TN

(

TIER 1

2

3

4

5

6

Premier 200

$95

$110

$125

Premier Plus 250A

$139

$165

$159

Premier 400

$60

$75

$90

Premier Plus 450C Premier Plus 450D Premier Plus 450E

$102 $82 $108

Please note the figures quoted herein are subject to the Final Bid Approval by CMS.

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