<CF5 pHospitalCode="50127"><DRGCLAIM ClaimNumber="2504416B" PrimaryCode="A01.1" NewBornAdmWeight="" Remarks=""><SECONDARYDIAGS/><PROCEDURES><PROCEDURE RvsCode="36430" Laterality="L" Ext1="1" Ext2="1" Remarks=""/></PROCEDURES></DRGCLAIM></CF5>
