There is another column that has been added that trumps everything.
We will call this column W. W contains the name look up of different
codes. The above array worked AWESOME! Any way to add this criteria
to it?

In the above, we had it look at claim, code, r.code and had it mark
all but the highest paid amount for that set, (it did not mark unique
ones, and only left unmarked one of the highest).

Well, I would like it to do the same thing, HOWEVER, maybe do this
check first: If claim, code (locking claim and code together), if any
of them list the word CLINIC in column W, then mark all but the one
with the highest value (like above) with a d. If it does NOT contain
CLINIC, then proceed with the above formula.