Physician (Provider Type 01) From HCPS Thru HCPCS Begin Amount 59400 59400 04/30/02 $10.00 59510 59510 04/30/02 $10.00 59610 59610 07/29/02 $10.00 59618 59618 07/29/02 $10.00 99201 99205 06/01/92 $10.00 99211 99215 06/01/92 $10.00 99324 99326 $10.00 99334 99337 $10.00 99341 99343 06/01/92 $10.00 99344 99345 03/01/99 $10.00 99347 99350 03/01/99 $10.00 99381 99387 06/01/92 $10.00 99391 99397 06/01/92 $10.00 Nurse Practitioner (Provider Type 17) From HCPS Thru HCPCS Begin Amount 99201 99205 06/01/92 $10.00 99211 99215 06/01/92 $10.00 99321 99323 06/01/92 $10.00 99331 99333 06/01/92 $10.00 99341 99343 06/01/92 $10.00 99344 99345 03/01/99 $10.00 99347 99350 03/01/99 $10.00 99381 99387 06/01/92 $10.00 99391 99397 06/01/92 $10.00 Community Health Center (Provider Type 20) From HCPS Thru HCPCS Begin Amount T1015 T1015 01/01/03 $10.00 59400 59400 04/30/02 $10.00 59510 59510 04/30/02 $10.00 59610 59610 7/29/02 $10.00 59618 59618 7/29/02 $10.00 99324 99326 $10.00 99334 99337 $10.00 99341 99343 8/01/00 $10.00 99347 99349 8/01/00 $10.00 99381 99385 8/01/00 $10.00 99391 99395 8/01/00 $10.00 Out Patient (Provider Type 80) From HCPS Thru HCPCS Begin Amount +99213 99213 06/01/92 $10.00 Hospital Licensed HLTH CTR (Provider Type 81) From HCPS Thru HCPCS Begin Amount +99213 99213 06/01/92 $10.00 ATTACHMENT A PCC ENHANCED FEE CODES AS OF 01/01/2011