| PROVIDER | NAME | ||||||||
| 052601 | MENTOR, Inc. | ||||||||
| Unit | S/A | ||||||||
| Srvc Cat | Service Desc | RU | FS | PA | Eff Date | Lap Date | Rate | Descr | Code |
| 14870000 | MENTOR RTF/99 RATE | 5035 | 35 | Y | 7/1/2001 | 06/30/10 | 99.00 | Day | 1487 |
| 14880000 | MENTOR RTF/84.50 RATE | 5031 | 31 | Y | 7/1/2001 | 06/30/10 | 84.50 | DAY | 1488 |
| 14880000 | MENTOR RTF/84.50 RATE | 5035 | 35 | Y | 7/1/2001 | 06/30/10 | 84.50 | DAY | 1488 |
| 14890000 | MENTOR RTF/14.69 RATE | 5031 | 31 | Y | 7/1/2001 | 06/30/10 | 14.69 | DAY | 1489 |
| 14890000 | MENTOR RTF/14.69 RATE | 5035 | 35 | Y | 7/1/2001 | 06/30/10 | 14.69 | DAY | 1489 |