3.40

1.50

2420

0.90

0.80

2048

2.50

1.00

2440

4.40

1.50

2052

6.80

3.00

2444

2.70

1.00

2060

4.30

1.50

2460

2.10

1.00

2064

5.80

1.50

2464

2.90

1.00

2068

4.80

1.50

2468

5.60

1.50

2072

5.00

1.50

2510

24.00

5.00

2076

5.80

2.00

2514

24.00

5.00

2081

4.40

1.50

2518

8.00

3.00

2091

6.50

1.50

2522

14.00

4.00

2094

7.90

2.00

2526

32.00

5.00

2098

6.30

3.00

2530

24.00

5.00

2110

4.00

1.50

2534

11.60

4.00

2114

5.40

1.50

2538

15.60

5.00

2119

4.00

1.50

2542

6.40

2.00


Third Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

2570

11.60

4.00

3115

2.50

1.00

2574

6.40

2.00

3119

5.60

3.00

2578

6.40

2.00

3121

16.40

5.00

2620

21.40

5.00

3125

13.40

4.00

2624

10.40

4.00

3126

18.00

5.00

2628

10.40

4.00

3131

16.00

5.00

2632

2.00

4.00

3132

22.00

5.00

2636

4.00

1.50

3137

3.50

1.00

2640

5.80

2.00

3138

11.80

3.00

2644

5.80

2.00

3143

4.90

2.00

2648

4.80

1.50

3144

8.80

3.00

2652

4.80

1.50

3149

13.60

4.00

2657

5.80

2.00

3150

16.00

5.00

2661

5.00

1.50

3155

28.00

5.00

2666

2.90

1.00

3156

32.00

5.00

2670

4.80

1.50

3161

34.00

5.00

2674

4.00

1.50

3162

37.00

5.00

2678

4.00

1.50

3166

48.00

5.00

2682

6.80

3.00

3170

8.80

3.00

2686

1.90

1.00

3174

2.60

1.00

2691

10.40

4.00

3178

1.00

1.00

2696

6.40

2.00

3180

6.00

1.50

2700

5.60

1.50

3184

2.60

1.00

2901

4.80

1.50

3185

5.20

1.50

2904

6.20

2.00

3190

3.40

1.50

2907

6.80

3.00

3191

5.20

2.00

2910

8.80

3.00

3196

3.60

1.50

2913

12.40

4.00

3197

5.30

2.00

3000

1.30

0.80

3201

4.90

2.00

3004

1.90

1.00

3202

5.80

2.00

3005

2.50

1.00

3206

7.80

3.00

3009

3.15

1.00

3207

10.40

4.00

3011

4.40

1.50

3211

2.00

1.00

3015

6.80

2.00

3216

2.00

1.00

3017

8.00

3.00

3220

4.90

2.00

3021

2.60

1.00

3221

12.80

4.00

3025

4.40

1.50

3225

6.40

2.00

3030

3.30

1.50

3226

7.60

3.00

3034

7.60

3.00

3230

10.60

3.00

3039

4.90

2.00

3232

14.00

4.00

3043

6.80

3.00

3236

10.60

3.00

3045

9.40

3.00

3238

14.00

4.00

3049

6.40

2.00

3242

6.40

2.00

3051

7.60

3.00

3244

7.60

3.00

3055

7.00

3.00

3248

6.80

2.00

3056

9.80

3.00

3250

8.00

3.00

3061

1.30

0.80

3254

17.60

5.00

3064

2.60

1.00

3255

24.00

5.00

3065

6.80

3.00

3259

24.00

5.00

3069

9.80

3.00

3263

50.00

5.00

3070

14.00

5.00

3267

13.40

4.00

3074

3.50

1.00

3269

18.00

5.00

3078

4.90

2.00

3273

34.00

5.00

3080

5.60

3.00

3274

46.00

5.00

3084

3.50

1.00

3279

31.00

5.00

3089

6.80

3.00

3280

42.00

5.00

3093

2.10

1.00

3285

3.15

1.00

3097

7.00

3.00

3286

4.40

1.50

3099

9.80

3.00

3291

7.00

3.00

3103

5.00

1.50

3292

9.80

3.00

3104

6.40

2.00

3297

2.50

1.00

3108

7.00

3.00

3298

3.40

1.00

3110

9.80

3.00

3303

6.40

2.00


Third Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

3304

7.60

3.00

3506

86.00

5.00

3309

7.60

3.00

3510

11.60

4.00

3313

37.00

5.00

3514

22.00

5.00

3315

50.00

5.00

3519

28.00

5.00

3319

2.50

1.00

3523

61.00

5.00

3323

10.60

3.00

3528

43.00

5.00

3324

14.00

4.00

3529

58.00

5.00

3328

13.40

4.00

3534

23.60

5.00

3329

18.00

5.00

3535

32.00

5.00

3334

26.60

5.00

3539

65.50

5.00

3335

36.00

5.00

3541

88.00

5.00

3340

50.00

5.00

3545

78.00

5.00

3344

86.00

5.00

3550

20.60

5.00

3348

19.00

5.00

3551

28.00

5.00

3349

26.00

5.00

3556

86.00

5.00

3353

42.00

5.00

3560

28.00

5.00

3357

62.00

5.00

3561

38.00

5.00

3361

38.00

5.00

3566

28.00

5.00

3362

66.00

5.00

3567

38.00

5.00

3367

34.60

5.00

3572

14.60

5.00

3368

47.00

5.00

3573

20.00

5.00

3372

26.60

5.00

3577

17.60

5.00

3373

36.00

5.00

3578

24.00

5.00

3377

11.50

5.00

3582

61.00

5.00

3378

16.00

5.00

3583

82.00

5.00

3383

24.00

5.00

3588

11.60

4.00

3387

18.00

5.00

3589

15.60

5.00

3392

20.60

5.00

3593

20.60

5.00

3393

28.00

5.00

3594

28.00

5.00

3397

46.00

5.00

3598

61.00

5.00

3402

10.40

4.00

3599

82.00

5.00

3406

22.00

5.00

3604

20.60

5.00

3408

30.00

5.00

3605

28.00

5.00

3412

17.60

5.00

3609

26.60

5.00

3414

21.00

5.00

3610

36.00

5.00

3418

17.20

5.00

3614

61.00

5.00

3419

22.00

5.00

3615

82.00

5.00

3423

17.20

5.00

3620

46.00

5.00

3424

22.00

5.00

3624

19.00

5.00

3428

46.00

5.00

3626

33.00

5.00

3430

62.00

5.00

3630

25.00

5.00

3434

6.40

2.00

3632

34.00

5.00

3436

7.60

3.00

3636

11.60

4.00

3440

24.00

5.00

3640

6.40

2.00

3442

40.00

5.00

3645

86.00

5.00

3446

25.00

5.00

3649

20.60

5.00

3448

38.00

5.00

3651

28.00

5.00

3452

31.00

5.00

3655

50.00

5.00

3454

42.00

5.00

3656

67.00

5.00

3458

23.60

5.00

3661

31.00

5.00

3460

32.00

5.00

3662

42.00

5.00

3464

42.00

5.00

3667

50.00

5.00

3469

86.00

5.00

3671

32.00

5.00

3473

32.00

5.00

3675

7.60

3.00

3478

42.00

5.00

3680

2.30

1.00

3482

42.00

5.00

3681

3.10

1.00

3486

32.00

5.00

3686

86.00

5.00

3487

54.00

5.00

3690

24.00

5.00

3491

23.60

5.00

3691

30.00

5.00

3492

32.00

5.00

3696

50.00

5.00

3497

50.00

5.00

3700

55.00

5.00

3498

62.00

5.00

3704

17.60

5.00

3502

58.00

5.00

3705

24.00

5.00


Third Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

3709

20.60

5.00

3904

7.00

2.00

3710

28.00

5.00

3908

5.80

2.00

3714

28.00

5.00

3909

6.80

3.00

3716

34.00

5.00

3914

8.40

3.00

3720

1.90

1.00

3915

11.00

4.00

3721

2.50

1.00

3917

24.50

5.00

3726

24.00

5.00

3920

36.00

5.00

3727

28.00

5.00

3921

8.80

3.00

3731

14.60

5.00

3923

11.60

4.00

3732

20.00

5.00

3926

24.00

5.00

3736

20.60

5.00

3927

34.00

5.00

3737

28.00

5.00

3931

20.00

5.00

3741

24.00

5.00

3932

30.00

5.00

3742

32.00

5.00

3936

14.60

5.00

3746

5.00

1.50

3937

20.00

5.00

3747

6.40

2.00

3941

50.00

5.00

3751

1.70

1.00

3945

3.50

1.00

3755

3.40

1.50

3949

2.25

1.00

3756

6.80

3.00

3951

3.00

1.00

3760

7.00

3.00

3955

5.60

1.50

3761

9.80

3.00

3957

7.20

2.00

3765

3.40

1.00

3961

14.60

5.00

3769

3.10

1.00

3963

20.00

5.00

3770

4.00

1.50

3967

28.00

5.00

3771

9.60

3.00

3971

32.00

5.00

3772

12.80

4.00

3975

46.00

5.00

3773

26.60

5.00

3979

58.00

5.00

3774

48.00

5.00

3983

86.00

5.00

3776

7.60

3.00

3987

78.00

5.00

3780

32.00

5.00

3991

86.00

5.00

3784

68.00

5.00

3995

42.00

5.00

3788

78.00

5.00

3999

42.00

5.00

3792

2.50

1.00

4004

98.00

5.00

3796

9.40

3.00

4008

86.00

5.00

3797

12.40

4.00

4013

86.00

5.00

3801

2.70

1.00

4017

86.00

5.00

3805

6.40

2.00

4022

42.00

5.00

3806

7.60

3.00

4026

50.00

5.00

3811

14.60

5.00

4031

32.00

5.00

3812

20.00

5.00

4035

32.00

5.00

3817

1.90

1.00

4040

16.00

5.00

3821

3.40

1.50

4050

3.10

1.00

3826

30.00

5.00

4051

4.40

1.50

3827

50.00

5.00

4055

6.80

2.00

3832

5.30

1.50

4056

8.00

3.00

3836

10.60

3.00

4060

10.60

3.00

3838

31.00

5.00

4061

14.00

4.00

3842

14.60

5.00

4065

17.60

5.00

3844

20.00

5.00

4066

24.00

5.00

3848

17.60

5.00

4070

14.60

5.00

3850

24.00

5.00

4071

20.00

5.00

3854

13.90

3.00

4075

17.60

5.00

3856

17.80

4.00

4076

24.00

5.00

3860

24.00

5.00

4090

6.80

2.00

3865

42.00

5.00

4091

8.00

3.00

3869

22.00

5.00

4095

17.60

5.00

3874

5.20

1.50

4096

24.00

5.00

3878

28.60

5.00

4101

17.60

5.00

3880

39.00

5.00

4102

24.00

5.00

3883

15.00

5.00

4107

31.00

5.00

3884

29.00

5.00

4108

42.00

5.00

3888

6.00

2.00

4113

23.60

5.00

3900

1.90

1.00

4114

32.00

5.00


Third Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

4119

17.60

5.00

4400

40.80

5.00

4120

24.00

5.00

4401

45.50

5.00

4125

31.00

5.00

4402

45.00

5.00

4126

42.00

5.00

4403

1.60

1.00

4150

10.40

4.00

4404

9.80

3.00

4151

14.00

5.00

4408

10.40

4.00

4156

1.60

0.80

4412

8.80

3.00

4157

2.30

1.00

4416

11.60

4.00

4161

8.80

3.00

4420

1.80

1.00

4162

11.60

4.00

4424

2.10

1.00

4166

14.60

5.00

4428

50.00

5.00

4167

20.00

5.00

4432

46.00

5.00

4171

17.60

5.00

4436

18.00

5.00

4172

24.00

5.00

4440

7.60

3.00

4176

31.00

5.00

4444

42.00

5.00

4177

42.00

5.00

4448

42.00

5.00

4182

64.00

5.00

4450

46.00

5.00

4183

86.00

5.00

4452

4.40

1.50

4188

5.80

2.00

4456

44.00

5.00

4189

6.80

3.00

4460

4.40

1.50

4194

1.90

1.00

4464

20.00

5.00

4195

2.50

1.00

4468

42.00

5.00

4200

7.00

3.00

4472

64.00

5.00

4201

9.80

3.00

4476

3.90

1.00

4206

17.60

5.00

4480

7.60

3.00

4207

24.00

5.00

4484

5.80

2.00

4212

14.60

5.00

4488

42.00

5.00

4213

20.00

5.00

4492

50.00

5.00

4218

23.60

5.00

4496

50.00

5.00

4219

32.00

5.00

4498

10.00

3.00

4224

34.00

5.00

4499

21.00

5.00

4225

46.00

5.00

4501

11.80

3.00

4230

38.60

5.00

4502

27.00

5.00

4231

52.00

5.00

4504

10.80

3.00

4236

108.00

5.00

4505

24.50

5.00

4300

5.80

2.00

4507

17.60

5.00

4304

7.40

2.00

4508

26.00

5.00

4305

8.80

3.00

4513

3.15

1.00

4309

7.80

3.00

4514

4.40

1.50

4311

10.40

4.00

4519

4.90

2.00

4315

68.00

5.00

4520

8.80

3.00

4320

73.00

5.00

4525

6.70

2.00

4324

38.00

5.00

4526

13.40

4.00

4328

78.00

5.00

4528

6.40

2.00

4333

50.00

5.00

4529

5.20

1.50

4337

76.00

5.00

4533

2.50

1.00

4342

86.00

5.00

4538

24.00

5.00

4346

42.00

5.00

4542

16.00

5.00

4350

78.00

5.00

4545

24.80

5.00

4355

50.00

5.00

4547

20.00

5.00

4359

3.50

1.00

4551

24.00

5.00

4360

14.80

3.00

4555

15.60

5.00

4364

50.00

5.00

4559

11.60

4.00

4368

11.00

5.00

4563

64.00

5.00

4372

3.40

1.00

4567

12.40

4.00

4376

6.80

3.00

4571

24.00

5.00

4381

4.00

1.50

4575

26.60

5.00

4385

5.80

1.50

4579

12.40

4.00

4389

4.60

1.50

4583

28.00

5.00

4390

5.80

2.00

4587

42.00

5.00

4394

10.40

4.00

4591

42.00

5.00

4395

14.00

5.00

4595

52.00

5.00

4399

40.00

5.00

4599

42.00

5.00


Third Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

4604

12.00

4.00

5124

9.80

3.00

4605

16.00

5.00

5128

9.80

3.00

4610

11.60

4.00

5132

11.60

4.00

4614

8.80

3.00

5136

5.80

2.00

4616

11.60

4.00

5140

42.00

5.00

4620

15.60

5.00

5145

20.00

5.00

4625

17.60

5.00

5149

18.00

5.00

4626

24.00

5.00

5153

42.00

5.00

4710

42.00

5.00

5157

34.00

5.00

4714

42.00

5.00

5161

50.00

5.00

4719

108.00

5.00

5165

24.00

5.00

4723

78.00

5.00

5170

38.00

5.00

4727

52.00

5.00

5174

15.60

5.00

4728

70.00

5.00

5178

42.00

5.00

4732

78.00

5.00

5182

52.00

5.00

4735

50.00

5.00

5186

10.40

4.00

4739

38.00

5.00

5190

5.80

2.00

4743

83.00

5.00

5194

24.00

5.00

4747

42.00

5.00

5198

50.00

5.00

4751

42.00

5.00

5202

64.00

5.00

4755

24.00

5.00

5206

20.00

5.00

4759

24.00

5.00

5220

9.80

3.00

4763

33.00

5.00

5223

13.40

4.00

4767

42.00

5.00

5224

18.00

5.00

4771

40.00

5.00

5228

14.00

5.00

4775

32.00

5.00

5232

64.00

5.00

4779

48.00

5.00

5236

24.00

5.00

4783

64.00

5.00

5240

22.00

5.00

4787

76.00

5.00

5244

42.00

5.00

4810

2.60

1.00

5248

10.40

4.00

4814

7.30

3.00

5252

14.00

4.00

4819

17.60

5.00

5256

50.00

5.00

4823

4.40

1.50

5260

12.00

4.00

4827

15.60

5.00

5261

16.00

5.00

4831

14.00

5.00

5310

4.30

1.50

4835

25.00

5.00

5311

5.80

2.00

4839

18.00

5.00

5316

5.00

1.50

4843

14.00

5.00

5317

6.40

2.00

4847

24.00

5.00

5322

5.00

1.50

4851

39.00

5.00

5323

6.40

2.00

4855

22.00

5.00

5328

9.40

3.00

4910

23.60

5.00

5329

12.40

4.00

4911

32.00

5.00

5334

7.00

3.00

4916

13.40

4.00

5335

9.80

3.00

4917

18.00

5.00

5340

3.15

1.00

4922

50.00

5.00

5341

4.40

1.50

4926

86.00

5.00

5346

6.40

2.00

4931

42.00

5.00

5350

3.15

1.00

4935

42.00

5.00

5352

4.40

1.50

4939

56.00

5.00

5356

7.00

3.00

4944

24.00

5.00

5358

9.80

3.00

5010

78.00

5.00

5362

18.00

5.00

5014

130.00

5.00

5367

24.00

5.00

5019

34.00

5.00

5371

64.00

5.00

5023

86.00

5.00

5376

50.00

5.00

5028

20.00

5.00

5380

3.20

1.00

5032

30.00

5.00

5385

50.00

5.00

5037

4.00

1.50

5387

50.00

5.00

5041

20.00

5.00

5394

28.00

5.00

5110

3.10

1.00

5398

7.80

3.00

5114

5.30

1.50

5399

10.40

4.00

5118

31.00

5.00

5403

6.80

2.00

5120

42.00

5.00

5404

8.00

3.00


Third Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

5408

11.00

5.00

5579

41.50

5.00

5410

15.00

5.00

5583

31.00

5.00

5414

28.00

5.00

5585

50.50

5.00

5416

38.00

5.00

5589

32.00

5.00

5419

29.00

5.00

5593

26.00

5.00

5420

32.00

5.00

5594

28.00

5.00

5422

34.60

5.00

5596

23.60

5.00

5423

40.50

5.00

5597

32.00

5.00

5425

11.60

4.00

5610

4.00

1.50

5429

50.00

5.00

5614

17.60

5.00

5434

48.00

5.00

5616

24.00

5.00

5438

3.10

1.00

5620

44.00

5.00

5439

4.00

1.50

5625

24.00

5.00

5443

3.50

1.00

5631

46.00

5.00

5444

4.40

1.50

5635

42.00

5.00

5448

4.20

1.50

5640

46.00

5.00

5451

10.40

4.00

5644

28.00

5.00

5452

14.00

5.00

5649

88.00

5.00

5453

15.60

5.00

5653

46.00

5.00

5454

22.50

5.00

5658

50.00

5.00

5457

8.80

3.00

5662

7.60

3.00

5458

11.60

4.00

5667

3.50

1.00

5462

4.50

1.50

5668

5.40

1.50

5463

5.20

2.00

5673

14.00

4.00

5467

6.80

3.00

5677

18.00

5.00

5471

10.00

3.00

5681

20.00

5.00

5472

15.40

4.00

5685

42.00

5.00

5475

11.60

3.00

5689

46.00

5.00

5477

16.40

5.00

5693

42.00

5.00

5481

11.80

3.00

5697

28.00

5.00

5483

16.60

5.00

5701

2.50

1.50

5487

11.60

4.00

5702

7.80

3.00

5489

17.60

5.00

5706

7.60

3.00

5493

14.60

5.00

5710

8.00

3.00

5495

20.00

5.00

5714

1.30

0.80

5499

34.00

5.00

5718

3.15

1.00

5501

46.00

5.00

5719

4.40

1.50

5505

34.00

5.00

5723

12.80

4.00

5507

46.00

5.00

5727

15.60

5.00

5511

39.60

5.00

5731

4.40

1.50

5512

54.50

5.00

5735

98.00

5.00

5513

54.00

5.00

5739

64.00

5.00

5515

78.00

5.00

5742

58.00

5.00

5518

44.50

5.00

5746

4.60

1.50

5519

63.50

5.00

5750

21.00

5.00

5523

26.00

5.00

5754

18.00

5.00

5525

38.00

5.00

5758

66.00

5.00

5529

28.00

5.00

5762

42.00

5.00

5531

38.00

5.00

5766

86.00

5.00

5535

28.00

5.00

5770

34.00

5.00

5537

38.00

5.00

5774

18.00

5.00

5541

29.00

5.00

5778

20.00

5.00

5543

33.00

5.00

5782

55.00

5.00

5547

24.00

5.00

5786

34.00

5.00

5551

20.60

5.00

5790

38.00

5.00

5553

28.00

5.00

5794

46.00

5.00

5557

3.30

1.50

5798

20.00

5.00

5561

32.00

5.00

5802

64.00

5.00

5565

4.80

1.50

5806

116.00

5.00

5569

3.10

1.00

5810

34.00

5.00

5573

22.00

5.00

5814

24.00

5.00

5574

33.00

5.00

5818

10.40

4.00

5577

27.60

5.00

5822

16.00

5.00


Third Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

5826

42.00

5.00

6169

50.00

5.00

5830

64.00

5.00

6173

64.00

5.00

5834

6.40

2.00

6177

24.00

5.00

5838

5.20

1.50

6181

19.00

5.00

5842

38.00

5.00

6182

31.00

5.00

5846

28.00

5.00

6186

10.40

4.00

5850

28.00

5.00

6187

14.00

5.00

5854

26.00

5.00

6191

17.60

5.00

5858

26.00

5.00

6192

24.00

5.00

5910

2.30

1.00

6196

15.60

5.00

5911

3.10

1.00

6197

31.00

5.00

5915

6.20

2.00

6198

42.00

5.00

5920

3.20

1.00

6202

43.00

5.00

5924

7.00

3.00

6203

58.00

5.00

5926

9.80

3.00

6207

64.00

5.00

5930

23.60

5.00

6211

58.00

5.00

5931

32.00

5.00

6215

54.00

5.00

5936

64.00

5.00

6219

108.00

5.00

5940

64.00

5.00

6223

78.00

5.00

5945

68.00

5.00

6227

86.00

5.00

5949

86.00

5.00

6231

86.00

5.00

5954

50.00

5.00

6235

50.00

5.00

5958

28.00

5.00

6239

64.00

5.00

5963

70.00

5.00

6243

108.00

5.00

5967

15.60

5.00

6247

86.00

5.00

5971

26.00

5.00

6251

64.00

5.00

5976

6.40

2.00

6255

70.00

5.00

5980

11.60

4.00

6259

64.00

5.00

5985

116.00

5.00

6263

42.00

5.00

5989

52.00

5.00

6310

3.40

1.00

5994

76.00

5.00

6314

2.10

1.00

5998

86.00

5.00

6318

4.20

1.50

6003

42.00

5.00

6320

5.60

1.50

6007

28.00

5.00

6324

6.40

2.00

6012

20.00

5.00

6328

5.60

1.50

6016

50.00

5.00

6333

4.40

1.50

6021

32.00

5.00

6337

5.80

2.00

6025

98.00

5.00

6338

6.80

3.00

6029

11.60

4.00

6343

4.00

1.50

6034

16.80

5.00

6344

5.20

1.50

6038

40.00

5.00

6349

8.80

3.00

6042

15.60

5.00

6350

11.60

4.00

6100

1.30

0.80

6354

1.50

0.80

6104

4.00

1.50

6355

2.10

1.00

6108

4.40

1.50

6359

5.00

1.50

6112

8.00

3.00

6360

6.40

2.00

6116

2.80

1.00

6365

14.60

5.00

6120

4.40

1.50

6366

20.00

5.00

6124

5.20

1.50

6371

10.60

3.00

6128

11.60

4.00

6372

14.00

4.00

6132

7.00

3.00

6377

4.00

1.50

6133

9.80

3.00

6378

5.20

1.50

6137

12.00

4.00

6382

6.40

2.00

6138

16.00

5.00

6383

7.60

3.00

6142

20.40

5.00

6387

1.90

1.00

6143

28.00

5.00

6388

2.50

1.00

6147

32.00

5.00

6392

5.00

1.50

6151

50.00

5.00

6393

6.40

2.00

6155

58.00

5.00

6397

13.40

4.00

6159

16.00

5.00

6398

18.00

5.00

6160

22.00

5.00

6164

10.40

4.00

6402

13.40

4.00

6165

14.00

5.00

6404

18.00

5.00


Third Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

6414

The amount shown in this column in the item relating to the dislocation concerned, plus one-half of that amount

The amount shown in this column in the item relating to the dislocation concerned, plus one-half of that amount

6568

3.45

1.00

 

6569

4.80

1.50

 

6574

1.30

0.80

 

6575

2.50

1.00

 

6578

1.30

0.80

 

6580

2.50

1.00

 

6584

5.30

3.00

 

6586

19.00

5.00

 

6590

7.00

3.00

 

6592

9.80

3.00

 

 

 

6596

22.00

5.00

 

 

 

6601

24.00

5.00

6420

3.40

1.00

6605

8.80

3.00

6425

6.40

2.00

6606

11.60

4.00

6426

8.80

3.00

6610

30.00

5.00

6431

3.40

1.00

6614

32.00

5.00

6432

4.60

1.50

6618

7.80

3.00

6437

4.90

2.00

6619

10.40

4.00

6438

12.40

4.00

6623

1.30

0.80

6442

6.80

3.00

6624

2.10

1.00

6443

14.00

5.00

6628

1.30

0.80

6447

3.90

1.00

6629

2.50

1.00

6448

5.20

1.50

6633

10.60

3.00

6453

7.00

3.00

6634

14.00

4.00

6454

9.80

3.00

6638

17.60

5.00

6458

10.60

3.00

6639

24.00

5.00

6459

11.00

5.00

6643

64.00

5.00

6463

7.60

3.00

 

 

 

6467

5.60

3.00

 

 

 

6468

16.40

5.00

6647

The amount shown in this column in the item relating to the fracture concerned, plus one-third of that amount

The amount shown in this column in the item relating to the fracture concerned, plus one-third of that amount

6472

6.40

2.00

 

6473

7.60

3.00

 

6477

8.60

4.00

 

6478

12.00

5.00

 

6482

10.40

4.00

 

6483

12.00

5.00

 

6487

5.90

2.00

 

6489

7.80

3.00

 

6493

6.40

2.00

 

 

 

6494

7.60

3.00

 

 

 

6498

1.30

0.80

 

 

 

6499

2.50

1.00

6651

The amount shown in this column in the item relating to the fracture concerned, plus one-half of that amount

The amount shown in this column in the item relating to the fracture concerned, plus one-half of that amount

6503

11.60

4.00

 

6505

15.60

5.00

 

6509

8.80

3.00

 

6510

11.60

4.00

 

6515

28.00

5.00

 

6516

38.00

5.00

 

6521

7.40

2.00

 

6522

10.40

3.00

 

6525

11.30

4.00

 

 

 

6527

14.00

5.00

 

 

 

6531

17.60

5.00

 

 

 

6532

24.00

5.00

6655

The amount shown in this column in the item relating to the fracture concerned, plus three-quarters of that amount

The amount shown in this column in the item relating to the fracture concerned, plus three-quarters of that amount

6537

17.60

5.00

 

6538

24.00

5.00

 

6543

17.60

5.00

 

6544

24.00

5.00

 

6549

4.90

2.00

 

6550

8.80

3.00

 

6555

3.40

1.00

 

6559

4.40

1.50

 

6564

3.70

1.00

 


Third Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

6659

One-half of the amount shown in this column in the item that would, but for item 6659 in the First Schedule to this Act, apply to the reduction concerned

One-half of the amount shown in this column in the item that would, but for item 6659 in the First Schedule to this Act, apply to the reduction concerned

7055

7.40

2.00

 

7056

8.80

3.00

 

7060

3.80

3.00

 

7061

3.40

3.00

 

7065

11.60

4.00

 

7069

10.40

4.00

 

7074

12.80

4.00

 

7078

108.00

5.00

 

7082

34.00

5.00

 

7087

22.00

5.00

 

7091

50.00

5.00

 

7095

90.00

5.00

 

7100

110.00

5.00

6663

One-half of the amount shown in this column in the item that would, but for item 6663 in the First Schedule to this Act, apply to the reduction concerned

One-half of the amount shown in this column in the item that would, but for item 6663 in the First Schedule to this Act, apply to the reduction concerned

7104

103.00

5.00

 

7108

38.00

5.00

 

7113

13.40

4.00

 

7114

18.00

5.00

 

7118

20.00

5.00

 

7122

54.00

5.00

 

7126

64.00

5.00

 

7130

22.00

5.00

 

7135

5.00

1.50

 

7136

6.40

2.00

 

7141

32.00

5.00

 

7145

36.00

5.00

 

7149

32.00

5.00

6667

The amount shown in this column in the item that would, but for item 6667 in the First Schedule to this Act, apply to the reduction concerned

The amount shown in this column in the item that would, but for item 6667 in the First Schedule to this Act, apply to the reduction concerned

7154

16.00

5.00

 

7155

22.00

5.00

 

7159

116.00

5.00

 

7163

42.00

5.00

 

7167

58.00

5.00

 

7171

28.00

5.00

 

7176

37.00

5.00

 

7180

42.00

5.00

 

7184

32.00

5.00

 

7189

28.00

5.00

 

7190

38.00

5.00

 

7195

32.00

5.00

6671

The amount shown in this column in the item that would apply in the case of a simple and uncomplicated fracture of the part concerned

The amount shown in this column in the item that would apply in the case of a simple and uncomplicated fracture of the part concerned

7199

1.90

1.00

 

7200

2.30

1.00

 

7205

1.60

0.80

 

7206

2.30

1.00

 

7210

11.60

4.00

 

7214

57.00

5.00

 

7218

24.00

5.00

 

7221

15.00

5.00

 

7222

26.00

5.00

 

7224

22.00

5.00

 

7225

24.45

5.00

 

7227

24.50

5.00

7010

18.00

5.00

7228

38.00

5.00

7014

9.40

3.00

7230

20.00

5.00

7016

12.40

4.00

7233

13.40

4.00

7020

2.50

1.00

7234

18.00

5.00

7025

2.10

1.00

7238

42.00

5.00

7029

3.90

1.00

7242

14.00

4.00

7031

5.20

1.50

7246

24.00

5.00

7035

7.90

2.00

7250

13.40

4.00

7037

10.00

4.00

7252

18.00

5.00

7041

6.40

2.00

7256

16.00

5.00

7043

7.60

3.00

7257

22.00

5.00

7047

70.00

5.00

7261

12.40

4.00

7051

24.00

5.00

7262

12.00

5.00


Third Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

7266

20.00

5.00

7545

64.00

5.00

7271

20.00

5.00

7549

64.00

5.00

7275

24.00

5.00

7553

42.00

5.00

7280

28.00

5.00

7557

14.00

4.00

7284

46.00

5.00

7561

32.00

5.00

7289

70.00

5.00

7565

24.00

5.00

7293

46.00

5.00

7569

76.00

5.00

7297

44.00

5.00

7573

76.00

5.00

7301

46.00

5.00

7577

50.00

5.00

7305

10.40

4.00

7581

25.00

5.00

7309

22.00

5.00

7582

34.00

5.00

7313

8.80

3.00

7586

42.00

5.00

7314

11.60

4.00

7590

50.00

5.00

7318

20.60

5.00

7594

64.00

5.00

7319

28.00

5.00

7598

32.00

5.00

7323

10.80

4.00

7602

42.00

5.00

7324

14.40

5.00

7607

64.00

5.00

7328

13.40

4.00

7611

24.00

5.00

7329

18.00

5.00

7616

42.00

5.00

7333

22.00

5.00

7620

24.00

5.00

7334

30.00

5.00

7625

64.00

5.00

7338

6.40

2.00

7629

6.40

2.00

7339

7.60

3.00

7631

7.60

3.00

7343

8.80

3.00

7635

50.00

5.00

7344

11.60

4.00

7640

36.00

5.00

7348

6.80

3.00

7644

32.00

5.00

7352

18.00

5.00

7649

18.00

5.00

7356

34.00

5.00

7653

6.40

2.00

7360

58.00

5.00

7655

7.60

3.00

7364

28.00

5.00

7659

7.40

2.00

7368

20.00

5.00

7661

8.80

3.00

7372

6.40

2.00

7665

32.00

5.00

7373

7.60

3.00

7670

6.40

2.00

7377

10.40

4.00

7671

7.60

3.00

7378

14.00

5.00

7676

20.00

5.00

7382

15.60

5.00

7680

36.00

5.00

7386

24.00

5.00

7685

32.00

5.00

7390

8.80

3.00

7700

50.00

5.00

7391

11.60

4.00

7704

6.40

2.00

7395

22.00

5.00

7708

4.00

1.50

7396

30.00

5.00

7750

24.00

5.00

7400

28.00

5.00

7754

11.60

4.00

7450

3.40

3.00

7758

20.00

5.00

7454

3.40

1.00

7762

2.50

1.00

7458

4.00

1.50

7767

3.40

1.00

7462

3.40

1.00

7771

8.80

3.00

7466

4.40

1.50

7775

10.40

4.00

7470

3.40

1.00

7779

14.00

5.00

7474

5.20

1.50

7783

22.00

5.00

7478

3.40

1.00

7787

40.00

5.00

7482

6.40

2.00

7791

42.00

5.00

7486

15.60

5.00

7795

20.00

5.00

7490

3.40

1.00

7850

14.00

5.00

7494

5.20

1.50

7854

18.00

5.00

7498

5.20

1.50

7858

14.00

4.00

7510

3.40

1.00

7862

7.60

3.00

7514

50.00

5.00

7866

9.80

3.00

7519

64.00

5.00

7870

5.20

1.50

7523

64.00

5.00

7874

15.60

5.00

7528

64.00

5.00

7877

9.80

3.00

7532

32.00

5.00

7881

24.00

5.00

7537

50.00

5.00

7885

14.00

4.00

7541

50.00

5.00

7889

9.80

3.00


Third Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

7893

6.40

2.00

8114

28.00

5.00

7897

16.00

5.00

8119

32.00

5.00

7901

24.00

5.00

8123

18.00

5.00

7905

10.80

4.00

8128

32.00

5.00

7909

34.00

5.00

8132

18.00

5.00

7913

20.00

5.00

8136

42.00

5.00

7917

32.00

5.00

8141

32.00

5.00

7921

64.00

5.00

8145

20.00

5.00

7925

54.00

5.00

8150

11.60

4.00

7929

64.00

5.00

8154

24.00

5.00

7950

14.00

5.00

8159

50.00

5.00

7952

15.50

5.00

8163

24.00

5.00

7953

19.00

5.00

8167

50.00

5.00

7954

24.00

5.00

8172

28.00

5.00

7958

14.00

5.00

8176

42.00

5.00

7962

7.60

3.00

8180

9.80

3.00

7966

20.00

5.00

8184

26.00

5.00

7970

14.00

4.00

8188

22.00

5.00

7974

32.00

5.00

8192

22.00

5.00

7978

20.00

5.00

8196

24.00

5.00

7982

14.00

4.00

8200

32.00

5.00

7986

34.00

5.00

8204

50.00

5.00

7990

10.40

4.00

8208

90.00

5.00

7994

7.60

3.00

8212

9.80

3.00

7998

22.00

5.00

8216

24.00

5.00

8002

36.00

5.00

8220

18.00

5.00

8007

18.00

5.00

8224

38.00

5.00

8011

28.00

5.00

8228

12.80

4.00

8015

28.00

5.00

8232

42.00

5.00

8020

50.00

5.00

8236

28.00

5.00

8024

16.00

5.00

8240

46.00

5.00

8029

50.00

5.00

8244

62.00

5.00

8033

36.00

5.00

8248

24.00

5.00

8037

98.00

5.00

8252

18.00

5.00

8042

34.00

5.00

8256

36.00

5.00

8046

64.00

5.00

8260

86.00

5.00

8050

50.00

5.00

8264

14.40

5.00

8054

42.00

5.00

8268

46.00

5.00

8058

42.00

5.00

8272

58.00

5.00

8062

24.00

5.00

8276

24.00

5.00

8066

20.00

5.00

8280

42.00

5.00

8070

24.00

5.00

8284

42.00

5.00

8110

18.00

5.00

8288

50.00

5.00


FOURTH SCHEDULE Section 13.

TABLE OF FUND MEDICAL BENEFITS IN RESPECT OF QUEENSLAND

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

2

0.95

0.80

352

10.40

3.00

3

1.40

1.20

355

11.60

4.00

9

4.25

1.50

357

16.00

5.00

11

6.50

2.00

370

5.40

1.50

13

2.00

1.00

371

6.00

2.00

15

8.00

2.00

375

5.40

2.00

17

10.00

3.00

376

6.10

2.00

18

3.25

1.00

378

7.30

3.00

24

1.10

2.30

379

8.90

3.00

37

8.50

3.00

381

9.70

3.00

38

13.00

4.00

382

11.30

3.00

39

17.50

5.00

384

12.50

4.00

40

22.50

5.00

386

16.90

5.00

43

0.95

0.80

388

9.00

3.00

45

2.00

1.00

389

10.20

4.00

203

0.95

0.80

391

10.40

4.00

206

6.90

3.00

392

12.60

4.00

209

8.60

4.00

394

13.80

5.00

210

16.00

5.00

396

10.80

4.00

220

8.80

3.00

397

12.40

4.00

223

16.00

5.00

399

13.20

4.00

224

26.00

5.00

400

14.80

4.00

226

16.90

5.00

402

16.00

5.00

227

24.50

5.00

430

3.10

1.00

230

23.00

5.00

435

6.70

2.00

231

25.50

5.00

436

8.50

2.00

235

26.00

5.00

451

5.90

2.00

236

38.00

5.00

455

4.60

1.50

243

0.30

0.80

456

5.80

2.00

247

0.70

0.80

501

4.80

1.50

251

7.80

3.00

601

3.50

1.00

252

10.40

4.00

611

2.40

1.00

255

3.10

1.00

616

5.60

1.50

256

4.40

1.50

621

11.60

4.00

259

0.70

0.80

625

10.40

4.00

263

4.40

1.50

631

4.40

1.50

267

3.10

1.00

641

6.90

2.00

268

4.40

1.50

651

8.40

3.00

271

3.90

1.50

661

11.60

4.00

275

15.60

5.00

681

3.20

1.00

279

2.90

1.50

691

2.50

1.00

283

17.20

5.00

701

4.50

1.50

287

3.10

1.00

703

2.30

1.00

288

4.40

1.50

705

7.00

2.00

291

7.60

3.00

707

2.70

1.00

301

3.50

1.00

708

1.90

1.00

302

3.80

1.00

715

2.90

1.00

305

4.50

1.50

721

2.70

1.00

306

5.90

1.50

731

9.80

3.00

309

5.90

2.00

741

3.90

1.50

310

6.80

2.00

751

6.00

2.00

313

7.60

3.00

761

28.00

5.00

317

11.60

4.00

771

42.00

5.00

321

0.70

0.80

781

32.00

5.00

323

4.80

1.50

791

7.60

3.00

341

4.50

1.50

801

7.20

2.00

342

5.30

1.50

831

1.60

1.00

344

4.70

1.50

841

3.00

1.00

345

5.20

2.00

851

3.30

1.00

347

7.40

2.00

861

5.60

1.50

348

8.00

3.00

866

7.60

3.00

351

8.80

3.00

871

6.40

2.00


Fourth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

881

3.90

1.50

1102

3.50

1.00

891

14.00

4.00

1104

0.70

0.80

901

11.60

4.00

1106

0.60

0.80

906

14.00

4.00

1108

1.50

1.00

911

3.20

1.00

1110

5.80

2.00

915

6.80

3.00

1112

0.70

0.80

921

0.90

0.80

1114

0.70

0.80

931

0.50

0.80

1116

4.10

1.50

941

1.00

0.80

1118

1.90

1.00

943

1.40

0.80

1120

4.80

1.50

945

2.30

1.00

1122

1.20

1.00

951

3.40

1.00

1124

1.90

1.00

961

2.10

1.00

1126

2.30

1.00

971

7.60

3.00

1128

1.20

0.80

976

15.60

5.00

1130

3.10

1.00

981

2.50

1.00

1132

1.90

1.00

985

4.80

1.50

1134

3.10

1.00

1000

0.20

0.80

1136

4.80

1.50

1002

1.20

0.80

1138

1.90

1.00

1004

0.70

0.80

1140

2.30

1.00

1006

0.90

0.80

1142

1.40

1.00

1008

0.20

0.80

1144

1.90

1.00

1010

0.60

0.80

1146

1.90

1.00

1012

3.50

1.00

1148

2.70

1.00

1014

0.90

1.00

1150

4.80

1.50

1016

2.60

1.00

1152

2.70

1.00

1018

3.30

1.50

1154

2.30

1.00

1020

5.20

3.00

1156

2.30

1.00

1022

0.20

0.80

1160

0.70

1.00

1024

1.20

0.80

1162

2.60

1.00

1026

1.20

0.80

1164

3.00

1.00

1028

2.70

1.00

1166

3.00

1.00

1030

2.60

1.00

1168

1.50

1.00

1032

2.70

1.00

1170

3.40

1.00

1034

1.90

1.00

1172

0.90

0.80

1036

2.70

1.00

1174

1.90

1.00

1038

3.10

1.00

1176

1.80

1.00

1040

3.10

1.00

1180

0.60

0.80

1042

0.70

1.00

1182

0.70

0.80

1044

4.00

1.50

1184

1.70

1.00

1046

1.40

0.80

1186

0.70

0.80

1048

5.60

1.50

1188

1.90

1.00

1050

4.00

1.50

1190

2.70

1.00

1052

8.80

3.00

1192

0.70

1.00

1054

0.70

0.80

1194

1.20

1.00

1060

0.20

0.80

1196

2.70

1.00

1062

0.60

0.80

1198

1.20

1.00

1064

0.70

0.80

1200

0.70

0.80

1066

2.30

1.00

1202

0.90

1.00

1068

2.00

1.00

1204

0.10

0.80

1070

1.30

1.00

1206

1.10

1.00

1072

2.70

1.00

1208

1.70

1.00

1074

7.60

3.00

1210

1.20

1.00

1076

0.90

0.80

1212

2.00

1.00

1080

1.20

0.80

1214

1.20

0.80

1082

2.30

1.00

1216

1.30

0.80

1084

8.80

3.00

1218

3.50

1.00

1090

1.90

1.00

1220

5.00

1.50

1092

1.90

1.00

1222

5.00

1.50

1094

1.90

1.00

1224

6.80

3.00

1096

0.90

0.80

1226

8.80

3.00

1098

1.30

0.80

1228

3.50

1.00

1100

1.50

1.00

1230

5.00

1.50


Fourth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

1232

2.70

1.00

1394

5.00

2.00

1234

3.80

1.50

1395

0.40

0.80

1236

5.30

1.50

1397

2.90

1.00

1238

6.00

2.00

1399

0.70

0.80

1240

1.90

1.00

1401

1.90

1.00

1242

3.10

1.00

1404

0.50

0.80

1244

4.20

1.50

1407

0.70

1.00

1246

5.00

1.50

1410

1.90

1.00

1248

0.70

0.80

1413

1.90

1.00

1250

1.20

1.00

1416

3.10

1.00

1252

3.30

1.50

1419

1.90

1.00

1254

5.20

1.50

1421

2.30

1.00

1256

6.30

2.00

1423

1.80

1.00

1258

6.90

3.00

1425

4.00

1.50

1260

2.70

1.00

1428

1.80

1.00

1262

4.40

1.50

1430

5.00

1.50

1264

1.20

1.00

1432

8.80

3.00

1266

3.30

1.50

1434

2.70

1.00

1268

5.20

1.50

1436

3.10

1.00

1270

6.30

2.00

1438

8.80

3.00

1272

3.00

1.00

1441

3.30

1.00

1274

8.80

3.00

1444

2.20

1.00

1276

5.80

2.00

1447

5.00

1.50

1278

1.20

1.00

1450

3.90

1.50

1280

3.30

1.50

1453

2.20

1.00

1282

5.20

1.50

1456

2.50

1.00

1284

6.30

2.00

1459

1.70

1.00

1286

6.90

3.00

1461

3.80

1.50

1288

4.00

1.50

1463

5.20

2.00

1290

4.10

1.50

1466

6.80

2.00

1292

4.10

1.50

1468

1.20

0.80

1294

1.20

1.00

1470

1.70

1.00

1296

1.90

1.00

1472

4.00

1.50

1298

3.30

1.50

1474

8.80

3.00

1301

1.20

1.00

1476

3.70

1.50

1302

3.30

1.50

1478

3.30

1.00

1304

5.20

1.50

1481

3.30

1.00

1305

6.30

2.00

1484

6.80

3.00

1307

6.90

3.00

1487

3.70

1.50

1310

1.20

1.00

1490

3.70

1.50

1313

1.90

1.00

1491

0.20

0.80

1316

2.70

1.00

1493

6.80

3.00

1319

3.60

1.50

1494

8.80

3.00

1322

0.70

0.80

1495

0.90

0.80

1325

0.70

0.80

1496

1.90

1.00

1328

2.40

1.00

1497

3.90

1.50

1331

3.00

1.50

1499

3.50

1.00

1334

1.60

1.00

1500

0.70

0.80

1337

3.70

1.50

1502

0.70

0.80

1340

5.50

2.00

1504

0.70

0.80

1343

2.20

1.50

1506

2.30

1.00

1346

6.80

3.00

1508

1.70

0.80

1349

3.30

1.00

1511

1.90

1.00

1352

3.50

1.00

1513

1.60

0.80

1355

3.00

1.00

1515

2.40

1.00

1358

1.80

1.00

1517

3.70

1.00

1380

0.70

0.80

1519

4.50

1.50

1382

0.70

0.80

1521

5.50

1.50

1385

1.20

1.00

1523

5.50

2.00

1388

3.30

1.50

1525

2.40

1.00

1389

4.80

1.50

1527

4.00

1.50

1391

2.50

1.00

1529

2.30

1.00

1392

4.30

1.50

1531

4.40

1.50


Fourth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

1534

1537

1539

1541

1543

1545

1546

1548

1551

1554

1557

1560

1562

1564

1566

1568

1571

1580

1582

1584

1586

1588

1590

1601

1604

1607

1609

1611

1613

1615

1616

1621

1623

1625

1627

1629

1631

1640

1643

1645

1647

1649

1651

1653

1661

1664

1667

1670

1673

1680

1682

1684

1686

1688

1691

1694

1697

1698

1700

1701

1703

1706

1.90

3.10

2.30

1.90

1.80

0.70

4.00

5.80

2.50

3.90

4.50

3.40

4.30

5.40

5.40

6.00

2.30

1.90

1.60

3.50

0.70

1.20

2.70

1.20

3.30

5.20

6.30

1.50

3.30

2.50

3.50

0.40

1.80

1.10

2.70

2.30

1.60

5.60

2.90

2.90

8.80

 7.00

8.80

4.00

0.70

5.80

0.70

2.70

3.50

0.70

0.70

0.40

1.10

1.90

1.90

1.00

1.80

3.30

1.90

5.10

1.90

1.90

1.00

1.00

1.00

1.00

1.00

0.80

1.00

1.50

1.00

1.50

2.00

1.50

1.50

2.00

2.00

3.00

1.00

1.00

1.00

1.00

0.80

1.00

1.00

1.00

1.50

1.50

2.00

1.00

1.00

1.00

1.00

0.80

1.00

0.80

1.00

1.00

0.80

1.50

1.00

1.00

3.00

2.00

3.00

1.50

0.80

2.00

1.00

1.00

1.00

0.80

0.80

0.80

0.80

1.00

1.00

0.80

1.00

1.50

1.00

2.00

1.00

1.00

1707

3.10

1.00

1710

0.70

0.80

1712

1.70

1.00

1714

1.70

1.00

1716

0.90

0.80

1718

1720

1722

1724

1726

1728

1730

1732

1734

2.00

4.00

5.10

1.90

4.00

5.80

4.00

0.20

0.20

1.00

2.00

3.00

1.00

1.50

2.00

1.50

0.80

0.80

1736

6.80

3.00

1738

0.90

0.80

1741

1.20

1.00

1744

0.90

0.80

1746

1.20

1.00

1748

1.20

1.00

1761

1.40

0.80

1764

2.70

1.00

1767

0.90

0.80

1770

1.70

1.00

1773

3.10

1.00

1776

4.80

1.50

1779

0.20

0.80

1782

0.20

0.80

1785

0.20

0.80

1790

1.90

1.00

1792

1.90

1.00

1794

4.00

1.50

1796

4.00

1.50

1798

1.90

1.00

1800

1.10

0.80

1802

3.70

1.50

1804

5.80

1.50

1806

2.70

1.00

1808

5.80

2.00

1810

2.70

1.00

1812

0.70

1.00

1820

2.80

1.50

1822

5.00

2.00

1824

6.40

3.00

1826

4.40

3.00

1828

7.40

3.00

1840

12.40

4.00

1841

16.00

5.00

1843

4.10

1.50

1846

4.00

1.50

1849

2.50

1.00

1850

3.80

1.50

1852

3.80

1.50

1855

5.30

1.50

1858

6.00

2.00

1861

4.20

1.50

1863

5.80

2.00

1865

14.00

5.00

1867

4.10

1.50

1869

4.80

1.50

1871

6.80

3.00

1873

14.00

5.00

1875

5.80

2.00


Fourth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

1877

5.80

2.00

2128

4.80

1.50

1879

4.10

1.50

2132

4.80

1.50

1881

3.10

1.00

2136

4.60

1.50

1884

2.50

1.00

2140

4.00

1.50

1887

4.00

1.50

2144

4.80

1.50

1889

12.40

4.00

2160

3.40

1.50

1891

1.90

1.00

2164

11.60

4.00

1893

3.90

1.50

2169

8.80

3.00

1901

1.70

1.00

2173

5.80

2.00

1903

3.50

1.00

2177

5.90

2.00

1905

3.50

1.00

2181

6.80

3.00

1907

5.30

1.50

2185

3.80

1.50

1909

4.00

1.50

2200

3.40

1.50

1911

6.00

2.00

2205

3.40

1.50

1913

1.30

1.00

2209

5.60

1.50

1915

1.50

1.00

2214

4.80

2.00

1921

7.00

2.00

2218

4.20

3.00

1923

7.20

3.00

2222

6.80

3.00

1925

8.40

3.00

2226

5.30

3.00

1941

8.80

3.00

2230

7.80

3.00

1943

4.00

1.50

2234

5.60

2.00

1945

4.00

1.50

2238

6.00

2.00

1947

3.40

1.50

2247

6.60

3.00

1949

2.70

1.00

2250

6.40

2.00

1951

4.00

1.50

2254

1.90

1.00

1953

4.00

1.50

2270

6.80

3.00

1955

4.40

1.50

2274

4.80

1.50

1957

7.00

2.00

2290

3.40

1.50

1959

7.00

2.00

2294

5.80

2.00

1961

5.80

2.00

2298

6.40

2.00

1963

4.00

1.50

2310

6.80

3.00

1965

5.60

1.50

2314

9.80

3.00

1967

5.60

1.50

2318

9.80

3.00

1969

5.60

1.50

2322

9.80

3.00

1971

6.80

3.00

2326

4.90

2.00

1973

7.00

2.00

2330

4.80

1.50

1975

5.60

1.50

2334

9.20

3.00

1977

5.80

2.00

2338

6.80

3.00

1979

4.00

1.50

2342

7.60

3.00

1981

5.80

2.00

2346

4.60

1.50

1983

5.80

2.00

2350

3.80

3.00

2010

1.60

1.00

2354

10.40

4.00

2014

2.50

1.00

2358

5.00

1.50

2018

2.70

1.00

2362

2.10

1.00

2022

3.00

1.00

2367

2.10

1.00

2026

3.50

1.00

2371

6.40

2.00

2040

2.70

1.00

2410

5.80

2.00

2044

1.90

1.00

2420

0.90

0.80

2048

1.50

1.00

2440

4.40

1.50

2052

6.80

3.00

2444

2.70

1.00

2060

3.30

1.50

2460

1.60

1.00

2064

3.30

1.50

2464

2.40

1.00

2068

3.30

1.50

2468

5.60

1.50

2072

3.50

1.00

2510

24.00

5.00

2076

4.80

1.50

2514

24.00

5.00

2081

2.90

1.00

2518

8.00

3.00

2091

3.50

1.50

2522

14.00

4.00

2094

4.90

2.00

2526

32.00

5.00

2098

4.30

3.00

2530

24.00

5.00

2110

3.50

1.00

2534

11.60

4.00

2114

4.90

1.50

2538

15.60

5.00

2119

3.50

1.00

2542

6.40

2.00

2123

1.60

1.00

2570

11.60

4.00


Fourth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

2574

6.40

2.00

3119

6.60

3.00

2578

6.40

2.00

3121

7.40

4.00

2620

12.40

4.00

3125

13.40

4.00

2624

10.40

4.00

3126

18.00

5.00

2628

10.40

4.00

3131

16.00

5.00

2632

2.00

4.00

3132

22.00

5.00

2636

4.00

1.50

3137

3.50

1.00

2640

5.80

2.00

3138

6.80

3.00

2644

5.80

2.00

3143

5.90

2.00

2648

4.80

1.50

3144

3.80

3.00

2652

4.80

1.50

3149

8.60

4.00

2657

5.80

2.00

3150

11.00

5.00

2661

5.00

1.50

3155

18.00

5.00

2666

2.90

1.00

3156

22.00

5.00

2670

4.80

1.50

3161

34.00

5.00

2674

4.00

1.50

3162

37.00

5.00

2678

4.00

1.50

3166

48.00

5.00

2682

6.80

3.00

3170

8.80

3.00

2686

1.90

1.00

3174

2.60

1.00

2691

10.40

4.00

3178

1.00

1.00

2696

6.40

2.00

3180

3.50

1.00

2700

5.60

1.50

3184

2.10

1.00

2901

4.80

1.50

3185

2.20

1.50

2904

6.20

2.00

3190

2.90

1.00

2907

6.80

3.00

3191

5.20

2.00

2910

8.80

3.00

3196

2.60

1.50

2913

12.40

4.00

3197

5.30

2.00

3000

0.95

0.80

3201

4.40

1.50

3004

1.90

1.00

3202

5.80

2.00

3005

2.50

1.00

3206

7.80

3.00

3009

3.15

1.00

3207

10.40

4.00

3011

4.40

1.50

3211

0.70

0.80

3015

6.80

2.00

3216

0.70

0.80

3017

8.00

3.00

3220

5.90

2.00

3021

2.60

1.00

3221

8.80

3.00

3025

4.90

1.50

3225

6.40

2.00

3030

3.30

1.50

3226

7.60

3.00

3034

7.60

3.00

3230

10.60

3.00

3039

2.90

1.50

3232

14.00

4.00

3043

6.80

3.00

3236

10.60

3.00

3045

9.40

3.00

3238

14.00

4.00

3049

6.40

2.00

3242

6.40

2.00

3051

7.60

3.00

3244

7.60

3.00

3055

7.00

3.00

3248

6.80

2.00

3056

9.80

3.00

3250

8.00

3.00

3061

0.80

0.80

3254

17.60

5.00

3064

2.60

1.00

3255

24.00

5.00

3065

6.80

3.00

3259

24.00

5.00

3069

8.80

3.00

3263

50.00

5.00

3070

14.00

5.00

3267

13.40

4.00

3074

4.00

1.50

3269

18.00

5.00

3078

4.90

2.00

3273

34.00

5.00

3080

5.60

3.00

3274

46.00

5.00

3084

3.50

1.00

3279

16.00

5.00

3089

6.80

3.00

3280

22.00

5.00

3093

2.10

1.00

3285

3.15

1.00

3097

7.00

3.00

3286

4.40

1.50

3099

9.80

3.00

3291

7.00

3.00

3103

5.00

1.50

3292

9.80

3.00

3104

6.40

2.00

3297

2.50

1.00

3108

7.00

3.00

3298

3.40

1.00

3110

9.80

3.00

3303

6.40

2.00

3115

2.50

1.00

3304

7.60

3.00


Fourth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

3309

7.60

3.00

3510

11.60

4.00

3313

37.00

5.00

3514

22.00

5.00

3315

50.00

5.00

3519

28.00

5.00

3319

2.50

1.00

3523

46.00

5.00

3323

10.60

3.00

3528

28.00

5.00

3324

14.00

4.00

3529

38.00

5.00

3328

13.40

4.00

3534

23.60

5.00

3329

18.00

5.00

3535

32.00

5.00

3334

26.60

5.00

3539

43.00

5.00

3335

36.00

5.00

3541

58.00

5.00

3340

50.00

5.00

3545

78.00

5.00

3344

86.00

5.00

3550

20.60

5.00

3348

19.00

5.00

3551

28.00

5.00

3349

26.00

5.00

3556

86.00

5.00

3353

42.00

5.00

3560

28.00

5.00

3357

62.00

5.00

3561

38.00

5.00

3361

38.00

5.00

3566

28.00

5.00

3362

46.00

5.00

3567

38.00

5.00

3367

23.60

5.00

3572

14.60

5.00

3368

32.00

5.00

3573

20.00

5.00

3372

26.60

5.00

3577

17.60

5.00

3373

36.00

5.00

3578

24.00

5.00

3377

11.50

5.00

3582

46.00

5.00

3378

16.00

5.00

3583

62.00

5.00

3383

24.00

5.00

3588

11.60

4.00

3387

18.00

5.00

3589

15.60

5.00

3392

20.60

5.00

3593

20.60

5.00

3393

28.00

5.00

3594

28.00

5.00

3397

46.00

5.00

3598

46.00

5.00

3402

10.40

4.00

3599

62.00

5.00

3406

22.00

5.00

3604

20.60

5.00

3408

30.00

5.00

3605

28.00

5.00

3412

10.60

4.00

3609

26.60

5.00

3414

16.00

5.00

3610

36.00

5.00

3418

17.20

5.00

3614

46.00

5.00

3419

22.00

5.00

3615

62.00

5.00

3423

17.20

5.00

3620

46.00

5.00

3424

22.00

5.00

3624

24.00

5.00

3428

46.00

5.00

3626

43.00

5.00

3430

62.00

5.00

3630

25.00

5.00

3434

6.40

2.00

3632

34.00

5.00

3436

7.60

3.00

3636

11.60

4.00

3440

24.00

5.00

3640

6.40

2.00

3442

50.00

5.00

3645

86.00

5.00

3446

25.00

5.00

3649

20.60

5.00

3448

38.00

5.00

3651

28.00

5.00

3452

31.00

5.00

3655

31.00

5.00

3454

42.00

5.00

3656

42.00

5.00

3458

23.60

5.00

3661

31.00

5.00

3460

32.00

5.00

3662

42.00

5.00

3464

42.00

5.00

3667

50.00

5.00

3469

86.00

5.00

3671

32.00

5.00

3473

32.00

5.00

3675

7.60

3.00

3478

42.00

5.00

3680

2.30

1.00

3482

42.00

5.00

3681

3.10

1.00

3486

32.00

5.00

3686

86.00

5.00

3487

54.00

5.00

3690

24.00

5.00

3491

23.60

5.00

3691

40.00

5.00

3492

32.00

5.00

3696

50.00

5.00

3497

30.00

5.00

3700

55.00

5.00

3498

62.00

5.00

3704

17.60

5.00

3502

58.00

5.00

3705

24.00

5.00

3506

86.00

5.00

3709

20.60

5.00


Fourth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

3710

28.00

5.00

3908

5.80

2.00

3714

28.00

5.00

3909

6.80

3.00

3716

34.00

5.00

3914

8.40

3.00

3720

1.90

1.00

3915

12.00

4.00

3721

2.50

1.00

3917

24.50

5.00

3726

19.00

5.00

3920

26.50

5.00

3727

28.00

5.00

3921

8.80

3.00

3731

14.60

5.00

3923

11.60

4.00

3732

20.00

5.00

3926

24.00

5.00

3736

20.60

5.00

3927

19.00

5.00

3737

28.00

5.00

3931

20.00

5.00

3741

19.00

5.00

3932

20.00

5.00

3742

22.00

5.00

3936

14.60

5.00

3746

5.00

1.50

3937

20.00

5.00

3747

6.40

2.00

3941

50.00

5.00

3751

1.70

1.00

3945

3.50

1.00

3755

3.40

1.50

3949

2.25

1.00

3756

3.80

2.00

3951

3.00

1.00

3760

7.00

3.00

3955

5.60

1.50

3761

9.80

3.00

3957

7.20

2.00

3765

3.40

1.00

3961

14.60

5.00

3769

1.60

1.00

3963

20.00

5.00

3770

2.50

1.00

3967

28.00

5.00

3771

9.60

3.00

3971

32.00

5.00

3772

12.80

4.00

3975

46.00

5.00

3773

15.85

5.00

3979

58.00

5.00

3774

22.00

5.00

3983

86.00

5.00

3776

7.60

3.00

3987

78.00

5.00

3780

32.00

5.00

3991

86.00

5.00

3784

68.00

5.00

3995

42.00

5.00

3788

78.00

5.00

3999

42.00

5.00

3792

2.50

1.00

4004

98.00

5.00

3796

9.40

3.00

4008

86.00

5.00

3797

12.40

4.00

4013

86.00

5.00

3801

2.70

1.00

4017

86.00

5.00

3805

6.40

2.00

4022

42.00

5.00

3806

7.60

3.00

4026

50.00

5.00

3811

14.60

5.00

4031

32.00

5.00

3812

20.00

5.00

4035

32.00

5.00

3817

1.10

0.80

4040

16.00

5.00

3821

3.90

1.50

4050

3.10

1.00

3826

20.00

5.00

4051

4.40

1.50

3827

25.00

5.00

4055

6.80

2.00

3832

5.30

1.50

4056

8.00

3.00

3836

5.60

3.00

4060

10.60

3.00

3838

16.00

5.00

4061

14.00

4.00

3842

14.60

5.00

4065

17.60

5.00

3844

20.00

5.00

4066

24.00

5.00

3848

17.60

5.00

4070

14.60

5.00

3850

24.00

5.00

4071

20.00

5.00

3854

7.40

2.00

4075

17.60

5.00

3856

8.80

3.00

4076

24.00

5.00

3860

24.00

5.00

4090

6.80

2.00

3865

42.00

5.00

4091

8.00

3.00

3869

22.00

5.00

4095

17.60

5.00

3874

5.20

1.50

4096

24.00

5.00

3878

17.60

5.00

4101

17.60

5.00

3880

24.00

5.00

4102

24.00

5.00

3883

10.00

5.00

4107

31.00

5.00

3884

19.00

5.00

4108

42.00

5.00

3888

6.00

2.00

4113

23.60

5.00

3900

1.90

1.00

4114

32.00

5.00

3904

7.00

2.00

4119

17.60

5.00


Fourth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

4120

24.00

5.00

4401

15.50

5.00

4125

31.00

5.00

4402

15.00

5.00

4126

42.00

5.00

4403

3.10

1.00

4150

10.40

4.00

4404

9.80

3.00

4151

14.00

5.00

4408

10.40

4.00

4156

1.60

0.80

4412

8.80

3.00

4157

2.30

1.00

4416

11.60

4.00

4161

8.80

3.00

4420

2.30

1.00

4162

11.60

4.00

4424

2.10

1.00

4166

14.60

5.00

4428

30.00

5.00

4167

20.00

5.00

4432

46.00

5.00

4171

17.60

5.00

4436

23.00

5.00

4172

24.00

5.00

4440

7.60

3.00

4176

31.00

5.00

4444

42.00

5.00

4177

42.00

5.00

4448

42.00

5.00

4182

64.00

5.00

4450

26.00

5.00

4183

86.00

5.00

4452

4.40

1.50

4188

5.80

2.00

4456

44.00

5.00

4189

6.80

3.00

4460

4.40

1.50

4194

1.90

1.00

4464

20.00

5.00

4195

2.50

1.00

4468

42.00

5.00

4200

7.00

3.00

4472

64.00

5.00

4201

9.80

3.00

4476

2.40

1.00

4206

17.60

5.00

4480

7.60

3.00

4207

24.00

5.00

4484

5.80

2.00

4212

14.60

5.00

4488

42.00

5.00

4213

20.00

5.00

4492

50.00

5.00

4218

23.60

5.00

4496

50.00

5.00

4219

32.00

5.00

4498

8.00

3.00

4224

34.00

5.00

4499

7.00

4.00

4225

46.00

5.00

4501

9.80

3.00

4230

38.60

5.00

4502

7.75

5.00

4231

52.00

5.00

4504

9.55

3.00

4236

108.00

5.00

4505

9.50

5.00

4300

5.80

2.00

4507

8.60

4.00

4304

7.40

2.00

4508

6.00

5.00

4305

8.80

3.00

4513

3.15

1.00

4309

7.80

3.00

4514

4.40

1.50

4311

10.40

4.00

4519

4.90

2.00

4315

68.00

5.00

4520

8.80

3.00

4320

43.00

5.00

4525

6.70

2.00

4324

38.00

5.00

4526

9.15

4.00

4328

78.00

5.00

4528

6.40

2.00

4333

50.00

5.00

4529

5.20

1.50

4337

76.00

5.00

4533

2.50

1.00

4342

86.00

5.00

4538

24.00

5.00

4346

42.00

5.00

4542

16.00

5.00

4350

78.00

5.00

4545

24.80

5.00

4355

50.00

5.00

4547

20.00

5.00

4359

3.50

1.00

4551

24.00

5.00

4360

7.30

2.00

4555

15.60

5.00

4364

30.00

5.00

4559

11.60

4.00

4368

2.00

4.00

4563

64.00

5.00

4372

3.40

1.00

4567

12.40

4.00

4376

6.80

3.00

4571

14.00

5.00

4381

4.00

1.50

4575

15.60

5.00

4385

5.80

1.50

4579

12.40

4.00

4389

4.60

1.50

4583

28.00

5.00

4390

5.80

2.00

4587

42.00

5.00

4394

3.90

3.00

4591

42.00

5.00

4395

5.00

4.00

4595

52.00

5.00

4399

10.00

5.00

4599

42.00

5.00

4400

11.55

5.00

4604

12.00

4.00


Fourth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

4605

16.00

5.00

5128

9.80

3.00

4610

11.60

4.00

5132

11.60

4.00

4614

8.80

3.00

5136

5.80

2.00

4616

11.60

4.00

5140

42.00

5.00

4620

15.60

5.00

5145

20.00

5.00

4625

17.60

5.00

5149

18.00

5.00

4626

24.00

5.00

5153

42.00

5.00

4710

42.00

5.00

5157

34.00

5.00

4714

42.00

5.00

5161

50.00

5.00

4719

108.00

5.00

5165

24.00

5.00

4723

78.00

5.00

5170

38.00

5.00

4727

52.00

5.00

5174

15.60

5.00

4728

70.00

5.00

5178

42.00

5.00

4732

78.00

5.00

5182

52.00

5.00

4735

50.00

5.00

5186

10.40

4.00

4739

38.00

5.00

5190

5.80

2.00

4743

58.00

5.00

5194

24.00

5.00

4747

42.00

5.00

5198

50.00

5.00

4751

42.00

5.00

5202

64.00

5.00

4755

24.00

5.00

5206

20.00

5.00

4759

24.00

5.00

5220

9.80

3.00

4763

33.00

5.00

5223

13.40

4.00

4767

42.00

5.00

5224

18.00

5.00

4771

40.00

5.00

5228

14.00

5.00

4775

32.00

5.00

5232

64.00

5.00

4779

48.00

5.00

5236

24.00

5.00

4783

64.00

5.00

5240

22.00

5.00

4787

76.00

5.00

5244

42.00

5.00

4810

2.10

1.00

5248

10.40

4.00

4814

4819

4823

4827

4831

4835

4839

4843

4847

4851

4.30

6.10

4.40

15.60

14.00

20.00

18.00

14.00

24.00

24.00

3.00

3.00

1.50

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5252

5256

5260

5261

5310

5311

5316

5317

5322

5323

5328

5329

5334

5335

5340

5341

5346

5350

5352

5356

5358

5362

5367

5371

5376

5380

5385

5387

5394

5398

5399

5403

5404

14.00

50.00

12.00

16.00

3.30

5.80

5.00

6.40

5.00

6.40

9.40

12.40

7.00

9.80

3.15

4.40

6.40

3.15

4.40

7.00

9.80

18.00

24.00

64.00

50.00

3.20

50.00

50.00

28.00

7.80

10.40

6.80

8.00

4.00

5.00

4.00

5.00

1.00

2.00

1.50

2.00

1.50

2.00

3.00

4.00

3.00

3.00

1.00

1.50

2.00

1.00

1.50

3.00

3.00

5.00

5.00

5.00

5.00

1.00

5.00

5.00

5.00

3.00

4.00

2.00

3.00

4855

22.00

5.00

4910

23.60

5.00

4911

32.00

5.00

4916

13.40

4.00

4917

18.00

5.00

4922

50.00

5.00

4926

86.00

5.00

4931

42.00

5.00

4935

42.00

5.00

4939

56.00

5.00

4944

24.00

5.00

5010

68.00

5.00

5014

60.00

5.00

5019

34.00

5.00

5023

86.00

5.00

5028

20.00

5.00

5032

30.00

5.00

5037

4.00

1.50

5041

20.00

5.00

5110

2.60

1.00

5114

5.80

2.00

5118

31.00

5.00

5120

42.00

5.00

5124

9.80

3.00


Fourth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

5408

11.00

5.00

5577

25.10

5.00

5410

15.00

5.00

5579

31.50

5.00

5414

28.00

5.00

5583

36.00

5.00

5416

38.00

5.00

5585

58.00

5.00

5419

29.00

5.00

5589

32.00

5.00

5420

32.00

5.00

5593

21.00

5.00

5422

32.10

5.00

5594

18.00

5.00

5423

35.50

5.00

5596

23.60

5.00

5425

11.60

4.00

5597

32.00

5.00

5429

50.00

5.00

5610

4.00

1.50

5434

48.00

5.00

5614

17.60

5.00

5438

3.10

1.00

5616

24.00

5.00

5439

4.00

1.50

5620

44.00

5.00

5443

3.50

1.00

5625

24.00

5.00

5444

4.40

1.50

5631

46.00

5.00

5448

5.20

1.50

5635

42.00

5.00

5451

10.40

4.00

5640

46.00

5.00

5452

14.00

5.00

5644

28.00

5.00

5453

13.10

5.00

5649

58.00

5.00

5454

17.50

5.00

5653

46.00

5.00

5457

8.80

3.00

5658

50.00

5.00

5458

11.60

4.00

5662

7.60

3.00

5462

3.00

1.50

5667

3.50

1.00

5463

2.70

1.50

5668

5.40

1.50

5467

6.80

3.00

5673

14.00

4.00

5471

5.00

3.00

5677

18.00

5.00

5472

6.40

3.00

5681

20.00

5.00

5475

6.60

3.00

5685

42.00

5.00

5477

7.40

4.00

5689

46.00

5.00

5481

6.80

3.00

5693

42.00

5.00

5483

7.60

4.00

5697

28.00

5.00

5487

7.60

3.00

5701

3.00

1.50

5489

8.60

4.00

5702

2.80

2.00

5493

14.60

5.00

5706

7.60

3.00

5495

20.00

5.00

5710

8.00

3.00

5499

34.00

5.00

5714

0.95

0.80

5501

46.00

5.00

5718

3.15

1.00

5505

34.00

5.00

5719

4.40

1.50

5507

46.00

5.00

5723

12.80

4.00

5511

37.10

5.00

5727

15.60

5.00

5512

49.50

5.00

5731

4.40

1.50

5513

54.00

5.00

5735

98.00

5.00

5515

78.00

5.00

5739

64.00

5.00

5518

47.00

5.00

5742

58.00

5.00

5519

68.50

5.00

5746

4.60

1.50

5523

36.00

5.00

5750

11.00

5.00

5525

38.00

5.00

5754

18.00

5.00

5529

28.00

5.00

5758

51.00

5.00

5531

38.00

5.00

5762

42.00

5.00

5535

28.00

5.00

5766

86.00

5.00

5537

38.00

5.00

5770

34.00

5.00

5541

24.00

5.00

5774

18.00

5.00

5543

28.00

5.00

5778

20.00

5.00

5547

24.00

5.00

5782

55.00

5.00

5551

20.60

5.00

5786

34.00

5.00

5553

28.00

5.00

5790

38.00

5.00

5557

5.30

1.50

5794

46.00

5.00

5561

32.00

5.00

5798

20.00

5.00

5565

4.80

1.50

5802

64.00

5.00

5569

3.10

1.00

5806

86.00

5.00

5573

22.00

5.00

5810

34.00

5.00

5574

28.00

5.00

5814

24.00

5.00


Fourth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

5818

10.40

4.00

6164

10.40

4.00

5822

16.00

5.00

6165

14.00

5.00

5826

42.00

5.00

6169

50.00

5.00

5830

64.00

5.00

6173

64.00

5.00

5834

6.40

2.00

6177

24.00

5.00

5838

5.20

1.50

6181

10.00

4.00

5842

23.00

5.00

6182

16.00

5.00

5846

28.00

5.00

6186

10.40

4.00

5850

28.00

5.00

6187

14.00

5.00

5854

26.00

5.00

6191

17.60

5.00

5858

26.00

5.00

6192

24.00

5.00

5910

2.30

1.00

6196

15.60

5.00

5911

3.10

1.00

6197

31.00

5.00

5915

6.20

2.00

6198

42.00

5.00

5920

3.20

1.00

6202

43.00

5.00

5924

7.00

3.00

6203

58.00

5.00

5926

9.80

3.00

6207

64.00

5.00

5930

23.60

5.00

6211

58.00

5.00

5931

32.00

5.00

6215

54.00

5.00

5936

64.00

5.00

6219

108.00

5.00

5940

64.00

5.00

6223

78.00

5.00

5945

68.00

5.00

6227

86.00

5.00

5949

86.00

5.00

6231

86.00

5.00

5954

50.00

5.00

6235

50.00

5.00

5958

28.00

5.00

6239

64.00

5.00

5963

70.00

5.00

6243

108.00

5.00

5967

15.60

5.00

6247

86.00

5.00

5971

26.00

5.00

6251

64.00

5.00

5976

6.40

2.00

6255

70.00

5.00

5980

11.60

4.00

6259

64.00

5.00

5985

86.00

5.00

6263

42.00

5.00

5989

52.00

5.00

6310

3.40

1.00

5994

76.00

5.00

6314

2.10

1.00

5998

86.00

5.00

6318

4.20

1.50

6003

42.00

5.00

6320

5.60

1.50

6007

28.00

5.00

6324

6.40

2.00

6012

20.00

5.00

6328

5.60

1.50

6016

50.00

5.00

6333

4.40

1.50

6021

32.00

5.00

6337

5.80

2.00

6025

98.00

5.00

6338

6.80

3.00

6029

11.60

4.00

6343

4.00

1.50

6034

16.80

5.00

6344

5.20

1.50

6038

40.00

5.00

6349

8.80

3.00

6042

15.60

5.00

6350

11.60

4.00

6100

0.95

0.80

6354

1.50

0.80

6104

4.00

1.50

6355

2.10

1.00

6108

4.40

1.50

6359

5.00

1.50

6112

8.00

3.00

6360

6.40

2.00

6116

3.30

1.00

6365

14.60

5.00

6120

4.40

1.50

6366

20.00

5.00

6124

5.20

1.50

6371

10.60

3.00

6128

11.60

4.00

6372

14.00

4.00

6132

7.00

3.00

6377

4.00

1.50

6133

9.80

3.00

6378

5.20

1.50

6137

12.00

4.00

6382

6.40

2.00

6138

16.00

5.00

6383

7.60

3.00

6142

20.40

5.00

6387

1.90

1.00

6143

28.00

5.00

6388

2.50

1.00

6147

32.00

5.00

6392

5.00

1.50

6151

50.00

5.00

6393

6.40

2.00

6155

58.00

5.00

6397

13.40

4.00

6159

16.00

5.00

6398

18.00

5.00

6160

22.00

5.00

6402

13.40

4.00


Fourth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

6404

18.00

5.00

6564

3.70

1.00

 

 

 

6568

3.45

1.00

6414

The amount shown in this column in the item relating to the dislocation concerned, plus one-half of that amount

The amount shown in this column in the item relating to the dislocation concerned, plus one-half of that amount

6569

4.80

1.50

 

6574

0.95

0.80

 

6575

2.00

1.00

 

6578

0.95

0.80

 

6580

2.00

1.00

 

6584

8.80

3.00

 

6586

14.00

5.00

 

6590

7.00

3.00

 

6592

9.80

3.00

 

6596

22.00

5.00

 

 

 

6601

24.00

5.00

6420

3.40

1.00

6605

8.80

3.00

6425

6.40

2.00

6606

11.60

4.00

6426

8.80

3.00

6610

30.00

5.00

6431

3.40

1.00

6614

32.00

5.00

6432

4.60

1.50

6618

7.80

3.00

6437

6.90

2.00

6619

10.40

4.00

6438

12.40

4.00

6623

0.95

0.80

6442

6.80

3.00

6624

1.60

1.00

6443

14.00

5.00

6628

0.95

0.80

6447

3.90

1.00

6629

2.00

1.00

6448

5.20

1.50

6633

10.60

3.00

6453

7.00

3.00

6634

14.00

4.00

6454

9.80

3.00

6638

17.60

5.00

6458

13.60

3.00

6639

24.00

5.00

6459

21.00

5.00

6643

64.00

5.00

6463

7.60

3.00

 

 

 

6467

6.60

3.00

6647

The amount shown in this column in the item relating to the fracture concerned, plus one-third of that amount

The amount shown in this column in the item relating to the fracture concerned, plus one-third of that amount

6468

7.40

4.00

 

6472

6.40

2.00

 

6473

7.60

3.00

 

6477

10.60

4.00

 

6478

12.00

5.00

 

6482

12.40

4.00

 

6483

12.00

5.00

 

6487

4.90

2.00

 

6489

8.80

3.00

 

 

 

6493

6.40

2.00

 

 

 

6494

7.60

3.00

 

 

 

6498

0.95

0.80

6651

The amount shown in this column in the item relating to the fracture concerned, plus one-half of that amount

The amount shown in this column in the item relating to the fracture concerned, plus one-half of that amount

6499

2.00

1.00

 

6503

11.60

4.00

 

6505

15.60

5.00

 

6509

8.80

3.00

 

6510

11.60

4.00

 

6515

28.00

5.00

 

6516

38.00

5.00

 

6521

5.90

2.00

 

6522

6.90

3.00

 

 

 

6525

8.80

3.00

 

 

 

6527

10.00

4.00

 

 

 

6531

17.60

5.00

6655

The amount shown in this column in the item relating to the fracture concerned, plus three-quarters of that amount

The amount shown in this column in the item relating to the fracture concerned, plus three-quarters of that amount

6532

24.00

5.00

 

6537

17.60

5.00

 

6538

24.00

5.00

 

6543

17.60

5.00

 

6544

24.00

5.00

 

6549

5.90

2.00

 

6550

8.80

3.00

 

6555

3.40

1.00

 

6559

4.40

1.50

 

 

 


Fourth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

6659

One-half of the amount shown in this column in the item that would, but for item 6659 in the First Schedule to this Act, apply to the reduction concerned

One-half of the amount shown in this column in the item that would, but for item 6659 in the First Schedule to this Act, apply to the reduction concerned

7055

7.40

2.00

 

7056

8.80

3.00

 

7060

3.80

3.00

 

7061

3.40

3.00

 

7065

11.60

4.00

 

7069

10.40

4.00

 

7074

12.80

4.00

 

7078

108.00

5.00

 

7082

34.00

5.00

 

7087

22.00

5.00

 

7091

50.00

5.00

 

7095

90.00

5.00

 

7100

90.00

5.00

6663

One-half of the amount shown in this column in the item that would, but for item 6663 in the First Schedule to this Act, apply to the reduction concerned

One-half of the amount shown in this column in the item that would, but for item 6663 in the First Schedule to this Act, apply to the reduction concerned

7104

7108

7113

7114

7118

7122

7126

7130

7135

7136

7141

7145

7149

7154

7155

7159

7163

7167

7171

7176

7180

7184

7189

7190

7195

7199

7200

7205

7206

7210

7214

7218

7221

7222

7224

7225

7227

7228

7230

7233

7234

7238

7242

7246

7250

7252

7256

7257

7261

78.00

38.00

13.40

18.00

20.00

54.00

64.00

12.00

5.00

6.40

32.00

36.00

32.00

16.00

22.00

86.00

42.00

58.00

28.00

32.00

42.00

32.00

28.00

38.00

32.00

1.90

2.30

1.60

2.30

11.60

42.00

24.00

10.00

16.00

17.00

17.50

19.45

28.00

20.00

13.40

18.00

42.00

14.00

24.00

13.40

18.00

16.00

22.00

12.40

5.00

5.00

4.00

5.00

5.00

5.00

5.00

5.00

1.50

2.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

1.00

1.00

0.80

1.00

4.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

5.00

4.00

5.00

5.00

4.00

5.00

4.00

5.00

5.00

5.00

4.00

 

 

 

 

 

 

 

 

 

 

 

 

6667

The amount shown in this column in the item that would, but for item 6667 in the First Schedule to this Act, apply to the reduction concerned

The amount shown in this column in the item that would, but for item 6667 in the First Schedule to this Act, apply to the reduction concerned

 

 

 

 

 

 

 

 

 

 

 

6671

The amount shown in this column in the item that would apply in the case of a simple and

uncomplicated fracture of the part concerned

The amount shown in this column in the item that would apply in the case of a simple and

uncomplicated fracture of the part concerned

 

 

 

 

 

 

 

 

 

 

 

7010

18.00

5.00

7014

9.40

3.00

7016

12.40

4.00

7020

1.00

1.00

7025

2.10

1.00

7029

3.90

1.00

7031

5.20

1.50

7035

4.90

2.00

7037

10.00

4.00

7041

6.40

2.00

7043

7.60

3.00

7047

70.00

5.00

7051

24.00

5.00


Fourth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

7262

7.00

5.00

7541

50.00

5.00

7266

20.00

5.00

7545

64.00

5.00

7271

20.00

5.00

7549

64.00

5.00

7275

24.00

5.00

7553

42.00

5.00

7280

28.00

5.00

7557

14.00

4.00

7284

46.00

5.00

7561

32.00

5.00

7289

70.00

5.00

7565

24.00

5.00

7293

46.00

5.00

7569

76.00

5.00

7297

44.00

5.00

7573

76.00

5.00

7301

46.00

5.00

7577

50.00

5.00

7305

10.40

4.00

7581

25.00

5.00

7309

22.00

5.00

7582

34.00

5.00

7313

8.80

3.00

7586

42.00

5.00

7314

11.60

4.00

7590

50.00

5.00

7318

20.60

5.00

7594

64.00

5.00

7319

28.00

5.00

7598

32.00

5.00

7323

10.80

4.00

7602

42.00

5.00

7324

14.40

5.00

7607

64.00

5.00

7328

13.40

4.00

7611

24.00

5.00

7329

18.00

5.00

7616

42.00

5.00

7333

22.00

5.00

7620

24.00

5.00

7334

30.00

5.00

7625

64.00

5.00

7338

6.40

2.00

7629

6.40

2.00

7339

7.60

3.00

7631

7.60

3.00

7343

8.80

3.00

7635

50.00

5.00

7344

11.60

4.00

7640

36.00

5.00

7348

6.80

3.00

7644

32.00

5.00

7352

18.00

5.00

7649

18.00

5.00

7356

34.00

5.00

7653

6.40

2.00

7360

58.00

5.00

7655

7.60

3.00

7364

28.00

5.00

7659

7.40

2.00

7368

20.00

5.00

7661

8.80

3.00

7372

6.40

2.00

7665

32.00

5.00

7373

7.60

3.00

7670

6.40

2.00

7377

10.40

4.00

7671

7.60

3.00

7378

14.00

5.00

7676

20.00

5.00

7382

15.60

5.00

7680

36.00

5.00

7386

24.00

5.00

7685

32.00

5.00

7390

8.80

3.00

7700

50.00

5.00

7391

11.60

4.00

7704

6.40

2.00

7395

22.00

5.00

7708

4.00

1.50

7396

30.00

5.00

7750

24.00

5.00

7400

28.00

5.00

7754

11.60

4.00

7450

3.40

3.00

7758

20.00

5.00

7454

3.40

1.00

7762

2.00

1.00

7458

4.00

1.50

7767

3.40

1.00

7462

3.40

1.00

7771

3.80

3.00

7466

4.40

1.50

7775

10.40

4.00

7470

3.40

1.00

7779

14.00

5.00

7474

5.20

1.50

7783

22.00

5.00

7478

3.40

1.00

7787

40.00

5.00

7482

6.40

2.00

7791

42.00

5.00

7486

15.60

5.00

7795

20.00

5.00

7490

3.40

1.00

7850

14.00

5.00

7494

5.20

1.50

7854

18.00

5.00

7498

5.20

1.50

7858

14.00

4.00

7510

3.40

1.00

7862

7.60

3.00

7514

50.00

5.00

7866

9.80

3.00

7519

64.00

5.00

7870

5.20

1.50

7523

64.00

5.00

7874

15.60

5.00

7528

64.00

5.00

7877

9.80

3.00

7532

32.00

5.00

7881

24.00

5.00

7537

50.00

5.00

7885

14.00

4.00


Fourth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

7889

9.80

3.00

8114

28.00

5.00

7893

6.40

2.00

8119

32.00

5.00

7897

16.00

5.00

8123

18.00

5.00

7901

24.00

5.00

8128

32.00

5.00

7905

10.80

4.00

8132

18.00

5.00

7909

24.00

5.00

8136

42.00

5.00

7913

20.00

5.00

8141

32.00

5.00

7917

32.00

5.00

8145

20.00

5.00

7921

64.00

5.00

8150

11.60

4.00

7925

54.00

5.00

8154

24.00

5.00

7929

64.00

5.00

8159

50.00

5.00

7950

14.00

5.00

8163

24.00

5.00

7952

15.50

5.00

8167

50.00

5.00

7953

16.50

5.00

8172

28.00

5.00

7954

24.00

5.00

8176

42.00

5.00

7958

14.00

5.00

8180

9.80

3.00

7962

7.60

3.00

8184

26.00

5.00

7966

20.00

5.00

8188

22.00

5.00

7970

14.00

4.00

8192

22.00

5.00

7974

32.00

5.00

8196

24.00

5.00

7978

20.00

5.00

8200

32.00

5.00

7982

14.00

4.00

8204

50.00

5.00

7986

34.00

5.00

8208

70.00

5.00

7990

10.40

4.00

8212

9.80

3.00

7994

7.60

3.00

8216

24.00

5.00

7998

22.00

5.00

8220

18.00

5.00

8002

36.00

5.00

8224

38.00

5.00

8007

18.00

5.00

8228

12.80

4.00

8011

28.00

5.00

8232

42.00

5.00

8015

28.00

5.00

8236

28.00

5.00

8020

50.00

5.00

8240

46.00

5.00

8024

16.00

5.00

8244

62.00

5.00

8029

50.00

5.00

8248

24.00

5.00

8033

36.00

5.00

8252

18.00

5.00

8037

98.00

5.00

8256

36.00

5.00

8042

34.00

5.00

8260

86.00

5.00

8046

64.00

5.00

8264

14.40

5.00

8050

50.00

5.00

8268

46.00

5.00

8054

42.00

5.00

8272

58.00

5.00

8058

42.00

5.00

8276

24.00

5.00

8062

24.00

5.00

8280

42.00

5.00

8066

20.00

5.00

8284

42.00

5.00

8070

24.00

5.00

8288

50.00

5.00

8110

18.00

5.00

 

 

 


FIFTH SCHEDULE Section 13.

TABLE OF FUND MEDICAL BENEFITS IN RESPECT OF SOUTH AUSTRALIA

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

2

0.90

0.80

351

6.80

3.00

3

1.35

1.20

352

8.40

3.00

9

4.25

1.50

355

11.60

4.00

11

6.50

2.00

357

16.00

5.00

13

2.00

1.00

370

3.40

1.50

15

8.00

2.00

371

4.50

1.50

17

10.00

3.00

375

4.90

1.50

18

3.25

1.00

376

5.60

2.00

24

1.10

2.30

378

5.80

3.00

37

8.50

3.00

379

7.40

3.00

38

13.00

4.00

381

7.20

3.00

39

17.50

5.00

382

8.80

3.00

40

22.50

5.00

384

12.00

4.00

43

0.90

0.80

386

16.40

5.00

45

1.70

0.80

388

7.50

3.00

203

0.90

0.80

389

9.70

3.00

206

6.40

3.00

391

8.90

3.00

209

4.60

3.00

392

10.10

4.00

210

11.00

5.00

394

13.30

5.00

220

8.80

3.00

396

9.80

4.00

223

11.00

5.00

397

11.40

4.00

224

36.00

5.00

399

11.20

4.00

226

11.40

5.00

400

12.80

4.00

227

34.00

5.00

402

16.00

5.00

230

16.50

5.00

430

3.10

1.00

231

34.00

5.00

435

4.20

1.50

235

26.00

5.00

436

5.50

1.50

236

28.00

5.00

451

4.90

2.00

243

0.55

0.80

455

4.60

1.50

247

0.55

0.80

456

5.80

2.00

251

7.80

3.00

501

4.80

1.50

252

10.40

4.00

601

1.70

1.00

255

3.10

1.00

611

2.10

1.00

256

4.40

1.50

616

5.60

1.50

259

0.55

0.80

621

11.60

4.00

263

4.40

1.50

625

10.40

4.00

267

3.10

1.00

631

4.40

1.50

268

4.40

1.50

641

6.90

2.00

271

3.40

1.50

651

8.40

3.00

275

15.60

5.00

661

11.60

4.00

279

2.90

1.50

681

3.20

1.00

283

17.20

5.00

691

2.50

1.00

287

3.10

1.00

701

4.00

1.50

288

4.40

1.50

703

2.30

1.00

291

5.60

3.00

705

7.00

2.00

301

2.50

1.00

707

2.70

1.00

302

2.80

1.00

708

1.90

1.00

305

4.00

1.50

715

2.90

1.00

306

5.40

1.50

721

2.70

1.00

309

4.90

2.00

731

9.80

3.00

310

5.80

2.00

741

2.90

1.00

313

7.60

3.00

751

6.00

2.00

317

11.60

4.00

761

28.00

5.00

321

0.20

0.80

771

42.00

5.00

323

4.80

1.50

781

32.00

5.00

341

3.50

1.00

791

7.60

3.00

342

3.80

1.50

801

7.20

2.00

344

4.20

1.50

831

1.60

1.00

345

5.20

2.00

841

2.50

1.00

347

6.40

2.00

851

3.30

1.00

348

7.00

3.00

861

5.60

1.50


Fifth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

866

7.60

2.00

1098

1.30

0.80

871

6.40

3.00

1100

1.50

1.00

881

4.40

1.50

1102

3.50

1.00

891

14.00

4.00

1104

0.20

0.80

901

11.60

4.00

1106

0.60

0.80

906

14.00

4.00

1108

1.50

1.00

911

3.20

1.00

1110

3.30

1.50

915

6.80

3.00

1112

0.20

0.80

921

0.90

0.80

1114

0.20

0.80

931

0.40

0.80

1116

1.60

1.50

941

1.00

0.80

1118

0.60

0.80

943

1.40

0.80

1120

4.80

1.50

945

2.30

1.00

1122

0.70

1.00

951

3.40

1.00

1124

1.90

1.00

961

2.10

1.00

1126

2.30

1.00

971

7.60

3.00

1128

0.20

0.80

976

15.60

5.00

1130

3.10

1.00

981

3.50

1.00

1132

1.90

1.00

985

4.80

1.50

1134

3.10

1.00

1000

0.20

0.80

1136

4.80

1.50

1002

0.20

0.80

1138

1.10

0.80

1004

0.20

0.80

1140

1.70

1.00

1006

0.90

0.80

1142

1.40

1.00

1008

0.20

0.80

1144

1.90

1.00

1010

0.60

0.80

1146

1.90

1.00

1012

3.00

1.00

1148

1.70

1.00

1014

0.40

1.00

1150

2.80

1.50

1016

2.10

1.00

1152

2.70

1.00

1018

2.30

1.00

1154

2.30

1.00

1020

4.70

2.00

1156

2.30

1.00

1022

0.20

0.80

1160

0.70

1.00

1024

0.20

0.80

1162

1.10

1.00

1026

0.20

0.80

1164

3.00

1.00

1028

0.20

1.00

1166

3.00

1.00

1030

0.10

1.00

1168

3.50

1.00

1032

0.20

1.00

1170

3.40

1.50

1034

1.90

1.00

1172

0.90

0.80

1036

2.70

1.00

1174

1.90

1.00

1038

3.10

1.00

1176

1.30

1.00

1040

3.10

1.00

1180

0.10

0.80

1042

0.70

1.00

1182

0.20

0.80

1044

4.00

1.50

1184

1.70

1.00

1046

1.40

0.80

1186

0.70

0.80

1048

5.60

1.50

1188

1.90

1.00

1050

2.00

1.00

1190

2.70

1.00

1052

8.80

3.00

1192

0.70

1.00

1054

0.20

0.80

1194

0.70

1.00

1060

0.20

0.80

1196

2.70

1.00

1062

0.10

0.80

1198

0.70

1.00

1064

0.70

0.80

1200

0.20

0.80

1066

2.30

1.00

1202

0.40

1.00

1068

1.00

1.00

1204

0.60

0.80

1070

1.30

1.00

1206

2.10

1.00

1072

2.70

1.00

1208

1.70

1.00

1074

7.60

3.00

1210

0.70

1.00

1076

0.90

0.80

1212

1.50

1.00

1080

0.20

0.80

1214

0.70

0.80

1082

2.30

1.00

1216

0.80

0.80

1084

8.80

3.00

1218

3.50

1.00

1090

1.60

0.80

1220

5.00

1.50

1092

1.90

1.00

1222

5.00

1.50

1094

1.60

0.80

1224

6.80

3.00

1096

0.90

0.80

1226

8.80

3.00


Fifth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

1228

3.50

1.00

1391

2.00

1.00

1230

5.00

1.50

1392

3.30

1.50

1232

0.70

1.00

1394

4.00

2.00

1234

2.80

1.50

1395

0.40

0.80

1236

4.30

1.50

1397

1.90

1.00

1238

5.00

2.00

1399

0.70

0.80

1240

1.90

1.00

1401

1.90

1.00

1242

3.10

1.00

1404

0.20

0.80

1244

3.20

1.50

1407

0.40

0.80

1246

5.00

1.50

1410

1.60

0.80

1248

0.20

0.80

1413

1.60

0.80

1250

0.70

1.00

1416

2.60

1.00

1252

2.80

1.50

1419

1.90

1.00

1254

4.70

1.50

1421

2.30

1.00

1256

5.80

2.00

1423

1.30

1.00

1258

6.40

3.00

1425

4.00

1.50

1260

2.70

1.00

1428

1.30

1.00

1262

4.40

1.50

1430

5.00

1.50

1264

0.70

1.00

1432

8.80

3.00

1266

2.80

1.50

1434

2.70

1.00

1268

4.70

1.50

1436

3.10

1.00

1270

5.80

2.00

1438

8.80

3.00

1272

3.00

1.00

1441

3.30

1.00

1274

8.80

3.00

1444

0.70

1.00

1276

5.80

2.00

1447

5.00

1.50

1278

0.70

1.00

1450

3.40

1.50

1280

2.80

1.50

1453

1.20

1.00

1282

4.70

1.50

1456

2.50

1.00

1284

5.80

2.00

1459

0.70

1.00

1286

6.40

3.00

1461

2.80

1.50

1288

4.00

1.50

1463

4.70

1.50

1290

3.10

1.50

1466

5.80

2.00

1292

3.10

1.50

1468

0.20

0.80

1294

0.70

1.00

1470

1.70

1.00

1296

1.90

1.00

1472

4.00

1.50

1298

2.80

1.50

1474

8.80

3.00

1301

0.70

1.00

1476

1.70

1.00

1302

2.80

1.50

1478

2.30

1.00

1304

4.70

1.50

1481

3.30

1.00

1305

5.80

2.00

1484

6.80

3.00

1307

6.40

3.00

1487

1.70

1.00

1310

0.70

1.00

1490

1.70

1.00

1313

1.90

1.00

1491

0.20

0.80

1316

2.70

1.00

1493

6.80

3.00

1319

3.10

1.50

1494

8.80

3.00

1322

0.20

0.80

1495

0.90

0.80

1325

0.40

0.80

1496

1.90

1.00

1328

1.90

1.00

1497

3.40

1.50

1331

2.50

1.50

1499

3.50

1.00

1334

1.10

1.00

1500

0.20

0.80

1337

3.20

1.50

1502

0.20

0.80

3340

5.00

2.00

1504

0.20

0.80

1343

1.70

1.00

1506

1.30

1.00

1346

6.80

3.00

1508

0.20

0.80

1349

3.30

1.00

1511

1.90

1.00

1352

3.50

1.00

1513

1.60

0.80

1355

3.00

1.00

1515

0.40

1.00

1358

1.30

1.00

1517

1.20

1.00

1380

0.20

0.80

1519

2.50

1.00

1382

0.20

0.80

1521

2.50

1.50

1385

0.70

1.00

1523

3.50

1.50

1388

2.80

1.50

1525

1.90

1.00

1389

4.30

1.50

1527

4.00

1.50


Fifth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

1529

2.30

1.00

1706

1.60

0.80

1531

4.40

1.50

1707

2.60

1.00

1534

1.60

0.80

1710

0.70

0.80

1537

2.60

1.00

1712

0.70

1.00

1539

2.30

1.00

1714

0.70

1.00

1541

1.90

1.00

1716

0.90

0.80

1543

1.30

1.00

1718

2.00

1.00

1545

0.20

0.80

1720

4.00

2.00

1546

1.50

1.00

1722

5.10

3.00

1548

2.80

1.50

1724

1.90

1.00

1551

2.00

1.00

1726

4.00

1.50

1554

2.90

1.50

1728

5.80

2.00

1557

3.50

2.00

1730

4.00

1.50

1560

2.90

1.50

1732

0.20

0.80

1562

3.80

1.50

1734

0.20

0.80

1564

4.40

2.00

1736

6.80

3.00

1566

4.90

2.00

1738

0.90

0.80

1568

5.00

3.00

1741

0.70

1.00

1571

1.30

1.00

1744

0.90

0.80

1580

1.90

1.00

1746

0.70

1.00

1582

1.30

0.80

1748

0.70

1.00

1584

3.50

1.00

1761

0.90

0.80

1586

0.20

0.80

1764

1.70

1.00

1588

0.70

1.00

1767

0.90

0.80

1590

2.70

1.00

1770

0.70

1.00

1601

0.70

1.00

1773

3.10

1.00

1604

2.80

1.50

1776

4.80

1.50

1607

4.70

1.50

1779

0.20

0.80

1609

5.80

2.00

1782

0.20

0.80

1611

1.00

1.00

1785

0.20

0.80

1613

3.30

1.00

1790

1.90

1.00

1615

2.50

1.00

1792

1.60

0.80

1616

3.50

1.00

1794

4.00

1.00

1621

0.40

0.80

1796

4.00

1.50

1623

1.30

1.00

1798

1.90

1.00

1625

1.10

0.80

1800

1.10

0.80

1627

2.70

1.00

1802

2.20

1.00

1629

2.30

1.00

1804

3.80

1.50

1631

1.60

0.80

1806

0.70

1.00

1640

5.60

1.50

1808

2.30

1.50

1643

2.90

1.00

1810

0.70

1.00

1645

2.90

1.00

1812

0.40

0.80

1647

8.80

3.00

1820

2.80

1.50

1649

7.00

2.00

1822

5.00

2.00

1651

8.80

3.00

1824

6.40

3.00

1653

4.00

1.50

1826

4.40

3.00

1661

0.20

0.80

1828

7.40

3.00

1664

5.80

2.00

1840

12.40

4.00

1667

0.70

1.00

1841

16.00

5.00

1670

2.70

1.00

1843

3.10

1.50

1673

3.50

1.00

1846

4.00

1.50

1680

0.20

0.80

1849

2.50

1.00

1682

0.20

0.80

1850

2.80

1.50

1684

0.40

0.80

1852

2.80

1.50

1686

1.10

0.80

1855

4.30

1.50

1688

1.90

1.00

1858

5.00

2.00

1691

1.90

1.00

1861

3.20

1.50

1694

1.00

0.80

1863

5.80

2.00

1697

1.30

1.00

1865

14.00

5.00

1698

2.80

1.50

1867

3.10

1.50

1700

1.90

1.00

1869

4.80

1.50

1701

4.60

2.00

1871

6.80

3.00

1703

1.90

1.00

1873

14.00

5.00


Fifth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

1875

5.80

2.00

2119

4.00

1.50

1877

5.80

2.00

2123

1.60

1.00

1879

3.10

1.50

2128

4.80

1.50

1881

2.10

1.00

2132

4.80

1.50

1884

1.50

1.00

2136

2.60

1.50

1887

4.00

1.50

2140

4.00

1.50

1889

12.40

4.00

2144

4.80

1.50

1891

1.60

0.80

2160

3.40

1.50

1893

3.40

1.50

2164

11.60

4.00

1901

1.70

1.00

2169

8.80

3.00

1903

3.50

1.00

2173

5.80

2.00

1905

3.50

1.00

2177

5.90

2.00

1907

5.30

1.50

2181

6.80

3.00

1909

4.00

1.50

2185

3.80

1.50

1911

6.00

2.00

2200

3.40

1.50

1913

1.30

1.00

2205

3.40

1.50

1915

1.50

1.00

2209

6.10

2.00

1921

7.00

2.00

2214

5.30

2.00

1923

7.20

3.00

2218

5.20

3.00

1925

8.40

3.00

2222

6.80

3.00

1941

8.80

3.00

2226

5.30

3.00

1943

4.00

1.50

2230

7.80

3.00

1945

4.00

1.50

2234

5.60

2.00

1947

3.40

1.50

2238

6.00

2.00

1949

2.70

1.00

2247

6.60

3.00

1951

4.00

1.50

2250

6.40

2.00

1953

4.00

1.50

2254

1.90

1.00

1955

4.40

1.50

2270

6.80

3.00

1957

7.00

2.00

2274

4.80

1.50

1959

7.00

2.00

2290

3.40

1.50

1961

5.80

2.00

2294

3.80

2.00

1963

4.00

1.50

2298

6.40

2.00

1965

5.60

1.50

2310

6.80

3.00

1967

5.60

1.50

2314

9.80

3.00

1969

5.60

1.50

2318

9.80

3.00

1971

6.80

3.00

2322

9.80

3.00

1973

7.00

2.00

2326

4.90

2.00

1975

5.60

1.50

2330

4.80

1.50

1977

5.80

2.00

2334

9.20

3.00

1979

4.00

1.50

2338

6.80

3.00

1981

5.80

2.00

2342

7.60

3.00

1983

5.80

2.00

2346

4.60

1.50

2010

2.10

1.00

2350

3.80

3.00

2014

0.50

1.00

2354

10.40

4.00

2018

2.20

1.00

2358

5.00

1.50

2022

3.50

1.00

2362

2.10

1.00

2026

4.00

1.50

2367

2.10

1.00

2040

3.70

1.50

2371

6.40

2.00

2044

1.90

1.00

2410

5.80

2.00

2048

2.00

1.00

2420

0.90

0.80

2052

6.80

3.00

2440

4.40

1.50

2060

3.80

1.50

2444

2.70

1.00

2064

2.80

1.50

2460

1.60

1.00

2068

4.80

1.50

2464

2.40

1.00

2072

3.50

1.00

2468

5.60

1.50

2076

4.80

1.50

2510

24.00

5.00

2081

2.90

1.00

2514

24.00

5.00

2091

5.50

1.50

2518

8.00

3.00

2094

4.90

2.00

2522

14.00

4.00

2098

4.30

3.00

2526

32.00

5.00

2530

24.00

5.00

2110

4.00

1.50

2534

11.60

4.00

2114

5.40

1.50

2538

15.60

5.00


Fifth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

2542

6.40

2.00

3110

9.80

3.00

2570

11.60

4.00

3115

2.50

1.00

2574

6.40

2.00

3119

5.60

3.00

2578

6.40

2.00

3121

7.40

4.00

2620

12.40

4.00

3125

13.40

4.00

2624

10.40

4.00

3126

18.00

5.00

2628

10.40

4.00

3131

16.00

5.00

2632

2.00

4.00

3132

22.00

5.00

2636

4.00

1.50

3137

3.50

1.00

2640

5.80

2.00

3138

6.80

3.00

2644

5.80

2.00

3143

4.90

2.00

2648

4.80

1.50

3144

3.80

3.00

2652

4.80

1.50

3149

8.60

4.00

2657

5.80

2.00

3150

7.00

4.00

2661

5.00

1.50

3155

18.00

5.00

2666

2.90

1.00

3156

22.00

5.00

2670

4.80

1.50

3161

34.00

5.00

2674

4.00

1.50

3162

37.00

5.00

2678

4.00

1.50

3166

48.00

5.00

2682

6.80

3.00

3170

8.80

3.00

2686

1.90

1.00

3174

2.60

1.00

2691

10.40

4.00

3178

1.00

1.00

2696

6.40

2.00

3180

3.50

1.00

2700

5.60

1.50

3184

2.10

1.00

2901

4.80

1.50

3185

2.20

1.50

2904

6.20

2.00

3190

3.90

1.50

2907

6.80

3.00

3191

5.20

2.00

2910

8.80

3.00

3196

3.60

1.50

2913

12.40

4.00

3197

5.30

2.00

3000

0.90

0.80

3201

4.90

2.00

3004

1.90

1.00

3202

5.80

2.00

3005

2.50

1.00

3206

7.80

3.00

3009

3.15

1.00

3207

10.40

4.00

3011

4.40

1.50

3211

0.70

0.80

3015

6.80

2.00

3216

0.70

0.80

3017

8.00

3.00

3220

4.90

2.00

3021

2.10

1.00

3221

3.80

3.00

3025

4.40

1.50

3225

6.40

2.00

3030

3.30

1.50

3226

7.60

3.00

3034

7.60

3.00

3230

10.60

3.00

3039

2.90

1.50

3232

14.00

4.00

3043

6.80

3.00

3236

10.60

3.00

3045

9.40

3.00

3238

14.00

4.00

3049

6.40

2.00

3242

6.40

2.00

3051

7.60

3.00

3244

7.60

3.00

3055

7.00

3.00

3248

6.80

2.00

3056

9.80

3.00

3250

8.00

3.00

3061

0.30

0.80

3254

17.60

5.00

3064

2.10

1.00

3255

24.00

5.00

3065

6.80

3.00

3259

24.00

5.00

3069

7.30

3.00

3263

50.00

5.00

3070

10.00

4.00

3267

13.40

4.00

3074

3.50

1.00

3269

18.00

5.00

3078

4.90

2.00

3273

34.00

5.00

3080

5.60

3.00

3274

46.00

5.00

3084

3.50

1.00

3279

16.00

5.00

3089

6.80

3.00

3280

22.00

5.00

3093

2.10

1.00

3285

3.15

1.00

3097

7.00

3.00

3286

4.40

1.50

3099

9.80

3.00

2191

7.00

3.00

3103

5.00

1.50

3292

9.80

3.00

3104

6.40

2.00

3297

2.50

1.00

3108

7.00

3.00

3298

3.40

1.00


Fifth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

3303

6.40

2.00

3506

86.00

5.00

3304

7.60

3.00

3510

11.60

4.00

3309

7.60

3.00

3514

22.00

5.00

3313

37.00

5.00

3519

28.00

5.00

3315

50.00

5.00

3523

46.00

5.00

3319

2.50

1.00

3528

28.00

5.00

3323

10.60

3.00

3529

38.00

5.00

3324

14.00

4.00

3534

23.60

5.00

3328

13.40

4.00

3535

32.00

5.00

3329

18.00

5.00

3539

43.00

5.00

3334

26.60

5.00

3541

58.00

5.00

3335

36.00

5.00

3545

78.00

5.00

3340

50.00

5.00

3550

20.60

5.00

3344

86.00

5.00

3551

28.00

5.00

3348

19.00

5.00

3556

86.00

5.00

3349

26.00

5.00

3560

28.00

5.00

3353

42.00

5.00

3561

38.00

5.00

3357

62.00

5.00

3566

28.00

5.00

3361

38.00

5.00

3567

38.00

5.00

3362

46.00

5.00

3572

14.60

5.00

3367

23.60

5.00

3573

20.00

5.00

3368

32.00

5.00

3577

17.60

5.00

3372

26.60

5.00

3578

24.00

5.00

3373

36.00

5.00

3582

46.00

5.00

3377

11.50

5.00

3583

62.00

5.00

3378

16.00

5.00

3588

11.60

4.00

3383

24.00

5.00

3589

15.60

5.00

3387

18.00

5.00

3593

20.60

5.00

3392

20.60

5.00

3594

28.00

5.00

3393

28.00

5.00

3598

46.00

5.00

3397

46.00

5.00

3599

62.00

5.00

3402

10.40

4.00

3604

20.60

5.00

3406

22.00

5.00

3605

28.00

5.00

3408

30.00

5.00

3609

26.60

5.00

3412

8.60

4.00

3610

36.00

5.00

3414

7.00

4.00

3614

46.00

5.00

3418

17.20

5.00

3615

62.00

5.00

3419

22.00

5.00

3620

46.00

5.00

3423

17.20

5.00

3624

19.00

5.00

3424

22.00

5.00

3626

23.00

5.00

3428

46.00

5.00

3630

25.00

5.00

3430

62.00

5.00

3632

34.00

5.00

3434

6.40

2.00

3636

11.60

4.00

3436

7.60

3.00

3640

6.40

2.00

3440

24.00

5.00

3645

86.00

5.00

3442

30.00

5.00

3649

20.60

5.00

3446

25.00

5.00

3651

28.00

5.00

3448

28.00

5.00

3655

31.00

5.00

3452

31.00

5.00

3656

42.00

5.00

3454

42.00

5.00

3661

31.00

5.00

3458

23.60

5.00

3662

42.00

5.00

3460

32.00

5.00

3667

50.00

5.00

3464

42.00

5.00

3671

32.00

5.00

3469

86.00

5.00

3675

7.60

3.00

3473

32.00

5.00

3680

2.30

1.00

3478

42.00

5.00

3681

3.10

1.00

3482

42.00

5.00

3686

86.00

5.00

3486

32.00

5.00

3690

19.00

5.00

3487

34.00

5.00

3691

20.00

5.00

3491

23.60

5.00

3696

50.00

5.00

3492

32.00

5.00

3700

55.00

5.00

3497

30.00

5.00

3704

17.60

5.00

3498

42.00

5.00

3705

24.00

5.00

3502

58.00

5.00

3709

20.60

5.00


Fifth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

3710

28.00

5.00

3908

5.80

2.00

3714

23.00

5.00

3909

6.80

3.00

3716

24.00

5.00

3914

6.40

3.00

3720

1.90

1.00

3915

10.00

4.00

3721

2.50

1.00

3917

18.50

5.00

3726

14.00

5.00

3920

25.50

5.00

3727

18.00

5.00

3921

8.80

3.00

3731

14.60

5.00

3923

11.60

4.00

3732

20.00

5.00

3926

19.00

5.00

3736

20.60

5.00

3927

19.00

5.00

3737

28.00

5.00

3931

15.00

5.00

3741

19.00

5.00

3932

20.00

5.00

3742

17.00

5.00

3936

14.60

5.00

3746

5.00

1.50

3937

20.00

5.00

3747

6.40

2.00

3941

50.00

5.00

3751

1.70

1.00

3945

3.50

1.00

3755

3.40

1.50

3949

2.25

1.00

3756

2.80

2.00

3951

3.00

1.00

3760

7.00

3.00

3955

5.60

1.50

3761

9.80

3.00

3957

7.20

2.00

3765

3.40

1.00

3961

14.60

5.00

3769

1.60

1.00

3963

20.00

5.00

3770

2.50

1.00

3967

28.00

5.00

3771

9.60

3.00

3971

32.00

5.00

3772

12.80

4.00

3975

46.00

5.00

3773

5.85

5.00

3979

58.00

5.00

3774

12.00

5.00

3983

86.00

5.00

3776

7.60

3.00

3987

78.00

5.00

3780

32.00

5.00

3991

86.00

5.00

3784

68.00

5.00

3995

42.00

5.00

3788

78.00

5.00

3999

42.00

5.00

3792

2.50

1.00

4004

98.00

5.00

3796

9.40

3.00

4008

86.00

5.00

3797

12.40

4.00

4013

86.00

5.00

3801

2.70

1.00

4017

86.00

5.00

3805

6.40

2.00

4022

42.00

5.00

3806

7.60

3.00

4026

50.00

5.00

3811

14.60

5.00

4031

32.00

5.00

3812

20.00

5.00

4035

32.00

5.00

3817

1.10

0.80

4040

16.00

5.00

3821

3.40

1.50

4050

3.10

1.00

3826

10.00

5.00

4051

4.40

1.50

3827

15.00

5.00

4055

6.80

2.00

3832

5.30

1.50

4056

8.00

3.00

3836

5.60

3.00

4060

10.60

3.00

3838

7.00

4.00

4061

14.00

4.00

3842

14.60

5.00

4065

17.60

5.00

3844

20.00

5.00

4066

24.00

5.00

3848

17.60

5.00

4070

14.60

5.00

3850

24.00

5.00

4071

20.00

5.00

3854

7.40

2.00

4075

17.60

5.00

3856

8.80

3.00

4076

24.00

5.00

3860

24.00

5.00

4090

6.80

2.00

3865

42.00

5.00

4091

8.00

3.00

3869

22.00

5.00

4095

17.60

5.00

3874

5.20

1.50

4096

24.00

5.00

3878

17.60

5.00

4101

17.60

5.00

3880

24.00

5.00

4102

24.00

5.00

3883

10.00

5.00

4107

31.00

5.00

3884

19.00

5.00

4108

42.00

5.00

3888

6.00

2.00

4113

23.60

5.00

3900

1.90

1.00

4114

32.00

5.00

3904

7.00

2.00

4119

17.60

5.00


Fifth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

4120

24.00

5.00

4401

13.00

5.00

4125

31.00

5.00

4402

15.00

5.00

4126

42.00

5.00

4403

3.10

1.00

4150

10.40

4.00

4404

5.80

2.00

4151

14.00

5.00

4408

10.40

4.00

4156

1.60

0.80

4412

8.80

3.00

4157

2.30

1.00

4416

11.60

4.00

4161

8.80

3.00

4420

2.30

1.00

4162

11.60

4.00

4424

2.10

1.00

4166

14.60

5.00

4428

30.00

5.00

4167

20.00

5.00

4432

46.00

5.00

4171

17.60

5.00

4436

8.00

5.00

4172

24.00

5.00

4440

7.60

3.00

4176

31.00

5.00

4444

42.00

5.00

4177

42.00

5.00

4448

42.00

5.00

4182

64.00

5.00

4450

26.00

5.00

4183

86.00

5.00

4452

4.40

1.50

4188

5.80

2.00

4456

44.00

5.00

4189

6.80

3.00

4460

4.40

1.50

4194

1.90

1.00

4464

20.00

5.00

4195

2.50

1.00

4468

42.00

5.00

4200

7.00

3.00

4472

64.00

5.00

4201

9.80

3.00

4476

1.90

1.00

4206

17.60

5.00

4480

7.60

3.00

4207

24.00

5.00

4484

5.80

2.00

4212

14.60

5.00

4488

42.00

5.00

4213

20.00

5.00

4492

50.00

5.00

4218

23.60

5.00

4496

50.00

5.00

4219

32.00

5.00

4498

8.00

3.00

4224

34.00

5.00

4499

11.00

5.00

4225

46.00

5.00

4501

9.30

3.00

4230

38.60

5.00

4502

12.00

5.00

4231

52.00

5.00

4504

9.55

3.00

4236

108.00

5.00

4505

12.00

5.00

4300

5.80

2.00

4507

8.60

4.00

4304

7.40

2.00

4508

6.00

5.00

4305

8.80

3.00

4513

3.15

1.00

4309

7.80

3.00

4514

4.40

1.50

4311

10.40

4.00

4519

2.40

1.50

4315

68.00

5.00

4520

8.80

3.00

4320

43.00

5.00

4525

3.20

2.00

4324

38.00

5.00

4526

8.40

4.00

4328

78.00

5.00

4528

6.40

2.00

4333

50.00

5.00

4529

5.20

1.50

4337

76.00

5.00

4533

2.50

1.00

4342

86.00

5.00

4538

24.00

5.00

4346

42.00

5.00

4542

16.00

5.00

4350

78.00

5.00

4545

24.80

5.00

4355

50.00

5.00

4547

20.00

5.00

4359

2.50

1.00

4551

24.00

5.00

4360

5.80

2.00

4555

15.60

5.00

4364

30.00

5.00

4559

11.60

4.00

4368

2.00

4.00

4563

64.00

5.00

4372

3.40

1.00

4567

12.40

4.00

4376

6.80

3.00

4571

14.00

5.00

4381

4.00

1.50

4575

15.60

5.00

4385

5.80

1.50

4579

12.40

4.00

4389

4.60

1.50

4583

28.00

5.00

4390

5.80

2.00

4587

42.00

5.00

4394

3.90

3.00

4591

42.00

5.00

4395

5.00

4.00

4595

52.00

5.00

4399

10.00

5.00

4599

42.00

5.00

4400

11.55

5.00

4604

12.00

4.00


Fifth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

4605

16.00

5.00

5128

9.80

3.00

4610

11.60

4.00

5132

11.60

4.00

4614

8.80

3.00

5136

5.80

2.00

4616

11.60

4.00

5140

42.00

5.00

4620

15.60

5.00

5145

20.00

5.00

4625

17.60

5.00

5149

18.00

5.00

4626

24.00

5.00

5153

42.00

5.00

4710

42.00

5.00

5157

34.00

5.00

4714

42.00

5.00

5161

50.00

5.00

4719

108.00

5.00

5165

24.00

5.00

4723

78.00

5.00

5170

38.00

5.00

4727

52.00

5.00

5174

15.60

5.00

4728

70.00

5.00

5178

42.00

5.00

4732

78.00

5.00

5182

52.00

5.00

4735

50.00

5.00

5186

10.40

4.00

4739

38.00

5.00

5190

5.80

2.00

4743

58.00

5.00

5194

24.00

5.00

4747

42.00

5.00

5198

50.00

5.00

4751

42.00

5.00

5202

64.00

5.00

4755

24.00

5.00

5206

20.00

5.00

4759

24.00

5.00

5220

9.80

3.00

4763

33.00

5.00

5223

13.40

4.00

4767

42.00

5.00

5224

18.00

5.00

4771

40.00

5.00

5228

14.00

5.00

4775

32.00

5.00

5232

64.00

5.00

4779

48.00

5.00

5236

24.00

5.00

4783

64.00

5.00

5240

22.00

5.00

4787

76.00

5.00

5244

42.00

5.00

4810

2.10

1.00

5248

10.40

4.00

4814

7.30

3.00

5252

14.00

4.00

4819

13.60

4.00

5256

50.00

5.00

4823

4.40

1.50

5260

12.00

4.00

4827

15.60

5.00

5261

16.00

5.00

4831

14.00

5.00

5310

2.80

1.00

4835

25.00

5.00

5311

5.80

2.00

4839

18.00

5.00

5316

5.00

1.50

4843

14.00

5.00

5317

6.40

2.00

4847

24.00

5.00

5322

5.00

1.50

4851

24.00

5.00

5323

6.40

2.00

4855

22.00

5.00

5328

9.40

3.00

4910

23.60

5.00

5329

12.40

4.00

4911

32.00

5.00

5334

7.00

3.00

4916

13.40

4.00

5335

9.80

3.00

4917

18.00

5.00

5340

3.15

1.00

4922

50.00

5.00

5341

4.40

1.50

4926

86.00

5.00

5346

6.40

2.00

4931

42.00

5.00

5350

3.15

1.00

4935

42.00

5.00

5352

4.40

1.50

4939

56.00

5.00

5356

7.00

3.00

4944

24.00

5.00

5358

9.80

3.00

5010

38.00

5.00

5362

18.00

5.00

5014

60.00

5.00

5367

24.00

5.00

5019

34.00

5.00

5371

64.00

5.00

5023

86.00

5.00

5376

50.00

5.00

5028

20.00

5.00

5380

3.20

1.00

5032

30.00

5.00

5385

50.00

5.00

5037

4.00

1.50

5387

50.00

5.00

5041

20.00

5.00

5394

28.00

5.00

5110

3.10

1.00

5398

7.80

3.00

5114

5.80

2.00

5399

10.40

4.00

5118

31.00

5.00

5403

6.80

2.00

5120

42.00

5.00

5404

8.00

3.00

5124

9.80

3.00

5408

11.00

5.00


Fifth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

5410

15.00

5.00

5583

31.00

5.00

5414

28.00

5.00

5585

45.50

5.00

5416

38.00

5.00

5589

32.00

5.00

5419

34.00

5.00

5593

16.00

5.00

5420

52.00

5.00

5594

8.00

5.00

5422

37.10

5.00

5596

23.60

5.00

5423

58.00

5.00

5597

32.00

5.00

5425

11.60

4.00

5610

4.00

1.50

5429

50.00

5.00

5614

17.60

5.00

5434

48.00

5.00

5616

24.00

5.00

5438

3.10

1.00

5620

44.00

5.00

5439

4.00

1.50

5625

24.00

5.00

5443

3.50

1.00

5631

46.00

5.00

5444

4.40

1.50

5635

42.00

5.00

5448

2.20

1.50

5640

46.00

5.00

5451

10.40

4.00

5644

28.00

5.00

5452

14.00

5.00

5649

58.00

5.00

5453

13.10

5.00

5653

46.00

5.00

5454

20.00

5.00

5658

50.00

5.00

5457

8.80

3.00

5662

7.60

3.00

5458

11.60

4.00

5667

3.50

1.00

5462

2.50

1.50

5668

5.40

1.50

5463

5.20

2.00

5673

14.00

4.00

5467

6.80

3.00

5677

18.00

5.00

5471

5.00

3.00

5681

20.00

5.00

5472

10.40

4.00

5685

42.00

5.00

5475

6.60

3.00

5689

46.00

5.00

5477

12.40

4.00

5693

42.00

5.00

5481

6.80

3.00

5697

28.00

5.00

5483

12.60

4.00

5701

4.50

1.50

5487

7.60

3.00

5702

2.80

2.00

5489

13.60

4.00

5706

7.60

3.00

5493

14.60

5.00

5710

8.00

3.00

5495

20.00

5.00

5714

0.90

0.80

5499

34.00

5.00

5718

3.15

1.00

5501

46.00

5.00

5719

4.40

1.50

5505

34.00

5.00

5723

12.80

4.00

5507

56.00

5.00

5727

15.60

5.00

5511

47.10

5.00

5731

4.40

1.50

5512

62.00

5.00

5735

98.00

5.00

5513

54.00

5.00

5739

64.00

5.00

5515

78.00

5.00

5742

58.00

5.00

5518

54.50

5.00

5746

4.60

1.50

5519

68.50

5.00

5750

7.00

4.00

5523

36.00

5.00

5754

18.00

5.00

5525

58.00

5.00

5758

41.00

5.00

5529

28.00

5.00

5762

42.00

5.00

5531

38.00

5.00

5766

86.00

5.00

5535

28.00

5.00

5770

34.00

5.00

5537

38.00

5.00

5774

18.00

5.00

5541

9.00

5.00

5778

20.00

5.00

5543

13.00

5.00

5782

55.00

5.00

5547

24.00

5.00

5786

34.00

5.00

5551

20.60

5.00

5790

38.00

5.00

5553

28.00

5.00

5794

46.00

5.00

5557

2.80

1.50

5798

20.00

5.00

5561

32.00

5.00

5802

64.00

5.00

5565

4.80

1.50

5806

86.00

5.00

5569

3.10

1.00

5810

34.00

5.00

5573

22.00

5.00

5814

24.00

5.00

5574

33.00

5.00

5818

10.40

4.00

5577

25.10

5.00

5822

16.00

5.00

5579

39.00

5.00

5826

42.00

5.00


Fifth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

5830

64.00

5.00

6173

64.00

5.00

5834

6.40

2.00

6177

24.00

5.00

5838

5.20

1.50

6181

5.00

4.00

5842

8.00

5.00

6182

11.00

5.00

5846

28.00

5.00

6186

10.40

4.00

5850

28.00

5.00

6187

14.00

5.00

5854

26.00

5.00

6191

17.60

5.00

5858

26.00

5.00

6192

24.00

5.00

5910

2.30

1.00

6196

15.60

5.00

5911

3.10

1.00

6197

31.00

5.00

9515

6.20

2.00

6198

42.00

5.00

5920

3.20

1.00

6202

43.00

5.00

5924

7.00

3.00

6203

58.00

5.00

5926

9.80

3.00

6207

64.00

5.00

5930

23.60

5.00

6211

58.00

5.00

5931

32.00

5.00

6215

54.00

5.00

5936

64.00

5.00

6219

108.00

5.00

5940

64.00

5.00

6223

78.00

5.00

5945

68.00

5.00

6227

86.00

5.00

5949

86.00

5.00

6231

86.00

5.00

5954

50.00

5.00

2635

50.00

5.00

5958

28.00

5.00

6239

64.00

5.00

5963

5967

5971

5976

5980

5985

5989

70.00

15.60

26.00

6.40

11.60

86.00

52.00

5.00

5.00

5.00

2.00

4.00

5.00

5.00

6243

6247

6251

6255

6259

6263

108.00

86.00

64.00

70.00

64.00

42.00

5.00

5.00

5.00

5.00

5.00

5.00

5994

76.00

5.00

6310

3.40

1.00

5998

86.00

5.00

6314

2.10

1.00

6003

42.00

5.00

6318

4.20

1.50

6007

28.00

5.00

6320

5.60

1.50

6012

20.00

5.00

6324

6.40

2.00

6016

50.00

5.00

6328

5.60

1.50

6021

32.00

5.00

6333

4.40

1.50

6025

98.00

5.00

6337

5.80

2.00

6029

11.60

4.00

6338

6.80

3.00

6034

16.80

5.00

6343

4.00

1.50

6038

40.00

5.00

6344

5.20

1.50

6042

15.60

5.00

6349

8.80

3.00

6100

0.90

0.80

6350

11.60

4.00

6104

4.00

1.50

6354

1.50

0.80

6108

4.40

1.50

6355

2.10

1.00

6112

8.00

3.00

6359

5.00

1.50

6116

3.80

1.00

6360

6.40

2.00

6120

4.40

1.50

6365

14.60

5.00

6124

5.20

1.50

6366

20.00

5.00

6128

11.60

4.00

6371

10.60

3.00

6132

7.00

3.00

6372

14.00

4.00

6133

9.80

3.00

6377

4.00

1.50

6137

12.00

4.00

6378

5.20

1.50

6138

16.00

5.00

6382

6.40

2.00

6142

20.40

5.00

6383

7.60

3.00

6143

28.00

5.00

6387

1.90

1.00

6147

32.00

5.00

6388

2.50

1.00

6151

50.00

5.00

6392

6393

6397

6398

6402

6404

5.00

6.40

13.40

18.00

13.40

18.00

1.50

2.00

4.00

5.00

4.00

5.00

6155

58.00

5.00

6159

16.00

5.00

6160

6164

6165

6169

22.00

10.40

14.00

50.00

5.00

4.00

5.00

5.00


Fourth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

6414

The amount shown in this column in the item relating to the dislocation concerned, plus one-half of that amount

The amount shown in this column in the item relating to the dislocation concerned, plus one-half of that amount

6569

4.80

1.50

 

6574

0.90

0.80

 

6575

2.00

1.00

 

6578

0.90

0.80

 

6580

2.00

1.00

 

6584

7.80

3.00

 

6586

5.00

4.00

 

6590

7.00

3.00

 

6592

9.80

3.00

6420

3.40

1.00

6596

22.00

5.00

6425

6.40

2.00

6601

24.00

5.00

6426

8.80

3.00

6605

8.80

3.00

6431

3.40

1.00

6606

11.60

4.00

6432

4.60

1.50

6610

30.00

5.00

6437

4.90

2.00

6614

32.00

5.00

6438

12.40

4.00

6618

7.80

3.00

6442

6.80

3.00

6619

10.40

4.00

6443

14.00

5.00

6623

0.90

0.80

6447

3.90

1.00

6624

1.60

1.00

6448

5.20

1.50

6628

0.90

0.80

6453

7.00

3.00

6629

2.00

1.00

6454

9.80

3.00

6633

10.60

3.00

6458

6.60

3.00

6634

14.00

4.00

6459

16.00

5.00

6638

17.60

5.00

6463

7.60

3.00

6639

24.00

5.00

6467

8.10

3.00

6643

64.00

5.00

6468

7.40

4.00

 

 

 

6472

6.40

2.00

 

 

 

6473

7.60

3.00

6647

The amount shown in this column in the item relating to the fracture concerned, plus one-third of that amount

The amount shown in this column in the item relating to the fracture concerned, plus one-third of that amount

6477

8.60

4.00

 

6478

12.00

5.00

 

6482

10.40

4.00

 

6483

12.00

5.00

 

6487

2.90

1.50

 

6489

3.80

3.00

 

6493

6.40

2.00

 

6494

7.60

3.00

 

6498

0.90

0.80

 

6499

2.00

1.00

 

6503

11.60

4.00

 

6505

15.60

5.00

 

 

 

6509

8.80

3.00

6651

The amount shown in this column in the item relating to the fracture concerned, plus one-half of that amount

The amount shown in this column in the item relating to the fracture concerned, plus one-half of that amount

6510

11.60

4.00

 

6515

28.00

5.00

 

6516

38.00

5.00

 

6521

4.90

2.00

 

6522

7.90

3.00

 

6525

7.30

3.00

 

6527

10.00

4.00

 

6531

17.60

5.00

 

6532

24.00

5.00

 

6537

17.60

5.00

 

 

 

6538

24.00

5.00

6655

The amount shown in this column in the item relating to the fracture concerned, plus three-quarters of that amount

The amount shown in this column in the item relating to the fracture concerned, plus three-quarters of that amount

6543

17.60

5.00

 

6544

24.00

5.00

 

6549

4.90

2.00

 

6550

8.80

3.00

 

6555

3.40

1.00

 

6559

4.40

1.50

 

6564

3.70

1.00

 

6568

3.45

1.00

 


Fifth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

6659

One-half of the amount shown in this column in the item that would, but for item 6659 in the First Schedule to this Act, apply to the reduction concerned

One-half of the amount shown in this column in the item that would, but for item 6659 in the First Schedule to this Act, apply to the reduction concerned

7056

8.80

3.00

 

7060

3.80

3.00

 

7061

3.40

3.00

 

7065

11.60

4.00

 

7069

10.40

4.00

 

7074

12.80

4.00

 

7078

108.00

5.00

 

7082

34.00

5.00

 

7087

22.00

5.00

 

7091

50.00

5.00

 

7095

90.00

5.00

 

7100

90.00

5.00

 

7104

78.00

5.00

6663

One-half of the amount shown in this column in the item that would, but for item 6663 in the First Schedule to this Act, apply to the reduction concerned

One-half of the amount shown in this column in the item that would, but for item 6663 in the First Schedule to this Act, apply to the reduction concerned

7108

38.00

5.00

 

7113

13.40

4.00

 

7114

18.00

5.00

 

7118

20.00

5.00

 

7122

54.00

5.00

 

7126

64.00

5.00

 

7130

7.00

5.00

 

7135

5.00

1.50

 

7136

6.40

2.00

 

7141

32.00

5.00

 

7145

36.00

5.00

 

7149

32.00

5.00

 

7154

16.00

5.00

6667

The amount shown in this column in the item that would, but for item 6667 in the First Schedule to this Act, apply to the reduction concerned

The amount shown in this column in the item that would, but for item 6667 in the First Schedule to this Act, apply to the reduction concerned

7155

22.00

5.00

 

7159

86.00

5.00

 

7163

42.00

5.00

 

7167

58.00

5.00

 

7171

28.00

5.00

 

7176

47.00

5.00

 

7180

42.00

5.00

 

7184

32.00

5.00

 

7189

28.00

5.00

 

7190

38.00

5.00

 

7195

32.00

5.00

 

7199

1.90

1.00

6671

The amount shown in this column in the item that would apply in the case of a simple and uncomplicated fracture of the part concerned

The amount shown in this column in the item that would apply in the case of a simple and uncomplicated fracture of the part concerned

7200

2.30

1.00

 

7205

1.60

0.80

 

7206

2.30

1.00

 

7210

11.60

4.00

 

7214

42.00

5.00

 

7218

24.00

5.00

 

7221

10.00

5.00

 

7222

16.00

5.00

 

7224

14.50

5.00

 

7225

15.00

5.00

 

7227

19.45

5.00

7010

18.00

5.00

7228

28.00

5.00

7014

9.40

3.00

7230

20.00

5.00

7016

12.40

4.00

7233

13.40

4.00

7020

1.00

1.00

7234

18.00

5.00

7025

2.10

1.00

7238

42.00

5.00

7029

3.90

1.00

7242

14.00

4.00

7031

5.20

1.50

7246

24.00

5.00

7035

4.90

2.00

7250

13.40

4.00

7037

6.00

3.00

7252

18.00

5.00

7041

6.40

2.00

7256

16.00

5.00

7043

7.60

3.00

7257

22.00

5.00

7047

70.00

5.00

7261

7.40

4.00

7051

24.00

5.00

7262

2.00

5.00

7055

7.40

2.00

7266

20.00

5.00


Fifth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

7271

20.00

5.00

7549

64.00

5.00

7275

24.00

5.00

7553

42.00

5.00

7280

28.00

5.00

7557

14.00

4.00

7284

46.00

5.00

7561

32.00

5.00

7289

70.00

5.00

7565

24.00

5.00

7293

46.00

5.00

7569

76.00

5.00

7297

44.00

5.00

7573

76.00

5.00

7301

46.00

5.00

7577

50.00

5.00

7305

10.40

4.00

7581

25.00

5.00

7309

22.00

5.00

7582

34.00

5.00

7313

8.80

3.00

7586

42.00

5.00

7314

11.60

4.00

7590

50.00

5.00

7318

20.60

5.00

7594

64.00

5.00

7319

28.00

5.00

7598

32.00

5.00

7323

10.80

4.00

7602

42.00

5.00

7324

14.40

5.00

7607

64.00

5.00

7328

13.40

4.00

7611

24.00

5.00

7329

18.00

5.00

7616

42.00

5.00

7333

22.00

5.00

7620

24.00

5.00

7334

30.00

5.00

7625

64.00

5.00

7338

6.40

2.00

7629

6.40

2.00

7339

7.60

3.00

7631

7.60

3.00

7343

8.80

3.00

7635

50.00

5.00

7344

11.60

4.00

7640

36.00

5.00

7348

6.80

3.00

7644

32.00

5.00

7352

18.00

5.00

7649

18.00

5.00

7356

34.00

5.00

7653

6.40

2.00

7360

58.00

5.00

7655

7.60

3.00

7364

28.00

5.00

7659

7.40

2.00

7368

20.00

5.00

7661

8.80

3.00

7372

6.40

2.00

7665

32.00

5.00

7373

7.60

3.00

7670

6.40

2.00

7377

10.40

4.00

7671

7.60

3.00

7378

14.00

5.00

7676

20.00

5.00

7382

15.60

5.00

7680

36.00

5.00

7386

24.00

5.00

7685

32.00

5.00

7390

8.80

3.00

7700

50.00

5.00

7391

11.60

4.00

7704

6.40

2.00

7395

22.00

5.00

7708

4.00

1.50

7396

30.00

5.00

7750

24.00

5.00

7400

28.00

5.00

7754

11.60

4.00

7450

3.40

3.00

7758

20.00

5.00

7454

3.40

1.00

7762

2.00

1.00

7458

4.00

1.50

7767

3.40

1.00

7462

3.40

1.00

7771

3.80

3.00

7466

4.40

1.50

7775

10.40

4.00

7470

3.40

1.00

7779

14.00

5.00

7474

5.20

1.50

7783

22.00

5.00

7478

3.40

1.00

7787

40.00

5.00

7482

6.40

2.00

7791

42.00

5.00

7486

15.60

5.00

7795

20.00

5.00

7490

3.40

1.00

7850

14.00

5.00

7494

5.20

1.50

7854

18.00

5.00

7498

5.20

1.50

7858

14.00

4.00

7510

3.40

1.00

7862

7.60

3.00

7514

50.00

5.00

7866

9.80

3.00

7519

64.00

5.00

7870

5.20

1.50

7523

64.00

5.00

7874

15.60

5.00

7528

64.00

5.00

7877

9.80

3.00

7532

32.00

5.00

7881

24.00

5.00

7537

50.00

5.00

7885

14.00

4.00

7541

50.00

5.00

7889

9.80

3.00

7545

64.00

5.00

7893

6.40

2.00


Fifth Schedulecontinued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

7897

16.00

5.00

8119

32.00

5.00

7901

24.00

5.00

8123

18.00

5.00

7905

10.80

4.00

8128

32.00

5.00

7909

24.00

5.00

8132

18.00

5.00

7913

20.00

5.00

8136

42.00

5.00

7917

32.00

5.00

8141

32.00

5.00

7921

64.00

5.00

8145

20.00

5.00

7925

54.00

5.00

8150

11.60

4.00

7929

64.00

5.00

8154

24.00

5.00

7950

14.00

5.00

8159

50.00

5.00

7952

15.50

5.00

8163

24.00

5.00

7953

16.50

5.00

8167

50.00

5.00

7954

24.00

5.00

8172

28.00

5.00

7958

14.00

5.00

8176

42.00

5.00

7962

7.60

3.00

8180

9.80

3.00

7966

20.00

5.00

8184

26.00

5.00

7970

14.00

4.00

8188

22.00

5.00

7974

32.00

5.00

8192

22.00

5.00

7978

20.00

5.00

8196

24.00

5.00

7982

14.00

4.00

8200

32.00

5.00

7986

34.00

5.00

8204

50.00

5.00

7990

10.40

4.00

8208

70.00

5.00

7994

7.60

3.00

8212

9.80

3.00

7998

22.00

5.00

8216

24.00

5.00

8002

36.00

5.00

8220

18.00

5.00

8007

18.00

5.00

8224

38.00

5.00

8011

28.00

5.00

8228

12.80

4.00

8015

28.00

5.00

8232

42.00

5:00

8020

50.00

5.00

8236

28.00

5.00

8024

16.00

5.00

8240

46.00

5.00

8029

50.00

5.00

8244

62.00

5.00

8033

36.00

5.00

8248

24.00

5.00

8037

98.00

5.00

8252

18.00

5.00

8042

34.00

5.00

8256

36.00

5.00

8046

64.00

5.00

8260

86.00

5.00

8050

50.00

5.00

8264

14.40

5.00

8054

42.00

5.00

8268

46.00

5.00

8058

42.00

5.00

8272

58.00

5.00

8062

24.00

5.00

8276

24.00

5.00

8066

20.00

5.00

8280

42.00

5.00

8070

24.00

5.00

8284

42.00

5.00

8110

18.00

5.00

8288

50.00

5.00

8114

28.00

5.00

 

 

 


SIXTH SCHEDULE Section 13.

TABLE OF FUND MEDICAL BENEFITS IN RESPECT OF WESTERN AUSTRALIA

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

2

0.90

0.80

352

10.40

3.00

3

1.35

1.20

355

11.60

4.00

9

3.25

1.00

357

16.00

5.00

11

5.50

1.50

370

4.40

1.50

13

2.00

1.00

371

5.50

2.00

15

8.00

2.00

375

4.90

1.50

17

10.00

3.00

376

5.60

2.00

18

3.25

1.00

378

5.80

3.00

24

1.60

1.80

379

7.40

3.00

37

8.50

3.00

381

9.20

3.00

38

13.00

4.00

382

10.80

3.00

39

17.50

5.00

384

12.00

4.00

40

22.50

5.00

386

16.40

5.00

43

0.90

0.80

388

7.50

3.00

45

2.00

1.00

389

9.70

3.00

203

0.90

0.80

391

10.90

3.00

206

6.40

3.00

392

12.10

4.00

209

4.60

3.00

394

13.30

5.00

210

11.00

5.00

396

9.80

4.00

220

8.80

3.00

397

11.40

4.00

223

11.00

5.00

399

13.20

4.00

224

26.00

5.00

400

14.80

4.00

226

11.40

5.00

402

16.00

5.00

227

24.00

5.00

430

3.10

1.00

230

16.50

5.00

435

4.20

1.50

231

24.00

5.00

436

5.50

1.50

235

26.00

5.00

451

4.90

2.00

236

38.00

5.00

455

4.60

1.50

243

0.60

0.80

456

5.80

2.00

247

0.60

0.80

501

4.80

1.50

251

7.80

3.00

601

1.70

1.00

252

10.40

4.00

611

2.10

1.00

255

3.10

1.00

616

5.60

1.50

256

4.40

1.50

621

11.60

4.00

259

0.60

0.80

625

10.40

4.00

263

4.40

1.50

631

4.40

1.50

267

3.10

1.00

641

4.40

1.50

268

4.40

1.50

651

8.40

3.00

271

3.40

1.50

661

11.60

4.00

275

15.60

5.00

681

3.20

1.00

279

2.90

1.50

691

2.50

1.00

283

17.20

5.00

701

2.50

1.00

287

3.10

1.00

703

2.30

1.00

288

4.40

1.50

705

7.00

2.00

291

5.60

3.00

707

2.70

1.00

301

3.50

1.00

708

1.90

1.00

302

3.80

1.00

715

2.90

1.00

305

6.00

1.50

721

2.70

1.00

306

7.40

1.50

731

9.80

3.00

309

5.90

2.00

741

2.90

1.00

310

6.80

2.00

751

6.00

2.00

313

7.60

3.00

761

28.00

5.00

317

11.60

4.00

771

42.00

5.00

321

0.20

0.80

781

32.00

5.00

323

4.80

1.50

791

7.60

3.00

341

4.00

1.50

801

7.20

2.00

342

5.30

1.50

831

1.60

1.00

344

4.20

1.50

841

2.50

1.00

345

5.20

2.00

851

3.30

1.00

347

6.40

2.00

861

5.60

1.50

348

7.00

3.00

866

7.60

3.00

351

8.80

3.00

871

6.40

2.00


Sixth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

881

4.40

1.50

1102

3.50

1.00

891

14.00

4.00

1104

0.20

0.80

901

11.60

4.00

1106

1.60

0.80

906

14.00

4.00

1108

1.50

1.00

911

3.20

1.00

1110

3.30

1.50

915

6.80

3.00

1112

0.20

0.80

921

0.90

0.80

1114

0.20

0.80

931

0.40

0.80

1116

2.60

1.50

941

1.00

0.80

1118

1.10

0.80

943

1.40

0.80

1120

4.80

1.50

945

2.30

1.00

1122

0.40

0.80

951

3.40

1.00

1124

1.90

1.00

961

2.10

1.00

1126

2.30

1.00

971

7.60

3.00

1128

0.70

0.80

976

15.60

5.00

1130

3.10

1.00

981

3.50

1.00

1132

1.90

1.00

985

4.80

1.50

1134

3.10

1.00

1000

0.20

0.80

1136

4.80

1.50

1002

0.70

0.80

1138

1.60

0.80

1004

0.20

0.80

1140

1.70

1.00

1006

0.90

0.80

1142

1.40

1.00

1008

0.20

0.80

1144

1.10

0.80

1010

0.60

0.80

1146

1.10

0.80

1012

3.00

1.00

1148

1.70

1.00

1014

1.40

1.00

1150

2.80

1.50

1016

3.60

1.00

1152

2.70

1.00

1018

3.80

1.50

1154

2.30

1.00

1020

5.70

3.00

1156

2.30

1.00

1022

0.20

0.80

1160

0.70

1.00

1024

0.70

0.80

1162

0.60

1.00

1026

0.70

0.80

1164

2.00

1.00

1028

1.70

1.00

1166

2.00

1.00

1030

1.60

1.00

1168

0.50

1.00

1032

1.70

1.00

1170

3.40

1.50

1034

1.90

1.00

1172

0.90

0.80

1036

2.70

1.00

1174

1.60

0.80

1038

3.10

1.00

1176

1.00

0.80

1040

3.10

1.00

1180

0.10

0.80

1042

0.40

0.80

1182

0.20

0.80

1044

4.00

1.50

1184

1.70

1.00

1046

1.40

0.80

1186

0.70

0.80

1048

5.60

1.50

1188

1.90

1.00

1050

1.00

1.00

1190

2.70

1.00

1052

3.80

3.00

1192

0.70

1.00

1054

0.20

0.80

1194

0.70

1.00

1060

0.20

0.80

1196

2.70

1.00

1062

1.10

0.80

1198

0.70

1.00

1064

0.70

0.80

1200

0.20

0.80

1066

2.30

1.00

1202

0.40

1.00

1068

1.00

1.00

1204

0.60

0.80

1070

1.30

1.00

1206

2.10

1.00

1072

2.70

1.00

1208

1.70

1.00

1074

7.60

3.00

1210

0.70

1.00

1076

0.90

0.80

1212

1.50

1.00

1080

0.70

0.80

1214

0.20

0.80

1082

2.30

1.00

1216

0.30

0.80

1084

3.80

3.00

1218

3.50

1.00

1090

1.60

0.80

1220

5.00

1.50

1092

1.90

1.00

1222

5.00

1.50

1094

1.90

1.00

1224

6.80

3.00

1096

0.90

0.80

1226

8.80

3.00

1098

1.30

0.80

1228

3.50

1.00

1100

1.50

1.00

1230

5.00

1.50


Sixth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

1232

0.40

0.80

1394

4.00

2.00

1234

2.80

1.50

1395

0.40

0.80

1236

4.30

1.50

1397

1.90

1.00

1238

5.00

2.00

1399

0.70

0.80

1240

1.90

1.00

1401

1.90

1.00

1242

3.10

1.00

1404

0.20

0.80

1244

2.20

1.50

1407

0.40

0.80

1246

5.00

1.50

1410

1.60

0.80

1248

0.20

0.80

1413

1.60

0.80

1250

0.70

1.00

1416

2.60

1.00

1252

2.80

1.50

1419

1.90

1.00

1254

4.70

1.50

1421

2.30

1.00

1256

5.80

2.00

1423

1.00

0.80

1258

6.40

3.00

1425

4.00

1.50

1260

2.70

1.00

1428

1.30

1.00

1262

4.40

1.50

1430

5.00

1.50

1264

0.70

1.00

1432

8.80

3.00

1266

2.80

1.50

1434

2.70

1.00

1268

4.70

1.50

1436

3.10

1.00

1270

5.80

2.00

1438

8.80

3.00

1272

2.00

1.00

1441

3.30

1.00

1274

8.80

3.00

1444

0.40

0.80

1276

5.80

2.00

1447

5.00

1.50

1278

0.70

1.00

1450

3.40

1.50

1280

2.80

1.50

1453

0.40

0.80

1282

4.70

1.50

1456

2.50

1.00

1284

5.80

2.00

1459

0.70

1.00

1286

6.40

3.00

1461

2.80

1.50

1288

4.00

1.50

1463

4.70

1.50

1290

3.10

1.50

1466

5.80

2.00

1292

3.10

1.50

1468

0.20

0.80

1294

0.70

1.00

1470

1.70

1.00

1296

1.60

0.80

1472

4.00

1.50

1298

2.80

1.00

1474

8.80

3.00

1301

0.70

1.00

1476

1.70

1.00

1302

2.80

1.50

1478

2.30

1.00

1304

4.70

1.50

1481

3.30

1.00

1305

5.80

2.00

1484

6.80

3.00

1307

6.40

3.00

1487

1.70

1.00

1310

0.70

1.00

1490

1.70

1.00

1313

1.90

1.00

1491

0.20

0.80

1316

2.70

1.00

1493

6.80

3.00

1319

3.10

1.50

1494

8.80

3.00

1322

0.20

0.80

1495

0.90

0.80

1325

0.40

0.80

1496

1.60

0.80

1328

1.60

0.80

1497

3.40

1.50

1331

2.50

1.00

1499

3.50

1.00

1334

1.10

1.00

1500

0.20

0.80

1337

3.20

1.50

1502

0.20

0.80

1340

5.00

2.00

1504

0.20

0.80

1343

1.70

1.00

1506

1.30

1.00

1346

6.80

3.00

1508

0.20

0.80

1349

3.30

1.00

1511

1.90

1.00

1352

3.50

1.00

1513

1.60

0.80

1355

2.00

1.00

1515

0.40

1.00

1358

1.00

0.80

1517

1.20

1.00

1380

0.20

0.80

1519

2.50

1.00

1382

0.20

0.80

1521

2.50

1.50

1385

0.70

1.00

1523

3.50

1.50

1388

2.80

1.50

1525

1.90

1.00

1389

4.30

1.50

1527

4.00

1.50

1391

2.00

1.00

1529

2.30

1.00

1392

3.30

1.50

1531

4.40

1.50


Sixth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

1534

1.60

0.80

1710

0.70

0.80

1537

2.60

1.00

1712

0.40

0.80

1539

2.30

1.00

1714

0.40

0.80

1541

1.90

1.00

1716

0.90

0.80

1543

1.00

0.80

1718

2.00

1.00

1545

0.20

0.80

1720

4.00

2.00

1546

1.50

1.00

1722

5.10

3.00

1548

2.80

1.50

1724

1.90

1.00

1551

2.00

1.00

1726

4.00

1.50

1554

2.90

1.50

1728

5.80

2.00

1557

3.50

2.00

1730

4.00

1.50

1560

2.90

1.50

1732

0.20

0.80

1562

3.80

1.50

1734

0.20

0.80

1564

4.40

2.00

1736

6.80

3.00

1566

4.90

2.00

1738

0.90

0.80

1568

5.00

3.00

1741

0.70

1.00

1571

1.30

1.00

1744

0.90

0.80

1580

1.90

1.00

1746

0.70

1.00

1582

1.30

0.80

1748

0.70

1.00

1584

3.50

1.00

1761

0.90

0.80

1586

0.20

0.80

1764

1.70

1.00

1588

0.70

1.00

1767

0.90

0.80

1590

2.70

1.00

1770

0.70

1.00

1601

0.70

1.00

1773

3.10

1.00

1604

2.80

1.50

1776

4.80

1.50

1607

4.70

1.50

1779

0.20

0.80

1609

5.80

2.00

1782

0.20

0.80

1611

1.00

1.00

1785

0.20

0.80

1613

3.30

1.00

1790

1.90

1.00

1615

2.50

1.00

1792

1.60

0.80

1616

3.50

1.00

1794

4.00

1.00

1621

0.40

0.80

1796

4.00

1.50

1623

1.00

0.80

1798

1.90

1.00

1625

1.10

0.80

1800

1.10

0.80

1627

2.70

1.00

1802

3.20

1.00

1629

2.30

1.00

1804

4.80

1.50

1631

1.60

0.80

1806

0.40

0.80

1640

5.60

1.50

1808

1.30

1.50

1643

2.90

1.00

1810

0.40

0.80

1645

2.90

1.00

1812

0.40

0.80

1647

8.80

3.00

1820

2.80

1.50

1649

7.00

2.00

1822

5.00

2.00

1651

8.80

3.00

1824

6.40

3.00

1653

4.00

1.50

1826

4.40

3.00

1661

0.20

0.80

1828

7.40

3.00

1664

5.80

2.00

1840

12.40

4.00

1667

0.70

1.00

1841

16.00

5.00

1670

2.70

1.00

1843

3.10

1.50

1673

3.50

1.00

1846

4.00

1.50

1680

0.20

0.80

1849

2.50

1.00

1682

0.20

0.80

1850

2.80

1.50

1684

0.40

0.80

1852

2.80

1.50

1686

1.10

0.80

1855

4.30

1.50

1688

1.90

1.00

1858

5.00

2.00

1691

1.90

1.00

1861

2.20

1.50

1694

1.30

1.00

1863

5.80

2.00

1697

1.80

1.00

1865

14.00

5.00

1698

3.30

1.50

1867

3.10

1.50

1700

1.90

1.00

1869

4.80

1.50

1701

5.10

2.00

1871

6.80

3.00

1703

1.90

1.00

1873

14.00

5.00

1706

1.60

0.80

1875

5.80

2.00

1707

2.60

1.00

1877

5.80

2.00


Sixth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

1879

3.10

1.50

2132

4.80

1.50

1881

2.10

1.00

2136

3.60

1.50

1884

1.50

1.00

2140

4.00

1.50

1887

4.00

1.50

2144

4.80

1.50

1889

12.40

4.00

2160

3.40

1.50

1891

1.60

0.80

2164

11.60

4.00

1893

3.40

1.50

2169

8.80

3.00

1901

1.70

1.00

2173

5.80

2.00

1903

3.50

1.00

2177

5.90

2.00

1905

3.50

1.00

2181

6.80

3.00

1907

5.30

1.50

2185

3.80

1.50

1909

4.00

1.50

2200

3.40

1.50

1911

6.00

2.00

2205

3.40

1.50

1913

1.30

1.00

2209

6.10

2.00

1915

1.50

1.00

2214

5.30

3.00

1921

7.00

2.00

2218

5.20

3.00

1923

7.20

3.00

2222

6.80

3.00

1925

8.40

3.00

2226

5.30

3.00

1941

8.80

3.00

2230

7.80

3.00

1943

3.50

1.00

2234

5.60

2.00

1945

3.50

1.00

2238

5.00

2.00

1947

3.40

1.50

2247

6.60

3.00

1949

2.70

1.00

2250

6.40

2.00

1951

4.00

1.50

2254

1.90

1.00

1953

4.00

1.50

2270

6.80

3.00

1955

4.40

1.50

2274

4.80

1.50

1957

7.00

2.00

2290

3.40

1.50

1959

7.00

2.00

2294

3.80

2.00

1961

5.80

2.00

2298

6.40

2.00

1963

4.00

1.50

2310

6.80

3.00

1965

5.60

1.50

2314

9.80

3.00

1967

5.60

1.50

2318

9.80

3.00

1969

5.60

1.50

2322

9.80

3.00

1971

6.80

3.00

2326

7.90

2.00

1973

7.00

2.00

2330

4.80

1.50

1975

5.60

1.50

2334

9.20

3.00

1977

5.80

2.00

2338

6.80

3.00

1979

4.00

1.50

2342

7.60

3.00

1981

5.80

2.00

2346

4.60

1.50

1983

5.80

2.00

2350

3.80

3.00

2010

2.60

1.00

2354

10.40

4.00

2014

3.50

1.00

2358

5.00

1.50

2018

3.20

1.00

2362

2.10

1.00

2022

4.00

1.00

2367

2.10

1.00

2026

4.00

1.50

2371

6.40

2.00

2040

4.20

1.50

2410

5.80

2.00

2044

3.40

1.50

2420

0.90

0.80

2048

2.50

1.00

2440

4.40

1.50

2052

6.80

3.00

2444

2.70

1.00

2060

3.30

1.50

2460

1.60

1.00

2064

2.80

1.50

2464

2.40

1.00

2068

4.80

1.50

2468

5.60

1.50

2072

4.00

1.00

2510

24.00

5.00

2076

4.80

1.50

2514

24.00

5.00

2081

3.40

1.00

2518

8.00

3.00

2091

3.50

1.50

2522

14.00

4.00

2094

7.90

2.00

2526

32.00

5.00

2098

9.30

3.00

2530

24.00

5.00

2110

4.00

1.50

2534

11.60

4.00

2114

5.40

1.50

2538

15.60

5.00

2119

4.00

1.50

2542

6.40

2.00

2123

1.60

1.00

2570

11.60

4.00

2128

4.80

1.50

2574

6.40

2.00


Sixth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

2578

6.40

2.00

3121

7.40

4.00

2620

12.40

4.00

3125

13.40

4.00

2624

10.40

4.00

3126

18.00

5.00

2628

10.40

4.00

3131

16.00

5.00

2632

2.00

4.00

3132

22.00

5.00

2636

4.00

1.50

3137

3.50

1.00

2640

5.80

2.00

3138

6.80

3.00

2644

5.80

2.00

3143

4.40

1.50

2648

4.80

1.50

3144

3.80

3.00

2652

4.80

1.50

3149

8.60

4.00

2657

5.80

2.00

3150

7.00

4.00

2661

5.00

1.50

3155

18.00

5.00

2666

2.90

1.00

3156

22.00

5.00

2670

4.80

1.50

3161

34.00

5.00

2674

4.00

1.50

3162

37.00

5.00

2678

4.00

1.50

3166

48.00

5.00

2682

6.80

3.00

3170

8.80

3.00

2686

1.90

1.00

3174

2.60

1.00

2691

10.40

4.00

3178

1.00

1.00

2696

6.40

2.00

3180

3.50

1.00

2700

5.60

1.50

3184

2.60

1.00

2901

4.80

1.50

3185

2.20

1.50

2904

6.20

2.00

3190

3.90

1.50

2907

6.80

3.00

3191

5.20

2.00

2910

8.80

3.00

3196

3.60

1.50

2913

12.40

4.00

3197

5.30

2.00

3000

0.90

0.80

3201

4.90

2.00

3004

1.90

1.00

3202

5.80

2.00

3005

2.50

1.00

3026

7.80

3.00

3009

3.15

1.00

3207

10.40

4.00

3011

4.40

1.50

3211

0.20

0.80

3015

6.80

2.00

3216

0.20

0.80

3017

8.00

3.00

3220

4.40

1.50

3021

3.10

1.00

3221

3.80

3.00

3025

4.40

1.50

3225

6.40

2.00

3030

3.30

1.50

3226

7.60

3.00

3034

7.60

3.00

3230

10.60

3.00

3039

2.90

1.50

3232

14.00

4.00

3043

6.80

3.00

3236

10.60

3.00

3045

9.40

3.00

3238

14.00

4.00

3049

6.40

2.00

3242

6.40

2.00

3051

7.60

3.00

3244

7.60

3.00

3055

7.00

3.00

3248

6.80

2.00

3056

9.80

3.00

3250

8.00

3.00

3061

0.30

0.80

3254

17.60

5.00

3064

2.60

1.00

3255

24.00

5.00

3065

6.80

3.00

3259

24.00

5.00

3069

7.30

3.00

3263

50.00

5.00

3070

10.00

4.00

3267

13.40

4.00

3074

1.50

1.00

3269

18.00

5.00

3078

4.90

2.00

3273

34.00

5.00

3080

5.60

3.00

3274

46.00

5.00

3084

3.50

1.00

3279

16.00

5.00

3089

6.80

3.00

3280

22.00

5.00

3093

2.10

1.00

3285

3.15

1.00

3097

7.00

3.00

3286

4.40

1.50

3099

9.80

3.00

3291

7.00

3.00

3103

5.00

1.50

3292

9.80

3.00

3104

6.40

2.00

3297

2.50

1.00

3108

7.00

3.00

3298

3.40

1.00

3110

9.80

3.00

3303

6.40

2.00

3115

2.50

1.00

3304

7.60

3.00

3119

1.60

2.00

3309

7.60

3.00


Sixth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

3313

37.00

5.00

3514

22.00

5.00

3315

50.00

5.00

3519

28.00

5.00

3319

2.50

1.00

3523

46.00

5.00

3323

10.60

3.00

3528

28.00

5.00

3324

14.00

4.00

3529

38.00

5.00

3328

13.40

4.00

3534

23.60

5.00

3329

18.00

5.00

3535

32.00

5.00

3334

26.60

5.00

3539

43.00

5.00

3335

36.00

5.00

3541

58.00

5.00

3340

50.00

5.00

3545

78.00

5.00

3344

86.00

5.00

3550

20.60

5.00

3348

19.00

5.00

3551

28.00

5.00

3349

26.00

5.00

3556

86.00

5.00

3353

42.00

5.00

3560

28.00

5.00

3357

62.00

5.00

3561

38.00

5.00

3361

38.00

5.00

3566

28.00

5.00

3362

46.00

5.00

3567

38.00

5.00

3367

23.60

5.00

3572

14.60

5.00

3368

32.00

5.00

3573

20.00

5.00

3372

26.60

5.00

3577

17.60

5.00

3373

36.00

5.00

3578

24.00

5.00

3377

11.50

5.00

3582

46.00

5.00

3378

16.00

5.00

3583

62.00

5.00

3383

24.00

5.00

3588

11.60

4.00

3387

18.00

5.00

3589

15.60

5.00

3392

20.60

5.00

3593

20.60

5.00

3393

28.00

5.00

3594

28.00

5.00

3397

46.00

5.00

3598

46.00

5.00

3402

10.40

4.00

3599

62.00

5.00

3406

22.00

5.00

3604

20.60

5.00

3408

30.00

5.00

3605

28.00

5.00

3412

8.60

4.00

3609

26.60

5.00

3414

7.00

4.00

3610

36.00

5.00

3418

17.20

5.00

3614

46.00

5.00

3419

22.00

5.00

3615

62.00

5.00

3423

17.20

5.00

3620

46.00

5.00

3424

22.00

5.00

3624

19.00

5.00

3428

46.00

5.00

3626

28.00

5.00

3430

62.00

5.00

3630

25.00

5.00

3434

6.40

2.00

3632

34.00

5.00

3436

7.60

3.00

3636

11.60

4.00

3440

19.00

5.00

3640

6.40

2.00

3442

30.00

5.00

3645

86.00

5.00

3446

25.00

5.00

3649

20.60

5.00

3448

38.00

5.00

3651

28.00

5.00

3452

31.00

5.00

3655

31.00

5.00

3454

42.00

5.00

3656

42.00

5.00

3458

23.60

5.00

3661

31.00

5.00

3460

32.00

5.00

3662

42.00

5.00

3464

42.00

5.00

3667

50.00

5.00

3469

86.00

5.00

3671

32.00

5.00

3473

32.00

5.00

3675

7.60

3.00

3478

42.00

5.00

3680

2.30

1.00

3482

42.00

5.00

3681

3.10

1.00

3486

17.00

5.00

3686

86.00

5.00

3487

14.00

5.00

3690

19.00

5.00

3491

23.60

5.00

3691

35.00

5.00

3492

32.00

5.00

3696

50.00

5.00

3497

20.00

5.00

3700

55.00

5.00

3498

32.00

5.00

3704

17.60

5.00

3502

58.00

5.00

3705

24.00

5.00

3506

86.00

5.00

3709

20.60

5.00

3510

11.60

4.00

3710

28.00

5.00


Sixth Schedule—continued

Number of item in Fust Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

3714

18.00

5.00

3909

6.80

3.00

3716

34.00

5.00

3914

6.40

3.00

3720

1.90

1.00

3915

10.00

4.00

3721

2.50

1.00

3917

23.50

5.00

3726

14.00

5.00

3920

25.50

5.00

3727

18.00

5.00

3921

8.80

3.00

3731

14.60

5.00

3923

11.60

4.00

3732

20.00

5.00

3926

24.00

5.00

3736

20.60

5.00

3927

19.00

5.00

3737

28.00

5.00

3931

20.00

5.00

3741

19.00

5.00

3932

20.00

5.00

3742

22.00

5.00

3936

14.60

5.00

3746

5.00

1.50

3937

20.00

5.00

3747

6.40

2.00

3941

50.00

5.00

3751

1.70

1.00

3945

3.50

1.00

3755

3.40

1.50

3949

2.25

1.00

3756

2.80

2.00

3951

3.00

1.00

3760

7.00

3.00

3955

5.60

1.50

3761

9.80

3.00

3957

7.20

2.00

3765

3.40

1.00

3961

14.60

5.00

3769

1.60

1.00

3963

20.00

5.00

3770

2.50

1.00

3967

28.00

5.00

3771

9.60

3.00

3971

32.00

5.00

3772

12.80

4.00

3975

46.00

5.00

3773

1.85

4.00

3979

58.00

5.00

3774

12.00

5.00

3983

86.00

5.00

3776

7.60

3.00

3987

78.00

5.00

3780

32.00

5.00

3991

86.00

5.00

3784

68.00

5.00

3995

42.00

5.00

3788

78.00

5.00

3999

42.00

5.00

3792

2.50

1.00

4004

98.00

5.00

3796

9.40

3.00

4008

86.00

5.00

3797

12.40

4.00

4013

86.00

5.00

3801

2.70

1.00

4017

86.00

5.00

3805

6.40

2.00

4022

42.00

5.00

3806

7.60

3.00

4026

50.00

5.00

3811

14.60

5.00

4031

32.00

5.00

3812

20.00

5.00

4035

32.00

5.00

3817

0.60

0.80

4040

16.00

5.00

3821

3.40

1.50

4050

3.10

1.00

3826

6.00

4.00

4051

4.40

1.50

3827

15.00

5.00

4055

6.80

2.00

3832

5.30

1.50

4056

8.00

3.00

3836

5.60

3.00

4060

10.60

3.00

3838

2.00

4.00

4061

14.00

4.00

3842

14.60

5.00

4065

17.60

5.00

3844

20.00

5.00

4066

24.00

5.00

3848

17.60

5.00

4070

14.60

5.00

3850

24.00

5.00

4071

20.00

5.00

3854

7.40

2.00

4075

17.60

5.00

3856

8.80

3.00

4076

24.00

5.00

3860

24.00

5.00

4090

6.80

2.00

3865

42.00

5.00

4091

8.00

3.00

3869

22.00

5.00

4095

17.60

5.00

3874

5.20

1.50

4096

24.00

5.00

3878

17.60

5.00

4101

17.60

5.00

3880

24.00

5.00

4102

24.00

5.00

3883

10.00

5.00

4107

31.00

5.00

3884

19.00

5.00

4108

42.00

5.00

3888

6.00

2.00

4113

23.60

5.00

3900

1.90

1.00

4114

32.00

5.00

3904

7.00

2.00

4119

17.60

5.00

3908

5.80

2.00

4120

24.00

5.00


Sixth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

4125

31.00

5.00

4402

35.00

5.00

4126

42.00

5.00

4403

1.60

1.00

4150

10.40

4.00

4404

1.30

1.50

4151

14.00

5.00

4408

10.40

4.00

4156

1.60

0.80

4412

8.80

3.00

4157

2.30

1.00

4416

11.60

4.00

4161

8.80

3.00

4420

2.30

1.00

4162

11.60

4.00

4424

2.10

1.00

4166

14.60

5.00

4428

30.00

5.00

4167

20.00

5.00

4432

46.00

5.00

4171

17.60

5.00

4436

8.00

5.00

4172

24.00

5.00

4440

7.60

3.00

4176

31.00

5.00

4444

42.00

5.00

4177

42.00

5.00

4448

42.00

5.00

4182

64.00

5.00

4450

26.00

5.00

4183

86.00

5.00

4452

4.40

1.50

4188

5.80

2.00

4456

44.00

5.00

4189

6.80

3.00

4460

4.40

1.50

4194

1.90

1.00

4464

20.00

5.00

4195

2.50

1.00

4468

42.00

5.00

4200

7.00

3.00

4472

64.00

5.00

4201

9.80

3.00

4476

1.90

1.00

4206

17.60

5.00

4480

7.60

3.00

4207

24.00

5.00

4484

5.80

2.00

4212

14.60

5.00

4488

42.00

5.00

4213

20.00

5.00

4492

50.00

5.00

4218

23.60

5.00

4496

50.00

5.00

4219

32.00

5.00

4498

5.00

3.00

4224

34.00

5.00

4499

7.00

4.00

4225

46.00

5.00

4501

6.30

3.00

4230

38.60

5.00

4502

7.00

5.00

4231

52.00

5.00

4504

5.80

3.00

4236

108.00

5.00

4505

4.50

5.00

4300

5.80

2.00

4507

8.60

4.00

4304

7.40

2.00

4508

6.00

5.00

4305

8.80

3.00

4513

3.15

1.00

4309

7.80

3.00

4514

4.40

1.50

4311

10.40

4.00

4519

2.40

1.50

4315

68.00

5.00

4520

8.80

3.00

4320

43.00

5.00

4525

3.20

2.00

4324

38.00

5.00

4526

8.40

4.00

4328

78.00

5.00

4528

6.40

2.00

4333

50.00

5.00

4529

5.20

1.50

4337

76.00

5.00

4533

2.50

1.00

4342

86.00

5.00

4538

24.00

5.00

4346

42.00

5.00

4542

16.00

5.00

4350

78.00

5.00

4545

24.80

5.00

4355

50.00

5.00

4547

20.00

5.00

4359

2.50

1.00

4551

24.00

5.00

4360

5.80

2.00

4555

15.60

5.00

4364

30.00

5.00

4559

11.60

4.00

4368

2.00

4.00

4563

64.00

5.00

4372

3.40

1.00

4567

12.40

4.00

4376

6.80

3.00

4571

14.00

5.00

4381

4.00

1.50

4575

15.60

5.00

4385

5.80

1.50

4579

12.40

4.00

4389

4.60

1.50

4583

28.00

5.00

4390

5.80

2.00

4587

42.00

5.00

4394

10.40

4.00

4591

42.00

5.00

4395

14.00

5.00

4595

52.00

5.00

4399

30.00

5.00

4599

42.00

5.00

4400

30.80

5.00

4604

12.00

4.00

4401

30.50

5.00

4605

16.00

5.00


Sixth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

4610

11.60

4.00

5132

11.60

4.00

4614

8.80

3.00

5136

5.80

2.00

4616

11.60

4.00

5140

42.00

5.00

4620

15.60

5.00

5145

20.00

5.00

4625

17.60

5.00

5149

18.00

5.00

4626

24.00

5.00

5153

42.00

5.00

4710

42.00

5.00

5157

34.00

5.00

4714

42.00

5.00

5161

50.00

5.00

4719

108.00

5.00

5165

24.00

5.00

4723

78.00

5.00

5170

38.00

5.00

4727

52.00

5.00

5174

15.60

5.00

4728

70.00

5.00

5178

42.00

5.00

4732

78.00

5.00

5182

52.00

5.00

4735

50.00

5.00

5186

10.40

4.00

4739

38.00

5.00

5190

5.80

2.00

4743

28.00

5.00

5194

24.00

5.00

4747

42.00

5.00

5198

50.00

5.00

4751

42.00

5.00

5202

64.00

5.00

4755

24.00

5.00

5206

20.00

5.00

4759

24.00

5.00

5220

9.80

3.00

4763

33.00

5.00

5223

13.40

4.00

4767

42.00

5.00

5224

18.00

5.00

4771

40.00

5.00

5228

14.00

5.00

4775

32.00

5.00

5232

64.00

5.00

4779

48.00

5.00

5236

24.00

5.00

4783

64.00

5.00

5240

22.00

5.00

4787

76.00

5.00

5244

42.00

5.00

4810

2.60

1.00

5248

10.40

4.00

4814

3.30

3.00

5252

14.00

4.00

4819

8.60

4.00

5256

50.00

5.00

4823

4.40

1.50

5260

12.00

4.00

4827

15.60

5.00

5261

16.00

5.00

4831

14.00

5.00

5310

1.30

1.00

4835

15.00

5.00

5311

5.80

2.00

4839

18.00

5.00

5316

5.00

1.50

4843

14.00

5.00

5317

6.40

2.00

4847

24.00

5.00

5322

5.00

1.50

4851

24.00

5.00

5323

6.40

2.00

4855

22.00

5.00

5328

9.40

3.00

4910

23.60

5.00

5329

12.40

4.00

4911

32.00

5.00

5334

7.00

3.00

4916

13.40

4.00

5335

9.80

3.00

4917

18.00

5.00

5340

3.15

1.00

4922

50.00

5.00

5341

4.40

1.50

4926

86.00

5.00

5346

6.40

2.00

4931

42.00

5.00

5350

3.15

1.00

4935

42.00

5.00

5352

4.40

1.50

4939

56.00

5.00

5356

7.00

3.00

4944

24.00

5.00

5358

9.80

3.00

5010

28.00

5.00

5362

18.00

5.00

5014

60.00

5.00

5367

24.00

5.00

5019

34.00

5.00

5371

64.00

5.00

5023

86.00

5.00

5376

50.00

5.00

5028

20.00

5.00

5380

3.20

1.00

5032

30.00

5.00

5385

50.00

5.00

5037

4.00

1.50

5387

50.00

5.00

5041

20.00

5.00

5394

28.00

5.00

5110

4.10

1.00

5398

7.80

3.00

5114

5.80

2.00

5399

10.40

4.00

5118

31.00

5.00

5403

6.80

2.00

5120

42.00

5.00

5404

8.00

3.00

5124

9.80

3.00

5408

11.00

5.00

5128

9.80

3.00

5410

15.00

5.00


Sixth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

5414

28.00

5.00

5585

40.50

5.00

5416

38.00

5.00

5589

32.00

5.00

5419

34.00

5.00

5593

11.00

5.00

5420

57.00

5.00

5594

8.00

5.00

5422

37.10

5.00

5596

23.60

5.00

5423

63.00

5.00

5597

32.00

5.00

5425

11.60

4.00

5610

4.00

1.50

5429

50.00

5.00

5614

17.60

5.00

5434

48.00

5.00

5616

24.00

5.00

5438

3.10

1.00

5620

44.00

5.00

5439

4.00

1.50

5625

24.00

5.00

5443

3.50

1.00

5631

46.00

5.00

5444

4.40

1.50

5635

42.00

5.00

5448

2.20

1.50

5640

46.00

5.00

5451

10.40

4.00

5644

28.00

5.00

5452

14.00

5.00

5649

58.00

5.00

5453

13.10

5.00

5653

46.00

5.00

5454

20.00

5.00

5658

50.00

5.00

5457

8.80

3.00

5662

7.60

3.00

5458

11.60

4.00

5667

2.50

1.00

5462

2.50

1.50

5668

3.40

1.50

5463

3.20

1.50

5673

14.00

4.00

5467

6.80

3.00

5677

18.00

5.00

5471

5.00

3.00

5681

20.00

5.00

5472

10.40

4.00

5685

42.00

5.00

5475

6.60

3.00

5689

46.00

5.00

5477

12.40

4.00

5693

42.00

5.00

5481

6.80

3.00

5697

28.00

5.00

5483

12.60

4.00

5701

4.50

1.50

5487

7.60

3.00

5702

2.80

2.00

5489

13.60

4.00

5706

7.60

3.00

5493

14.60

5.00

5710

8.00

3.00

5495

20.00

5.00

5714

0.90

0.80

5499

34.00

5.00

5718

3.15

1.00

5501

46.00

5.00

5719

4.40

1.50

5505

44.00

5.00

5723

12.80

4.00

5507

51.00

5.00

5727

15.60

5.00

5511

47.10

5.00

5731

4.40

1.50

5512

57.00

5.00

5735

98.00

5.00

5513

54.00

5.00

5739

64.00

5.00

5515

78.00

5.00

5742

58.00

5.00

5518

54.50

5.00

5746

4.60

1.50

5519

66.00

5.00

5750

11.00

5.00

5523

36.00

5.00

5754

18.00

5.00

5525

48.00

5.00

5758

41.00

5.00

5529

28.00

5.00

5762

42.00

5.00

5531

38.00

5.00

5766

86.00

5.00

5535

28.00

5.00

5770

34.00

5.00

5537

38.00

5.00

5774

18.00

5.00

5541

19.00

5.00

5778

20.00

5.00

5543

23.00

5.00

5782

55.00

5.00

5547

24.00

5.00

5786

34.00

5.00

5551

20.60

5.00

5790

38.00

5.00

5553

28.00

5.00

5794

46.00

5.00

5557

2.80

1.50

5798

20.00

5.00

5561

32.00

5.00

5802

64.00

5.00

5565

4.80

1.50

5806

86.00

5.00

5569

3.10

1.00

5810

34.00

5.00

5573

17.00

5.00

5814

24.00

5.00

5574

23.00

5.00

5818

10.40

4.00

5577

20.10

5.00

5822

16.00

5.00

5579

29.00

5.00

5826

42.00

5.00

5583

28.50

5.00

5830

64.00

5.00


Sixth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

5834

6.40

2.00

6173

64.00

5.00

5838

5.20

1.50

6177

24.00

5.00

5842

23.00

5.00

6181

10.00

4.00

5846

28.00

5.00

6182

16.00

5.00

5850

28.00

5.00

6186

10.40

4.00

5854

26.00

5.00

6187

14.00

5.00

5858

26.00

5.00

6191

17.60

5.00

5910

5911

5915

5920

5924

2.30

3.10

6.20

3.20

7.00

1.00

1.00

2.00

1.00

3.00

6192

6196

6197

6198

24.00

15.60

31.00

42.00

5.00

5.00

5.00

5.00

5926

9.80

3.00

6202

43.00

5.00

5930

23.60

5.00

6203

58.00

5.00

5931

32.00

5.00

6207

64.00

5.00

5936

64.00

5.00

6211

58.00

5.00

5940

64.00

5.00

6215

54.00

5.00

5945

68.00

5.00

6219

108.00

5.00

5949

86.00

5.00

6223

78.00

5.00

5954

50.00

5.00

6227

86.00

5.00

5958

28.00

5.00

6231

86.00

5.00

5963

70.00

5.00

6235

50.00

5.00

5967

15.60

5.00

6239

64.00

5.00

5971

26.00

5.00

6243

108.00

5.00

5976

6.40

2.00

6247

86.00

5.00

5980

11.60

4.00

6251

64.00

5.00

5985

86.00

5.00

6255

70.00

5.00

5989

52.00

5.00

6259

64.00

5.00

5994

76.00

5.00

6263

42.00

5.00

5998

86.00

5.00

6310

3.40

1.00

6003

42.00

5.00

6314

2.10

1.00

6007

28.00

5.00

6318

4.20

1.50

6012

20.00

5.00

6320

5.60

1.50

6016

50.00

5.00

6324

6.40

2.00

6021

32.00

5.00

6328

5.60

1.50

6025

98.00

5.00

6333

4.40

1.50

6029

11.60

4.00

6337

5.80

2.00

6034

16.80

5.00

6338

6.80

3.00

6038

40.00

5.00

6343

4.00

1.50

6042

15.60

5.00

6344

5.20

1.50

6100

0.90

0.80

6349

8.80

3.00

6104

4.00

1.50

6350

11.60

4.00

6108

4.40

1.50

6354

1.50

0.80

6112

8.00

3.00

6355

2.10

1.00

6116

4.30

1.50

6359

5.00

1.50

6120

4.40

1.50

6360

6.40

2.00

6124

5.20

1.50

6365

14.60

5.00

6128

11.60

4.00

6366

20.00

5.00

6132

7.00

3.00

6371

10.60

3.00

6133

9.80

3.00

6372

14.00

4.00

6137

12.00

4.00

6377

4.00

1.50

6138

16.00

5.00

6378

5.20

1.50

6142

20.40

5.00

6382

6.40

2.00

6143

28.00

5.00

6383

7.60

3.00

6147

32.00

5.00

6387

1.90

1.00

6151

50.00

5.00

6388

2.50

1.00

6155

58.00

5.00

6392

5.00

1.50

6159

16.00

5.00

6393

6.40

2.00

6160

22.00

5.00

6397

13.40

4.00

6164

10.40

4.00

6398

18.00

5.00

6165

14.00

5.00

6402

13.40

4.00

6169

50.00

5.00

6404

18.00

5.00


Sixth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

6414

The amount shown in this column in the item relating to the dislocation concerned, plus one-half of that amount

The amount shown in this column in the item relating to the dislocation concerned, plus one-half of that amount

6575

2.00

1.00

 

6578

0.90

0.80

 

6580

2.00

1.00

 

6584

5.30

3.00

 

6586

7.00

4.00

 

6590

7.00

3.00

 

6592

9.80

3.00

 

6596

22.00

5.00

 

6601

24.00

5.00

 

6605

8.80

3.00

 

6606

11.60

4.00

6420

3.40

1.00

6610

30.00

5.00

6425

6.40

2.00

6614

32.00

5.00

6426

8.80

3.00

6618

7.80

3.00

6431

3.40

1.00

6619

10.40

4.00

6432

4.60

1.50

6623

0.90

0.80

6437

4.90

2.00

6624

1.60

1.00

6438

12.40

4.00

6628

0.90

0.80

6442

6.80

3.00

6629

2.00

1.00

6443

14.00

5.00

6633

10.60

3.00

6447

3.90

1.00

6634

14.00

4.00

6448

5.20

1.50

6638

17.60

5.00

6453

7.00

3.00

6639

24.00

5.00

6454

9.80

3.00

6643

64.00

5.00

6458

6.60

3.00

 

 

 

6459

16.00

5.00

6647

The amount shown in this column in the item relating to the fracture concerned, plus one-third of that amount

The amount shown in this column in the item relating to the fracture concerned, plus one-third of that amount

6463

7.60

3.00

 

6467

8.10

3.00

 

6468

16.40

5.00

 

6472

6.40

2.00

 

6473

7.60

3.00

 

6477

12.60

4.00

 

6478

7.00

5.00

 

6482

14.40

4.00

 

6483

7.00

5.00

6651

The amount shown in this column in the item relating to the fracture concerned, plus one-half of that amount

The amount shown in this column in the item relating to the fracture concerned, plus one-half of that amount

6487

4.40

1.50

 

6489

3.80

3.00

 

6493

6.40

2.00

 

6494

7.60

3.00

 

6498

0.90

0.80

 

6499

2.00

1.00

 

6503

11.60

4.00

 

6505

15.60

5.00

 

6509

8.80

3.00

6655

The amount shown in this column in the item relating to the fracture concerned, plus three-quarters of that amount

The amount shown in this column in the item relating to the fracture concerned, plus three-quarters of that amount

6510

11.60

4.00

 

6515

28.00

5.00

 

6516

38.00

5.00

 

6521

4.90

2.00

 

6522

7.90

3.00

 

6525

7.30

3.00

 

6527

10.00

4.00

 

6531

17.60

5.00

 

6532

24.00

5.00

6659

One-half of the amount shown in this column in the item that would, but for item 6659 in the First Schedule to this Act, apply to the reduction concerned

One-half of the amount shown in this column in the item that would, but for item 6659 in the First Schedule to this Act, apply to the reduction concerned

6537

17.60

5.00

 

6538

24.00

5.00

 

6543

17.60

5.00

 

6544

24.00

5.00

 

6549

4.90

2.00

 

6550

8.80

3.00

 

6555

3.40

1.00

 

6559

4.40

1.50

 

6564

3.70

1.00

 

6568

3.45

1.00

 

6569

4.80

1.50

 

6574

0.90

0.80

 


Sixth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

6663

One-half of the amount shown in this column in the item that would, but for item 6663 in the First Schedule to this Act, apply to the reduction concerned

One-half of the amount shown in this column in the item that would, but for item 6663 in the First Schedule to this Act, apply to the reduction concerned

7114

18.00

5.00

 

7118

20.00

5.00

 

7122

54.00

5.00

 

7126

64.00

5.00

 

7130

7.00

5.00

 

7135

5.00

1.50

 

7136

6.40

2.00

 

7141

32.00

5.00

 

7145

36.00

5.00

 

7149

32.00

5.00

 

7154

16.00

5.00

 

7155

22.00

5.00

 

7159

86.00

5.00

6667

The amount shown in this column in the item that would, but for item 6667 in the First Schedule to this Act, apply to the reduction concerned

The amount shown in this column in the item that would, but for item 6667 in the First Schedule to this Act, apply to the reduction concerned

7163

42.00

5.00

 

7167

58.00

5.00

 

7171

28.00

5.00

 

7176

32.00

5.00

 

7180

42.00

5.00

 

7184

32.00

5.00

 

7189

28.00

5.00

 

7190

38.00

5.00

 

7195

32.00

5.00

 

7199

1.90

1.00

 

7200

2.30

1.00

 

7205

1.60

0.80

6671

The amount shown in this column in the item that would apply in the case of a simple and uncomplicated fracture of the part concerned

The amount shown in this column in the item that would apply in the case of a simple and uncomplicated fracture of the part concerned

7206

2.30

1.00

 

7210

11.60

4.00

 

7214

42.00

5.00

 

7218

24.00

5.00

 

7221

10.00

5.00

 

7222

16.00

5.00

 

7224

17.00

5.00

 

7225

20.00

5.00

 

7227

19.45

5.00

 

7228

28.00

5.00

 

7230

20.00

5.00

7010

18.00

5.00

7233

13.40

4.00

7014

9.40

3.00

7234

18.00

5.00

7016

12.40

4.00

7238

42.00

5.00

7020

1.00

1.00

7242

14.00

4.00

7025

2.10

1.00

7246

24.00

5.00

7029

3.90

1.00

7250

13.40

4.00

7031

5.20

1.50

7252

18.00

5.00

7035

4.90

2.00

7256

16.00

5.00

7037

10.00

4.00

7257

22.00

5.00

7041

6.40

2.00

7261

12.40

4.00

7043

7.60

3.00

7262

12.00

5.00

7047

70.00

5.00

7266

20.00

5.00

7051

24.00

5.00

7271

20.00

5.00

7055

7.40

2.00

7275

24.00

5.00

7056

8.80

3.00

7280

28.00

5.00

7060

3.80

3.00

7284

46.00

5.00

7061

3.40

3.00

7289

70.00

5.00

7065

11.60

4.00

7293

46.00

5.00

7069

10.40

4.00

7297

44.00

5.00

7074

12.80

4.00

7301

46.00

5.00

7078

108.00

5.00

7305

10.40

4.00

7082

34.00

5.00

7309

22.00

5.00

7087

22.00

5.00

7313

8.80

3.00

7091

50.00

5.00

7314

11.60

4.00

7095

90.00

5.00

7318

20.60

5.00

7100

90.00

5.00

7319

28.00

5.00

7104

78.00

5.00

7323

10.80

4.00

7108

38.00

5.00

7324

14.40

5.00

7113

13.40

4.00

7328

13.40

4.00


Sixth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

7329

18.00

5.00

7616

42.00

5.00

7333

22.00

5.00

7620

24.00

5.00

7334

30.00

5.00

7625

64.00

5.00

7338

6.40

2.00

7629

6.40

2.00

7339

7.60

3.00

7631

7.60

3.00

7343

8.80

3.00

7635

50.00

5.00

7344

11.60

4.00

7640

36.00

5.00

7348

6.80

3.00

7644

32.00

5.00

7352

18.00

5.00

7649

18.00

5.00

7356

34.00

5.00

7653

6.40

2.00

7360

58.00

5.00

7655

7.60

3.00

7364

28.00

5.00

7659

7.40

2.00

7368

20.00

5.00

7661

8.80

3.00

7372

6.40

2.00

7665

32.00

5.00

7373

7.60

3.00

7670

6.40

2.00

7377

10.40

4.00

7671

7.60

3.00

7378

14.00

5.00

7676

20.00

5.00

7382

15.60

5.00

7680

36.00

5.00

7386

24.00

5.00

7685

32.00

5.00

7390

8.80

3.00

7700

50.00

5.00

7391

11.60

4.00

7704

6.40

2.00

7395

22.00

5.00

7708

4.00

1.50

7396

30.00

5.00

7750

24.00

5.00

7400

28.00

5.00

7754

11.60

4.00

7450

3.40

3.00

7758

20.00

5.00

7454

3.40

1.00

7762

2.50

1.00

7458

4.00

1.50

7767

3.40

1.00

7462

3.40

1.00

7771

3.80

3.00

7466

4.40

1.50

7775

10.40

4.00

7470

3.40

1.00

7779

14.00

5.00

7474

5.20

1.50

7783

22.00

5.00

7478

3.40

1.00

7787

40.00

5.00

7482

6.40

2.00

7791

42.00

5.00

7486

15.60

5.00

7795

20.00

5.00

7490

3.40

1.00

7850

14.00

5.00

7494

5.20

1.50

7854

18.00

5.00

7498

5.20

1.50

7858

14.00

4.00

7510

3.40

1.00

7862

7.60

3.00

7514

50.00

5.00

7866

9.80

3.00

7519

64.00

5.00

7870

5.20

1.50

7523

64.00

5.00

7874

15.60

5.00

7528

64.00

5.00

7877

9.80

3.00

7532

32.00

5.00

7881

24.00

5.00

7537

50.00

5.00

7885

14.00

4.00

7541

50.00

5.00

7889

9.80

3.00

7545

64.00

5.00

7893

6.40

2.00

7549

64.00

5.00

7897

16.00

5.00

7553

42.00

5.00

7901

24.00

5.00

7557

14.00

4.00

7905

10.80

4.00

7561

32.00

5.00

7909

24.00

5.00

7565

24.00

5.00

7913

20.00

5.00

7569

76.00

5.00

7917

32.00

5.00

7573

76.00

5.00

7921

64.00

5.00

7577

50.00

5.00

7925

54.00

5.00

7581

25.00

5.00

7929

64.00

5.00

7582

34.00

5.00

7950

14.00

5.00

7586

42.00

5.00

7952

15.50

5.00

7590

50.00

5.00

7953

16.50

5.00

7594

64.00

5.00

7954

24.00

5.00

7598

32.00

5.00

7958

14.00

5.00

7602

42.00

5.00

7962

7.60

3.00

7607

64.00

5.00

7966

20.00

5.00

7611

24.00

5.00

7970

14.00

4.00


Sixth Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

7974

32.00

5.00

8154

24.00

5.00

7978

20.00

5.00

8159

50.00

5.00

7982

14.00

4.00

8163

24.00

5.00

7986

34.00

5.00

8167

50.00

5.00

7990

10.40

4.00

8172

28.00

5.00

7994

7.60

3.00

8176

42.00

5.00

7998

22.00

5.00

8180

9.80

3.00

8002

36.00

5.00

8184

26.00

5.00

8007

18.00

5.00

8188

22.00

5.00

8011

28.00

5.00

8192

22.00

5.00

8015

28.00

5.00

8196

24.00

5.00

8020

50.00

5.00

8200

32.00

5.00

8024

16.00

5.00

8204

50.00

5.00

8029

50.00

5.00

8208

70.00

5.00

8033

36.00

5.00

8212

9.80

3.00

8037

98.00

5.00

8216

24.00

5.00

8042

34.00

5.00

8220

18.00

5.00

8046

64.00

5.00

8224

38.00

5.00

8050

50.00

5.00

8228

12.80

4.00

8054

42.00

5.00

8232

42.00

5.00

8058

42.00

5.00

8236

28.00

5.00

8062

24.00

5.00

8240

46.00

5.00

8066

20.00

5.00

8244

62.00

5.00

8070

24.00

5.00

8248

24.00

5.00

8110

18.00

5.00

8252

18.00

5.00

8114

28.00

5.00

8256

36.00

5.00

8119

32.00

5.00

8260

86.00

5.00

8123

18.00

5.00

8264

14.40

5.00

8128

32.00

5.00

8268

46.00

5.00

8132

18.00

5.00

8272

58.00

5.00

8136

42.00

5.00

8276

24.00

5.00

8141

32.00

5.00

8280

42.00

5.00

8145

20.00

5.00

8284

42.00

5.00

8150

11.60

4.00

8288

50.00

5.00


SEVENTH SCHEDULE Section 13.

TABLE OF FUND MEDICAL BENEFITS IN RESPECT OF TASMANIA

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

2

1.10

0.80

357

16.00

5.00

3

1.15

1.20

370

4.90

1.50

9

2.75

1.00

371

5.50

2.00

11

5.00

1.50

375

5.40

2.00

13

2.00

1.00

376

6.10

2.00

15

5.00

2.00

378

6.30

3.00

17

7.00

3.00

379

7.90

3.00

18

2.25

1.00

381

9.70

3.00

24

1.60

1.80

382

11.30

3.00

37

8.50

3.00

384

12.50

4.00

38

13.10

4.00

386

16.90

5.00

39

17.50

5.00

388

8.00

3.00

40

22.50

5.00

389

9.20

4.00

43

1.10

0.80

391

10.40

4.00

45

1.20

0.80

392

12.60

4.00

203

1.10

0.80

394

13.80

5.00

206

7.40

4.00

396

9.30

4.00

209

4.60

3.00

397

10.90

4.00

210

7.00

4.00

399

12.70

4.00

220

3.80

3.00

400

14.30

4.00

223

11.00

5.00

402

15.50

5.00

224

6.00

5.00

430

3.10

1.00

226

11.40

5.00

435

4.20

1.50

227

4.00

5.00

436

5.50

1.50

230

15.50

5.00

451

4.40

1.50

231

3.00

5.00

455

4.60

1.50

235

16.00

5.00

456

5.80

2.00

236

8.00

5.00

501

4.80

1.50

243

0.30

0.80

601

1.70

1.00

247

0.30

0.80

611

2.10

1.00

251

7.80

3.00

616

5.60

1.50

252

10.40

4.00

621

11.60

4.00

255

3.10

1.00

625

10.40

4.00

256

4.40

1.50

631

4.40

1.50

259

0.30

0.80

641

3.40

1.50

263

4.40

1.50

651

8.40

3.00

267

3.10

1.00

661

11.60

4.00

268

4.40

1.50

681

3.20

1.00

271

3.40

1.50

691

2.50

1.00

275

15.60

5.00

701

2.50

1.00

279

2.40

1.50

703

2.30

1.00

283

17.20

5.00

705

7.00

2.00

287

3.10

1.00

707

2.70

1.00

288

4.40

1.50

708

1.90

1.00

291

5.60

3.00

715

2.90

1.00

301

3.00

1.00

721

2.70

1.00

302

3.30

1.00

731

9.80

3.00

305

6.00

1.50

741

2.40

1.00

306

7.40

1.50

751

6.00

2.00

309

4.90

2.00

761

28.00

5.00

310

5.80

2.00

771

42.00

5.00

313

7.60

3.00

781

32.00

5.00

317

11.60

4.00

791

7.60

3.00

321

0.70

0.80

801

7.20

2.00

323

4.80

1.50

831

1.60

1.00

341

4.00

1.50

841

2.50

1.00

342

4.80

1.50

851

3.30

1.00

344

4.70

1.50

861

5.60

1.50

345

5.20

2.00

866

7.60

3.00

347

6.40

2.00

871

6.40

2.00

348

7.00

3.00

881

3.40

1.50

351

8.80

3.00

891

14.00

4.00

352

10.40

3.00

901

11.60

4.00

355

11.60

4.00

906

14.00

4.00


Seventh Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

911

3.20

1.00

1110

3.30

1.50

915

6.80

3.00

1112

0.20

0.80

921

0.90

0.80

1114

0.20

0.80

931

0.40

0.80

1116

2.60

1.50

941

1.00

0.80

1118

1.10

0.80

943

1.40

0.80

1120

4.80

1.50

945

2.30

1.00

1122

0.70

1.00

951

3.40

1.00

1124

1.90

1.00

961

2.10

1.00

1126

2.30

1.00

971

7.60

3.00

1128

0.70

0.80

976

15.60

5.00

1130

3.10

1.00

981

3.50

1.00

1132

1.90

1.00

985

4.80

1.50

1134

3.10

1.00

1000

0.20

0.80

1136

4.80

1.50

1002

0.70

0.80

1138

1.60

0.80

1004

0.20

0.80

1140

1.70

1.00

1006

0.90

0.80

1142

1.40

1.00

1008

0.20

0.80

1144

1.60

0.80

1010

0.60

0.80

1146

1.60

0.80

1012

3.00

1.00

1148

1.70

1.00

1014

0.90

1.00

1150

2.80

1.50

1016

3.10

1.00

1152

2.70

1.00

1018

3.80

1.50

1154

2.30

1.00

1020

5.70

3.00

1156

2.30

1.00

1022

0.20

0.80

1160

0.70

1.00

1024

0.70

0.80

1162

1.10

1.00

1026

0.70

0.80

1164

2.50

1.00

1028

1.20

1.00

1166

2.50

1.00

1030

1.10

1.00

1168

2.50

1.00

1032

1.20

1.00

1170

2.90

1.00

1034

1.90

1.00

1172

0.90

0.80

1036

2.70

1.00

1174

1.60

0.80

1038

3.10

1.00

1176

1.00

0.80

1040

3.10

1.00

1180

0.10

0.80

1042

0.40

0.80

1182

0.20

0.80

1044

4.00

1.50

1184

1.70

1.00

1046

1.40

0.80

1186

0.70

0.80

1048

5.60

1.50

1188

1.90

1.00

1050

1.50

1.00

1190

2.70

1.00

1052

6.30

3.00

1192

0.70

1.00

1054

0.20

0.80

1194

0.70

1.00

1060

0.20

0.80

1196

2.70

1.00

1062

0.60

0.80

1198

0.70

1.00

1064

0.70

0.80

1200

0.20

0.80

1066

2.30

1.00

1202

0.40

1.00

1068

1.00

1.00

1204

0.60

0.80

1070

1.30

1.00

1206

2.10

1.00

1072

2.70

1.00

1208

1.70

1.00

1074

7.60

3.00

1210

0.70

1.00

1076

0.90

0.80

1212

1.50

1.00

1080

0.70

0.80

1214

0.70

0.80

1082

2.30

1.00

1216

0.80

0.80

1084

3.80

3.00

1218

3.50

1.00

1090

1.60

0.80

1220

5.00

1.50

1092

1.90

1.00

1222

5.00

1.50

1094

1.90

1.00

1224

6.80

3.00

1096

0.90

0.80

1226

8.80

3.00

1098

1.30

0.80

1228

3.50

1.00

1100

1.50

1.00

1230

5.00

1.50

1102

3.50

1.00

1232

0.40

0.80

1104

0.20

0.80

1234

2.80

1.50

1106

1.10

0.80

1236

4.30

1.50

1108

1.50

1.00

1238

5.00

2.00


Seventh Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

1240

1.90

1.00

1401

1.90

1.00

1242

3.10

1.00

1404

0.20

0.80

1244

2.70

1.50

1407

0.70

1.00

1246

5.00

1.50

1410

1.60

0.80

1248

0.20

0.80

1413

1.60

0.80

1250

0.70

1.00

1416

2.60

1.00

1252

2.80

1.50

1419

1.90

1.00

1254

4.70

1.50

1421

2.30

1.00

1256

5.80

2.00

1423

1.00

0.80

1258

6.40

3.00

1425

4.00

1.50

1260

2.70

1.00

1428

1.30

1.00

1262

4.40

1.50

1430

5.00

1.50

1264

0.70

1.00

1432

8.80

3.00

1266

2.80

1.50

1434

2.70

1.00

1268

4.70

1.50

1436

3.10

1.00

1270

5.80

2.00

1438

8.80

3.00

1272

2.50

1.00

1441

3.30

1.00

1274

8.80

3.00

1444

0.40

0.80

1276

5.80

2.00

1447

5.00

1.50

1278

0.70

1.00

1450

3.40

1.50

1280

2.80

1.50

1453

1.20

1.00

1282

4.70

1.50

1456

2.50

1.00

1284

5.80

2.00

1459

0.70

1.00

1286

6.40

3.00

1461

2.80

1.50

1288

4.00

1.50

1463

4.70

1.50

1290

3.10

1.50

1466

5.80

2.00

1292

3.10

1.50

1468

0.20

0.80

1294

0.70

1.00

1470

1.70

1.00

1296

1.60

0.80

1472

4.00

1.50

1298

2.80

1.00

1474

8.80

3.00

1301

0.70

1.00

1476

1.70

1.00

1302

2.80

1.50

1478

2.30

1.00

1304

4.70

1.50

1481

3.30

1.00

1305

5.80

2.00

1484

6.80

3.00

1307

6.40

3.00

1487

1.70

1.00

1310

0.70

1.00

1490

1.70

1.00

1313

1.90

1.00

1491

0.20

0.80

1316

2.70

1.00

1493

6.80

3.00

1319

3.10

1.50

1494

8.80

3.00

1322

0.20

0.80

1495

0.90

0.80

1325

0.40

0.80

1496

1.60

0.80

1328

1.90

1.00

1497

3.40

1.50

1331

3.00

1.50

1499

3.50

1.00

1334

1.10

1.00

1500

0.20

0.80

1337

3.20

1.50

1502

0.20

0.80

1340

5.00

2.00

1504

0.20

0.80

1343

1.70

1.00

1506

1.30

1.00

1346

6.80

3.00

1508

0.20

0.80

1349

3.30

1.00

1511

1.90

1.00

1352

3.50

1.00

1513

1.60

0.80

1355

2.50

1.00

1515

0.40

1.00

1358

1.00

0.80

1517

1.20

1.00

1380

0.70

0.80

1519

2.50

1.00

1382

0.70

0.80

1521

2.50

1.50

1385

0.70

1.00

1523

3.50

1.50

1388

2.80

1.50

1525

1.90

1.00

1389

4.30

1.50

1527

4.00

1.50

1391

2.00

1.00

1529

2.30

1.00

1392

3.30

1.50

1531

4.40

1.50

1394

4.00

2.00

1534

1.60

0.80

1395

0.40

0.80

1537

2.60

1.00

1397

1.90

1.00

1539

2.30

1.00

1399

0.70

0.80

1541

1.90

1.00


Seventh Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

1543

1.00

0.80

1718

2.00

1.00

1545

0.20

0.80

1720

4.00

2.00

1546

1.50

1.00

1722

5.10

3.00

1548

2.80

1.50

1724

1.90

1.00

1551

2.00

1.00

1726

4.00

1.50

1554

2.90

1.50

1728

5.80

2.00

1557

3.50

2.00

1730

4.00

1.50

1560

2.90

1.50

1732

0.20

0.80

1562

3.80

1.50

1734

0.20

0.80

1564

4.40

2.00

1736

6.80

3.00

1566

4.90

2.00

1738

0.90

0.80

1568

5.00

3.00

1741

0.70

1.00

1571

1.30

1.00

1744

0.90

0.80

1580

1.90

1.00

1746

0.70

1.00

1582

1.30

0.80

1748

0.70

1.00

1584

3.50

1.00

1761

0.90

0.80

1586

0.20

0.80

1764

1.70

1.00

1588

0.70

1.00

1767

0.90

0.80

1590

2.70

1.00

1770

0.70

1.00

1601

0.70

1.00

1773

3.10

1.00

1604

2.80

1.50

1776

4.80

1.50

1607

4.70

1.50

1779

0.20

0.80

1609

5.80

2.00

1782

0.20

0.80

1611

1.00

1.00

1785

0.20

0.80

1613

3.30

1.00

1790

1.90

1.00

1615

2.50

1.00

1792

1.60

0.80

1616

3.50

1.00

1794

4.00

1.00

1621

0.40

0.80

1796

4.00

1.50

1623

1.00

0.80

1798

1.90

1.00

1625

1.10

0.80

1800

1.10

0.80

1627

2.70

1.00

1802

2.20

1.00

1629

2.30

1.00

1804

3.80

1.50

1631

1.60

0.80

1806

0.40

0.80

1640

5.60

1.50

1808

1.30

1.50

1643

2.90

1.00

1810

0.40

0.80

1645

2.90

1.00

1812

0.40

0.80

1647

8.80

3.00

1820

2.80

1.50

1649

7.00

2.00

1822

5.00

2.00

1651

8.80

3.00

1824

6.40

3.00

1653

4.00

1.50

1826

4.40

3.00

1661

0.20

0.80

1828

7.40

3.00

1664

5.80

2.00

1840

12.40

4.00

1667

0.70

1.00

1841

16.00

5.00

1670

2.70

1.00

1843

3.10

1.50

1673

3.50

1.00

1846

4.00

1.50

1680

0.20

0.80

1849

2.50

1.00

1682

0.20

0.80

1850

2.80

1.50

1684

0.40

0.80

1852

2.80

1.50

1686

1.10

0.80

1855

4.30

1.50

1688

1.90

1.00

1858

5.00

2.00

1691

1.90

1.00

1861

2.70

1.50

1694

1.30

1.00

1863

5.80

2.00

1697

1.80

1.00

1865

14.00

5.00

1698

3.30

1.50

1867

3.10

1.50

1700

1.90

1.00

1869

4.80

1.50

1701

5.10

2.00

1871

6.80

3.00

1703

1.90

1.00

1873

14.00

5.00

1706

1.60

0.80

1875

5.80

2.00

1707

2.60

1.00

1877

5.80

2.00

1710

0.70

0.80

1879

3.10

1.50

1712

0.70

1.00

1881

2.10

1.00

1714

0.70

1.00

1884

1.50

1.00

1716

0.90

0.80

1887

4.00

1.50


Seventh Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

1889

12.40

4.00

2160

3.40

1.00

1891

1.60

0.80

2164

11.60

4.00

1893

3.40

1.50

2169

8.80

3.00

1901

1.70

1.00

2173

5.80

2.00

1903

3.50

1.00

2177

5.90

2.00

1905

3.50

1.00

2181

6.80

3.00

1907

5.30

1.50

2185

3.30

1.50

1909

4.00

1.50

2200

2.90

1.00

1911

6.00

2.00

2205

2.90

1.00

1913

1.30

1.00

2209

5.60

1.50

1915

1.50

1.00

2214

4.80

2.00

1921

7.00

2.00

2218

4.20

3.00

1923

7.20

3.00

2222

6.80

3.00

1925

8.40

3.00

2226

4.30

2.00

1941

8.80

3.00

2230

4.80

3.00

1943

4.00

1.50

2234

4.60

2.00

1945

3.50

1.00

2238

5.00

2.00

1947

3.40

1.50

2247

5.60

3.00

1949

2.70

1.00

2250

6.40

2.00

1951

4.00

1.50

2254

1.90

1.00

1953

4.00

1.50

2270

6.80

3.00

1955

4.40

1.50

2274

4.80

1.50

1957

7.00

2.00

2290

3.40

1.50

1959

7.00

2.00

2294

3.80

2.00

1961

5.80

2.00

2298

6.40

2.00

1963

4.00

1.50

2310

6.80

3.00

1965

5.60

1.50

2314

9.80

3.00

1967

5.60

1.50

2318

9.80

3.00

1969

5.60

1.50

2322

9.80

3.00

1971

6.80

3.00

2326

6.40

2.00

1973

7.00

2.00

2330

4.80

1.50

1975

5.60

1.50

2334

9.20

3.00

1977

5.80

2.00

2338

6.80

3.00

1979

4.00

1.50

2342

7.60

3.00

1981

5.80

2.00

2346

4.60

1.50

1983

5.80

2.00

2350

3.80

3.00

2010

1.60

1.00

2354

10.40

4.00

2014

2.50

1.00

2358

5.00

1.50

2018

2.20

1.00

2362

2.10

1.00

2022

2.50

1.00

2367

2.10

1.00

2026

2.50

1.00

2371

6.40

2.00

2040

1.70

1.00

2410

5.80

2.00

2044

1.40

1.00

2420

0.90

0.80

2048

2.00

1.00

2440

4.40

1.50

2052

6.80

3.00

2444

2.70

1.00

2060

4.30

1.50

2460

1.60

1.00

2064

2.80

1.50

2464

2.40

1.00

2068

2.80

1.50

2468

5.60

1.50

2072

3.00

1.00

2510

24.00

5.00

2076

4.80

1.50

2514

24.00

5.00

2081

2.40

1.00

2518

8.00

3.00

2091

3.50

1.50

2522

14.00

4.00

2094

6.40

2.00

2526

32.00

5.00

2098

2.30

3.00

2530

24.00

5.00

2110

4.00

1.00

2534

11.60

4.00

2114

4.40

1.50

2538

15.60

5.00

2119

4.00

1.00

2542

6.40

2.00

2123

1.60

1.00

2570

11.60

4.00

2128

4.80

1.50

2574

6.40

2.00

2132

4.80

1.50

2578

6.40

2.00

2136

2.60

1.50

2620

12.40

4.00

2140

4.00

1.50

2624

10.40

4 00

2144

4.80

1.50

2628

10.40

4.00


Seventh Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

2632

2.00

4.00

3132

22.00

5.00

2636

4.00

1.50

3137

2.50

1.00

2640

5.80

2.00

3138

3.80

2.00

2644

5.80

2.00

3143

4.90

2.00

2648

4.80

1.50

3144

3.80

3.00

2652

4.80

1.50

3149

8.60

4.00

2657

5.80

2.00

3150

7.00

4.00

2661

5.00

1.50

3155

8.00

5.00

2666

2.90

1.00

3156

12.00

5.00

2670

4.80

1.50

3161

34.00

5.00

2674

4.00

1.50

3162

37.00

5.00

2678

4.00

1.50

3166

48.00

5.00

2682

6.80

3.00

3170

8.80

3.00

2686

1.90

1.00

3174

2.60

1.00

2691

10.40

4.00

3178

1.00

1.00

2696

6.40

2.00

3180

3.50

1.00

2700

5.60

1.50

3184

2.60

1.00

2901

4.80

1.50

3185

2.20

1.50

2904

6.20

2.00

3190

3.40

1.50

2907

6.80

3.00

3191

5.20

2.00

2910

8.80

3.00

3196

3.60

1.50

2913

12.40

4.00

3197

5.30

2.00

3000

1.10

0.80

3201

4.90

2.00

3004

1.90

1.00

3202

5.80

2.00

3005

2.50

1.00

3206

7.80

3.00

3009

3.15

1.00

3207

10.40

4.00

3011

4.40

1.50

3211

0.70

0.80

3015

6.80

2.00

3216

0.70

0.80

3017

8.00

3.00

3220

2.90

1.50

3021

2.60

1.00

3221

3.80

3.00

3025

2.90

1.50

3225

6.40

2.00

3030

3.30

1.50

3226

7.60

3.00

3034

7.60

3.00

3230

10.60

3.00

3039

2.40

1.50

3232

14.00

4.00

3043

6.80

3.00

3236

10.60

3.00

3045

9.40

3.00

3238

14.00

4.00

3049

6.40

2.00

3242

6.40

2.00

3051

7.60

3.00

3244

7.60

3.00

3055

7.00

3.00

3248

6.80

2.00

3056

9.80

3.00

3250

8.00

3.00

3061

0.30

0.80

3254

17.60

5.00

3064

2.10

1.00

3255

24.00

5.00

3065

6.80

3.00

3259

24.00

5.00

3069

7.30

3.00

3263

50.00

5.00

3070

10.00

4.00

3267

13.40

4.00

3074

2.50

1.00

3269

18.00

5.00

3078

4.90

2.00

3273

34.00

5.00

3080

5.60

3.00

3274

46.00

5.00

3084

3.50

1.00

3279

16.00

5.00

3089

6.80

3.00

3280

22.00

5.00

3093

2.10

1.00

3285

3.15

1.00

3097

7.00

3.00

3286

4.40

1.50

3099

9.80

3.00

3291

7.00

3.00

3103

5.00

1.50

3292

9.80

3.00

3104

6.40

2.00

3297

2.50

1.00

3108

7.00

3.00

3298

3.40

1.00

3110

9.80

3.00

3303

6.40

2.00

3115

2.50

1.00

3304

7.60

3.00

3119

1.60

2.00

3309

7.60

3.00

3121

3.40

3.00

3313

37.00

5.00

3125

13.40

4.00

3315

50.00

5.00

3126

18.00

5.00

3319

2.50

1.00

3131

16.00

5.00

3323

10.60

3.00


Seventh Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

3324

14.00

4.00

3529

38.00

5.00

3328

13.40

4.00

3534

23.60

5.00

3329

18.00

5.00

3535

32.00

5.00

3334

26.60

5.00

3539

43.00

5.00

3335

36.00

5.00

3541

58.00

5.00

3340

50.00

5.00

3545

78.00

5.00

3344

86.00

5.00

3550

20.60

5.00

3348

19.00

5.00

3551

28.00

5.00

3349

26.00

5.00

3556

86.00

5.00

3353

42.00

5.00

3560

28.00

5.00

3357

62.00

5.00

3561

38.00

5.00

3361

38.00

5.00

3566

28.00

5.00

3362

46.00

5.00

3567

38.00

5.00

3367

23.60

5.00

3572

14.60

5.00

3368

32.00

5.00

3573

20.00

5.00

3372

26.60

5.00

3577

17.60

5.00

3373

36.00

5.00

3578

24.00

5.00

3377

11.50

5.00

3582

46.00

5.00

3378

16.00

5.00

3583

62.00

5.00

3383

24.00

5.00

3588

11.60

4.00

3387

18.00

5.00

3589

15.60

5.00

3392

20.60

5.00

3593

20.60

5.00

3393

28.00

5.00

3594

28.00

5.00

3397

46.00

5.00

3598

46.00

5.00

3402

10.40

4.00

3599

62.00

5.00

3406

22.00

5.00

3604

20.60

5.00

3408

30.00

5.00

3605

28.00

5.00

3412

4.60

3.00

3609

26.60

5.00

3414

2.00

4.00

3610

36.00

5.00

3418

17.20

5.00

3614

46.00

5.00

3419

22.00

5.00

3615

62.00

5.00

3423

17.20

5.00

3620

46.00

5.00

3424

22.00

5.00

3624

14.00

5.00

3428

46.00

5.00

3626

18.00

5.00

3430

62.00

5.00

3630

25.00

5.00

3434

6.40

2.00

3632

34.00

5.00

3436

7.60

3.00

3636

11.60

4.00

3440

19.00

5.00

3640

6.40

2.00

3442

30.00

5.00

3645

86.00

5.00

3446

15.00

5.00

3649

20.60

5.00

3448

18.00

5.00

3651

28.00

5.00

3452

31.00

5.00

3655

31.00

5.00

3454

42.00

5.00

3656

42.00

5.00

3458

23.60

5.00

3661

31.00

5.00

3460

32.00

5.00

3662

42.00

5.00

3464

42.00

5.00

3667

50.00

5.00

3469

86.00

5.00

3671

32.00

5.00

3473

32.00

5.00

3675

7.60

3.00

3478

42.00

5.00

3680

2.30

1.00

3482

42.00

5.00

3681

3.10

1.00

3486

12.00

5.00

3686

86.00

5.00

3487

14.00

5.00

3690

9.00

5.00

3491

23.60

5.00

3691

10.00

5.00

3492

32.00

5.00

3696

50.00

5.00

3497

20.00

5.00

3700

55.00

5.00

3498

22.00

5.00

3704

17.60

5.00

3502

58.00

5.00

3705

24.00

5.00

3506

86.00

5.00

3709

20.60

5.00

3510

11.60

4.00

3710

28.00

5.00

3514

22.00

5.00

3714

18.00

5.00

3519

28.00

5.00

3716

19.00

5.00

3523

36.00

5.00

3720

1.90

1.00

3528

28.00

5.00

3721

2.50

1.00


Seventh Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

3726

14.00

5.00

3920

10.50

5.00

3727

18.00

5.00

3921

8.80

3.00

3731

14.60

5.00

3923

11.60

4.00

3732

20.00

5.00

3926

9.00

5.00

3736

20.60

5.00

3927

4.00

5.00

3737

28.00

5.00

3931

10.00

5.00

3741

19.00

5.00

3932

5.00

5.00

3742

17.00

5.00

3936

14.60

5.00

3746

5.00

1.50

3937

20.00

5.00

3747

6.40

2.00

3941

50.00

5.00

3751

1.70

1.00

3945

3.50

1.00

3755

3.40

1.50

3949

2.25

1.00

3756

2.80

2.00

3951

3.00

1.00

3760

7.00

3.00

3955

5.60

1.50

3761

9.80

3.00

3957

7.20

2.00

3765

3.40

1.00

3961

14.60

5.00

3769

1.60

1.00

3963

20.00

5.00

3770

2.50

1.00

3967

28.00

5.00

3771

9.60

3.00

3971

32.00

5.00

3772

12.80

4.00

3975

46.00

5.00

3773

1.85

4.00

3979

58.00

5.00

3774

2.00

5.00

3983

86.00

5.00

3776

7.60

3.00

3987

78.00

5.00

3780

32.00

5.00

3991

86.00

5.00

3784

68.00

5.00

3995

42.00

5.00

3788

78.00

5.00

3999

42.00

5.00

3792

2.50

1.00

4004

98.00

5.00

3796

9.40

3.00

4008

86.00

5.00

3797

12.40

4.00

4013

86.00

5.00

3801

2.70

1.00

4017

86.00

5.00

3805

6.40

2.00

4022

42.00

5.00

3806

7.60

3.00

4026

50.00

5.00

3811

14.60

5.00

4031

32.00

5.00

3812

20.00

5.00

4035

32.00

5.00

3817

1.10

0.80

4040

16.00

5.00

3821

3.40

1.50

4050

3.10

1.00

3826

6.00

4.00

4051

4.40

1.50

3827

5.00

5.00

4055

6.80

2.00

3832

5.30

1.50

4056

8.00

3.00

3836

1.60

2.00

4060

10.60

3.00

3838

2.00

4.00

4061

14.00

4.00

3842

14.60

5.00

4065

17.60

5.00

3844

20.00

5.00

4066

24.00

5.00

3848

17.60

5.00

4070

14.60

5.00

3850

24.00

5.00

4071

20.00

5.00

3854

7.40

2.00

4075

17.60

5.00

3856

8.80

3.00

4076

24.00

5.00

3860

24.00

5.00

4090

6.80

2.00

3865

42.00

5.00

4091

8.00

3.00

3869

22.00

5.00

4095

17.60

5.00

3874

5.20

1.50

4096

24.00

5.00

3878

17.60

5.00

4101

17.60

5.00

3880

24.00

5.00

4102

24.00

5.00

3883

5.00

5.00

4107

31.00

5.00

3884

4.00

5.00

4108

42.00

5.00

3888

6.00

2.00

4113

23.60

5.00

3900

1.90

1.00

4114

32.00

5.00

3904

7.00

2.00

4119

17.60

5.00

3908

5.80

2.00

4120

24.00

5.00

3909

6.80

3.00

4125

31.00

5.00

3914

6.40

3.00

4126

42.00

5.00

3915

10.00

4.00

4150

10.40

4.00

3917

13.50

5.00

4151

14.00

5.00


Seventh Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

4156

1.60

0.80

4412

8.80

3.00

4157

2.30

1.00

4416

11.60

4.00

4161

8.80

3.00

4420

2.30

1.00

4162

11.60

4.00

4424

2.10

1.00

4166

14.60

5.00

4428

30.00

5.00

4167

20.00

5.00

4432

46.00

5.00

4171

17.60

5.00

4436

8.00

5.00

4172

24.00

5.00

4440

7.60

3.00

4176

31.00

5.00

4444

42.00

5.00

4177

42.00

5.00

4448

42.00

5.00

4182

64.00

5.00

4450

26.00

5.00

4183

86.00

5.00

4452

4.40

1.50

4188

5.80

2.00

4456

44.00

5.00

4189

6.80

3.00

4460

4.40

1.50

4194

1.90

1.00

4464

20.00

5.00

4195

2.50

1.00

4468

42.00

5.00

4200

7.00

3.00

4472

64.00

5.00

4201

9.80

3.00

4476

1.90

1.00

4206

17.60

5.00

4480

7.60

3.00

4207

24.00

5.00

4484

5.80

2.00

4212

14.60

5.00

4488

42.00

5.00

4213

20.00

5.00

4492

50.00

5.00

4218

23.60

5.00

4496

50.00

5.00

4219

32.00

5.00

4498

8.00

3.00

4224

34.00

5.00

4499

3.50

4.00

4225

46.00

5.00

4501

9.30

3.00

4230

38.60

5.00

4502

2.00

4.00

4231

52.00

5.00

4504

8.80

3.00

4236

108.00

5.00

4505

2.00

4.00

4300

5.80

2.00

4507

8.60

4.00

4304

7.40

2.00

4508

1.00

5.00

4305

8.80

3.00

4513

3.15

1.00

4309

7.80

3.00

4514

4.40

1.50

4311

10.40

4.00

4519

2.40

1.50

4315

68.00

5.00

4520

3.80

3.00

4320

43.00

5.00

4525

3.20

2.00

4324

38.00

5.00

4526

1.90

3.00

4328

78.00

5.00

4528

6.40

2.00

4333

50.00

5.00

4529

5.20

1.50

4337

76.00

5.00

4533

2.50

1.00

4342

86.00

5.00

4538

24.00

5.00

4346

42.00

5.00

4542

16.00

5.00

4350

78.00

5.00

4545

24.80

5.00

4355

50.00

5.00

4547

20.00

5.00

4359

2.50

1.00

4551

24.00

5.00

4360

1.30

1.50

4555

15.60

5.00

4364

30.00

5.00

4559

11.60

4.00

4368

2.00

4.00

4563

64.00

5.00

4372

3.40

1.00

4567

12.40

4.00

4376

6.80

3.00

4571

14.00

5.00

4381

4.00

1.50

4575

15.60

5.00

4385

5.80

1.50

4579

12.40

4.00

4389

4.60

1.50

4583

28.00

5.00

4390

5.80

2.00

4587

42.00

5.00

4394

3.90

3.00

4591

42.00

5.00

4395

5.00

4.00

4595

52.00

5.00

4399

10.00

5.00

4599

42.00

5.00

4400

10.80

5.00

4604

12.00

4.00

4401

10.50

5.00

4605

16.00

5.00

4402

15.00

5.00

4610

11.60

4.00

4403

1.60

1.00

4614

8.80

3.00

4404

1.30

1.50

4616

11.60

4.00

4408

10.40

4.00

4620

15.60

5.00


Seventh Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

4625

17.60

5.00

5149

18.00

5.00

4626

24.00

5.00

5153

42.00

5.00

4710

42.00

5.00

5157

34.00

5.00

4714

42.00

5.00

5161

50.00

5.00

4719

108.00

5.00

5165

24.00

5.00

4723

78.00

5.00

5170

38.00

5.00

4727

52.00

5.00

5174

15.60

5.00

4728

70.00

5.00

5178

42.00

5.00

4732

78.00

5.00

5182

52.00

5.00

4735

50.00

5.00

5186

10.40

4.00

4739

38.00

5.00

5190

5.80

2.00

4743

8.00

5.00

5194

24.00

5.00

4747

42.00

5.00

5198

50.00

5.00

4751

42.00

5.00

5202

64.00

5.00

4755

24.00

5.00

5206

20.00

5.00

4759

24.00

5.00

5220

9.80

3.00

4763

33.00

5.00

5223

13.40

4.00

4767

42.00

5.00

5224

18.00

5.00

4771

40.00

5.00

5228

14.00

5.00

4775

32.00

5.00

5232

64.00

5.00

4779

48.00

5.00

5236

24.00

5.00

4783

64.00

5.00

5240

22.00

5.00

4787

76.00

5.00

5244

42.00

5.00

4810

1.60

1.00

5248

10.40

4.00

4814

3.30

3.00

5252

14.00

4.00

4819

8.60

4.00

5256

50.00

5.00

4823

4.40

1.50

5260

12.00

4.00

4827

15.60

5.00

5261

16.00

5.00

4831

14.00

5.00

5310

1.30

1.00

4835

15.00

5.00

5311

5.80

2.00

4839

18.00

5.00

5316

5.00

1.50

4843

14.00

5.00

5317

6.40

2.00

4847

24.00

5.00

5322

5.00

1.50

4851

24.00

5.00

5323

6.40

2.00

4855

22.00

5.00

5328

9.40

3.00

4910

23.60

5.00

5329

12.40

4.00

4911

32.00

5.00

5334

7.00

3.00

4916

13.40

4.00

5335

9.80

3.00

4917

18.00

5.00

5340

3.15

1.00

4922

50.00

5.00

5341

4.40

1.50

4926

86.00

5.00

5346

6.40

2.00

4931

42.00

5.00

5350

3.15

1.00

4935

42.00

5.00

5352

4.40

1.50

4939

56.00

5.00

5356

7.00

3.00

4944

24.00

5.00

5358

9.80

3.00

5010

28.00

5.00

5362

18.00

5.00

5014

20.00

5.00

5367

24.00

5.00

5019

34.00

5.00

5371

64.00

5.00

5023

86.00

5.00

5376

50.00

5.00

5028

20.00

5.00

5380

3.20

1.00

5032

30.00

5.00

5385

50.00

5.00

5037

4.00

1.50

5387

50.00

5.00

5041

20.00

5.00

5394

28.00

5.00

5110

3.10

1.00

5398

7.80

3.00

5114

5.80

2.00

5399

10.40

4.00

5118

31.00

5.00

5403

6.80

2.00

5120

42.00

5.00

5404

8.00

3.00

5124

9.80

3.00

5408

11.00

5.00

5128

9.80

3.00

5410

15.00

5.00

5132

11.60

4.00

5414

28.00

5.00

5136

5.80

2.00

5416

38.00

5.00

5140

42.00

5.00

5419

29.00

5.00

5145

20.00

5.00

5420

32.00

5.00


Seventh Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

5422

32.10

5.00

5597

32.00

5.00

5423

35.50

5.00

5610

4.00

1.50

5425

11.60

4.00

5614

17.60

5.00

5429

50.00

5.00

5616

24.00

5.00

5434

48.00

5.00

5620

44.00

5.00

5438

3.10

1.00

5625

24.00

5.00

5439

4.00

1.50

5631

46.00

5.00

5443

3.50

1.00

5635

42.00

5.00

5444

4.40

1.50

5640

46.00

5.00

5448

2.20

1.50

5644

28.00

5.00

5451

10.40

4.00

5649

58.00

5.00

5452

14.00

5.00

5653

46.00

5.00

5453

13.10

5.00

5658

50.00

5.00

5454

17.50

5.00

5662

7.60

3.00

5457

8.80

3.00

5667

2.50

1.00

5458

11.60

4.00

5668

3.40

1.50

5462

2.50

1.50

5673

14.00

4.00

5463

5.20

2.00

5677

18.00

5.00

5467

6.80

3.00

5681

20.00

5.00

5471

5.00

3.00

5685

42.00

5.00

5472

6.40

3.00

5689

46.00

5.00

5475

6.60

3.00

5693

42.00

5.00

5477

7.40

4.00

5697

28.00

5.00

5481

6.80

3.00

5701

4.50

1.50

5483

7.60

4.00

5702

2.80

2.00

5487

7.60

3.00

5706

7.60

3.00

5489

8.60

4.00

5710

8.00

3.00

5493

14.60

5.00

5714

1.10

0.80

5495

20.00

5.00

5718

3.15

1.00

5499

34.00

5.00

5719

4.40

1.50

5501

46.00

5.00

5723

12.80

4.00

5505

24.00

5.00

5727

15.60

5.00

5507

26.00

5.00

5731

4.40

1.50

5511

27.10

5.00

5735

98.00

5.00

5512

29.50

5.00

5739

64.00

5.00

5513

54.00

5.00

5742

58.00

5.00

5515

78.00

5.00

5746

4.60

1.50

5518

32.00

5.00

5750

7.00

4.00

5519

36.00

5.00

5754

18.00

5.00

5523

26.00

5.00

5758

16.00

5.00

5525

38.00

5.00

5762

42.00

5.00

5529

28.00

5.00

5766

86.00

5.00

5531

38.00

5.00

5770

34.00

5.00

5535

28.00

5.00

5774

18.00

5.00

5537

38.00

5.00

5778

20.00

5.00

5541

19.00

5.00

5782

55.00

5.00

5543

23.00

5.00

5786

34.00

5.00

5547

24.00

5.00

5790

38.00

5.00

5551

20.60

5.00

5794

46.00

5.00

5553

28.00

5.00

5798

20.00

5.00

5557

2.80

1.50

5802

64.00

5.00

5561

32.00

5.00

5806

86.00

5.00

5565

4.80

1.50

5810

34.00

5.00

5569

3.10

1.00

5814

24.00

5.00

5573

12.00

5.00

5818

10.40

4.00

5574

13.00

5.00

5822

16.00

5.00

5577

15.10

5.00

5826

42.00

5.00

5579

16.50

5.00

5830

64.00

5.00

5583

21.00

5.00

5834

6.40

2.00

5585

25.50

5.00

5838

5.20

1.50

5589

32.00

5.00

5842

8.00

5.00

5593

11.00

5.00

5846

28.00

5.00

5594

8.00

5.00

5850

28.00

5.00

5596

23.60

5.00

5854

26.00

5.00


Seventh Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

5858

26.00

5.00

6196

15.60

5.00

5910

2.30

1.00

6197

31.00

5.00

5911

3.10

1.00

6198

42.00

5.00

5915

6.20

2.00

6202

43.00

5.00

5920

3.20

1.00

6203

58.00

5.00

5924

7.00

3.00

6207

64.00

5.00

5926

9.80

3.00

6211

58.00

5.00

5930

23.60

5.00

6215

54.00

5.00

5931

32.00

5.00

6219

108.00

5.00

5936

64.00

5.00

6223

78.00

5.00

5940

64.00

5.00

6227

86.00

5.00

5945

68.00

5.00

6231

86.00

5.00

5949

86.00

5.00

6235

50.00

5.00

5954

50.00

5.00

6239

64.00

5.00

5958

28.00

5.00

6243

108.00

5.00

5963

70.00

5.00

6247

86.00

5.00

5967

15.60

5.00

6251

64.00

5.00

5971

26.00

5.00

6255

70.00

5.00

5976

6.40

2.00

6259

64.00

5.00

5980

11.60

4.00

6263

42.00

5.00

5985

86.00

5.00

6310

3.40

1.00

5989

52.00

5.00

6314

2.10

1.00

5994

76.00

5.00

6318

4.20

1.50

5998

86.00

5.00

6320

5.60

1.50

6003

42.00

5.00

6324

6.40

2.00

6007

28.00

5.00

6328

5.60

1.50

6012

20.00

5.00

6333

4.40

1.50

6016

50.00

5.00

6337

5.80

2.00

6021

32.00

5.00

6338

6.80

3.00

6025

98.00

5.00

6343

4.00

1.50

6029

11.60

4.00

6344

5.20

1.50

6034

16.80

5.00

6349

8.80

3.00

6038

40.00

5.00

6350

11.60

4.00

6042

15.60

5.00

6354

1.50

0.80

6100

1.10

0.80

6355

2.10

1.00

6104

4.00

1.50

6359

5.00

1.50

6108

4.40

1.50

6360

6.40

2.00

6112

8.00

3.00

6365

14.60

5.00

6116

3.80

1.00

6366

20.00

5.00

6120

4.40

1.50

6371

10.60

3.00

6124

5.20

1.50

6372

14.00

4.00

6128

11.60

4.00

6377

4.00

1.50

6132

7.00

3.00

6378

5.20

1.50

6133

9.80

3.00

6382

6.40

2.00

6137

12.00

4.00

6383

7.60

3.00

6138

16.00

5.00

6387

1.90

1.00

6142

20.40

5.00

6388

2.50

1.00

6143

28.00

5.00

6392

5.00

1.50

6147

32.00

5.00

6393

6.40

2.00

6151

50.00

5.00

6397

13.40

4.00

6155

58.00

5.00

6398

18.00

5.00

6159

16.00

5.00

6402

13.40

4.00

6160

22.00

5.00

6404

18.00

5.00

6164

10.40

4.00

6414

 

 

6165

14.00

5.00

 

The amount shown in this column in the item relating to the dislocation concerned, plus one-half of that amount

The amount shown in this column in the item relating to the dislocation concerned, plus one-half of that amount

6169

50.00

5.00

 

6173

64.00

5.00

 

6177

24.00

5.00

 

6181

5.00

4.00

 

6182

11.00

5.00

 

6186

10.40

4.00

 

6187

14.00

5.00

 

6191

17.60

5.00

 

6192

24.00

5.00

 


Seventh Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

6420

3.40

1.00

6610

30.00

5.00

6425

6.40

2.00

6614

32.00

5.00

6426

8.80

3.00

6618

7.80

3.00

6431

3.40

1.00

6619

10.40

4.00

6432

4.60

1.50

6623

1.10

0.80

6437

4.90

2.00

6624

1.60

1.00

6438

7.40

4.00

6628

1.10

0.80

6442

6.80

3.00

6629

2.00

1.00

6443

14.00

5.00

6633

10.60

3.00

6447

3.90

1.00

6634

14.00

4.00

6448

5.20

1.50

6638

17.60

5.00

6453

7.00

3.00

6639

24.00

5.00

6454

9.80

3.00

6643

64.00

5.00

6458

6.60

3.00

6647

The amount shown in this column in the item relating to the fracture concerned, plus one-third of that amount

The amount shown in this column in the item relating to the fracture concerned, plus one-third of that amount

6459

11.00

5.00

 

6463

7.60

3.00

 

6467

5.60

3.00

 

6468

7.40

4.00

 

6472

6.40

2.00

 

6473

7.60

3.00

 

6477

8.60

4.00

 

6478

7.00

5.00

 

6482

10.40

4.00

6651

The amount shown in this column in the item relating to the fracture concerned, plus one-half of that amount

The amount shown in this column in the item relating to the fracture concerned, plus one-half of that amount

6483

7.00

5.00

 

6487

2.90

1.50

 

6489

3.80

3.00

 

6493

6.40

2.00

 

6494

7.60

3.00

 

6498

1.10

0.80

 

6499

2.00

1.00

 

6503

11.60

4.00

6655

The amount shown in this column in the item relating to the fracture concerned, plus three-quarters of that amount

The amount shown in this column in the item relating to the fracture concerned, plus three-quarters of that amount

6505

15.60

5.00

 

6509

8.80

3.00

 

6510

11.60

4.00

 

6515

28.00

5.00

 

6516

38.00

5.00

 

6521

4.90

2.00

 

6522

7.90

3.00

 

6525

7.30

3.00

 

6527

10.00

4.00

6659

One-half of the amount shown in this column in the item that would, but for item 6659 in the First Schedule to this Act, apply to the reduction concerned

One-half of the amount shown in this column in the item that would, but for item 6659 in the First Schedule to this Act, apply to the reduction concerned

6531

17.60

5.00

 

6532

24.00

5.00

 

6537

17.60

5.00

 

6538

24.00

5.00

 

6543

17.60

5.00

 

6544

24.00

5.00

 

6549

4.90

2.00

 

6550

8.80

3.00

 

6555

3.40

1.00

 

6559

4.40

1.50

 

6564

3.70

1.00

 

6568

3.45

1.00

 

6569

4.80

1.50

6663

One-half of the amount shown in this column in the item that would, but for item 6663 in the First Schedule to this Act, apply to the reduction concerned

One-half of the amount shown in this column in the item that would, but for item 6663 in the First Schedule to this Act, apply to the reduction concerned

6574

1.10

0.80

 

6575

2.00

1.00

 

6578

1.10

0.80

 

6580

2.00

1.00

 

6584

1.30

2.00

 

6586

1.00

3.00

 

6590

7.00

3.00

 

6592

9.80

3.00

 

6596

22.00

5.00

 

6601

24.00

5.00

 

6605

8.80

3.00

 

6606

11.60

4.00

 


Seventh Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

6667

The amount shown in this column in the item that would, but for item 6667 in the First Schedule to this Act, apply to the reduction concerned

The amount shown in this column in the item that would, but for item 6667 in the First Schedule to this Act, apply to the reduction concerned

7163

42.00

5.00

 

7167

58.00

5.00

 

7171

28.00

5.00

 

7176

12.00

5.00

 

7180

42.00

5.00

 

7184

32.00

5.00

 

7189

28.00

5.00

 

7190

38.00

5.00

 

7195

32.00

5.00

 

7199

1.90

1.00

 

7200

2.30

1.00

 

7205

1.60

0.80

6671

The amount shown in this column in the item that would apply in the case of a simple and uncomplicated fracture of the part concerned

The amount shown in this column in the item that would apply in the case of a simple and uncomplicated fracture of the part concerned

7206

2.30

1.00

 

7210

11.60

4.00

 

7214

42.00

5.00

 

7218

24.00

5.00

 

7221

1.00

4.00

 

7222

6.00

5.00

 

7224

4.50

5.00

 

7225

5.00

5.00

 

7227

10.70

5.00

 

7228

18.00

5.00

 

7230

20.00

5.00

7010

18.00

5.00

7233

13.40

4.00

7014

9.40

3.00

7234

18.00

5.00

7016

12.40

4.00

7238

42.00

5.00

7020

1.00

1.00

7242

14.00

4.00

7025

2.10

1.00

7246

24.00

5.00

7029

3.90

1.00

7250

13.40

4.00

7031

5.20

1.50

7252

18.00

5.00

7035

4.90

2.00

7256

16.00

5.00

7037

1.00

3.00

7257

22.00

5.00

7041

6.40

2.00

7261

7.40

4.00

7043

7.60

3.00

7262

2.00

5.00

7047

70.00

5.00

7266

20.00

5.00

7051

24.00

5.00

7271

20.00

5.00

7055

7.40

2.00

7275

24.00

5.00

7056

8.80

3.00

7280

28.00

5.00

7060

3.80

3.00

7284

46.00

5.00

7061

3.40

3.00

7289

70.00

5.00

7065

11.60

4.00

7293

46.00

5.00

7069

10.40

4.00

7297

44.00

5.00

7074

12.80

4.00

7301

46.00

5.00

7078

108.00

5.00

7305

10.40

4.00

7082

34.00

5.00

7309

22.00

5.00

7087

22.00

5.00

7313

8.80

3.00

7091

50.00

5.00

7314

11.60

4.00

7095

90.00

5.00

7318

20.60

5.00

7100

90.00

5.00

7319

28.00

5.00

7104

78.00

5.00

7323

10.80

4.00

7108

38.00

5.00

7324

14.40

5.00

7113

13.40

4.00

7328

13.40

4.00

7114

18.00

5.00

7329

18.00

5.00

7118

20.00

5.00

7333

22.00

5.00

7122

54.00

5.00

7334

30.00

5.00

7126

64.00

5.00

7338

6.40

2.00

7130

7.00

5.00

7339

7.60

3.00

7135

5.00

1.50

7343

8.80

3.00

7136

6.40

2.00

7344

11.60

4.00

7141

32.00

5.00

7348

6.80

3.00

7145

36.00

5.00

7149

32.00

5.00

7352

18.00

5.00

7154

16.00

5.00

7356

34.00

5.00

7155

22.00

5.00

7360

58.00

5.00

7159

86.00

5.00

7364

28.00

5.00


Seventh Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

7368

20.00

5.00

7661

8.80

3.00

7372

6.40

2.00

7665

32.00

5.00

7373

7.60

3.00

7670

6.40

2.00

7377

10.40

4.00

7671

7.60

3.00

7378

14.00

5.00

7676

20.00

5.00

7382

15.60

5.00

7680

36.00

5.00

7386

24.00

5.00

7685

32.00

5.00

7390

8.80

3.00

7700

50.00

5.00

7391

11.60

4.00

7704

6.40

2.00

7395

22.00

5.00

7708

4.00

1.50

7396

30.00

5.00

7750

24.00

5.00

7400

28.00

5.00

7754

11.60

4.00

7450

3.40

3.00

7758

20.00

5.00

7454

3.40

1.00

7762

2.00

1.00

7458

4.00

1.50

7767

3.40

1.00

7462

3.40

1.00

7771

0.80

2.00

7466

4.40

1.50

7775

10.40

4.00

7470

3.40

1.00

7779

14.00

5.00

7474

5.20

1.50

7783

22.00

5.00

7478

3.40

1.00

7787

40.00

5.00

7482

6.40

2.00

7791

42.00

5.00

7486

15.60

5.00

7795

20.00

5.00

7490

3.40

1.00

7850

14.00

5.00

7494

5.20

1.50

7854

18.00

5.00

7498

5.20

1.50

7858

14.00

4.00

7510

3.40

1.00

7862

7.60

3.00

7514

50.00

5.00

7866

9.80

3.00

7519

64.00

5.00

7870

5.20

1.50

7523

64.00

5.00

7874

15.60

5.00

7528

64.00

5.00

7877

9.80

3.00

7532

32.00

5.00

7881

24.00

5.00

7537

50.00

5.00

7885

14.00

4.00

7541

50.00

5.00

7889

9.80

3.00

7545

64.00

5.00

7893

6.40

2.00

7549

64.00

5.00

7897

16.00

5.00

7553

42.00

5.00

7901

24.00

5.00

7557

14.00

4.00

7905

10.80

4.00

7561

32.00

5.00

7909

24.00

5.00

7565

24.00

5.00

7913

20.00

5.00

7569

76.00

5.00

7917

32.00

5.00

7573

76.00

5.00

7921

64.00

5.00

7577

50.00

5.00

7925

54.00

5.00

7581

25.00

5.00

7929

64.00

5.00

7582

34.00

5.00

7950

14.00

5.00

7586

42.00

5.00

7952

15.00

5.00

7590

50.00

5.00

7953

14.50

5.00

7594

64.00

5.00

7954

24.00

5.00

7598

32.00

5.00

7958

14.00

5.00

7602

42.00

5.00

7962

7.60

3.00

7607

64.00

5.00

7966

20.00

5.00

7611

24.00

5.00

7970

14.00

4.00

7616

42.00

5.00

7974

32.00

5.00

7620

24.00

5.00

7978

20.00

5.00

7625

64.00

5.00

7982

14.00

4.00

7629

6.40

2.00

7986

34.00

5.00

7631

7.60

3.00

7990

10.40

4.00

7635

50.00

5.00

7994

7.60

3.00

7640

36.00

5.00

7998

22.00

5.00

7644

32.00

5.00

8002

36.00

5.00

7649

18.00

5.00

8007

18.00

5.00

7653

6.40

2.00

8011

28.00

5.00

7655

7.60

3.00

8015

28.00

5.00

7659

7.40

2.00

8020

50.00

5.00


Seventh Schedule—continued

Number of item in First Schedule

Fund medical benefit

Specified excess

Number of item in First Schedule

Fund medical benefit

Specified excess

 

$

$

 

$

$

8024

16.00

5.00

8180

9.80

3.00

8029

50.00

5.00

8184

26.00

5.00

8033

36.00

5.00

8188

22.00

5.00

8037

98.00

5.00

8192

22.00

5.00

8042

34.00

5.00

8196

24.00

5.00

8046

64.00

5.00

8200

32.00

5.00

8050

50.00

5.00

8204

50.00

5.00

8054

42.00

5.00

8208

70.00

5.00

8058

42.00

5.00

8212

9.80

3.00

8062

24.00

5.00

8216

24.00

5.00

8066

20.00

5.00

8220

18.00

5.00

8070

24.00

5.00

8224

38.00

5.00

8110

18.00

5.00

8228

12.80

4.00

8114

28.00

5.00

8232

42.00

5.00

8119

32.00

5.00

8236

28.00

5.00

8123

18.00

5.00

8240

46.00

5.00

8128

32.00

5.00

8244

62.00

5.00

8132

18.00

5.00

8248

24.00

5.00

8136

42.00

5.00

8252

18.00

5.00

8141

32.00

5.00

8256

36.00

5.00

8145

20.00

5.00

8260

86.00

5.00

8150

11.60

4.00

8264

14.40

5.00

8154

24.00

5.00

8268

46.00

5.00

8159

50.00

5.00

8272

58.00

5.00

8163

24.00

5.00

8276

24.00

5.00

8167

50.00

5.00

8280

42.00

5.00

8172

28.00

5.00

8284

42.00

5.00

8176

42.00

5.00

8288

50.00

5.00