Can you post the definitions for MyStoreProcedure and CM.dbo.saveCodedProcTx, as well as the indexes on the tables CM.dbo.tblEncounters and CM.dbo.tblCharge?
Gail Shaw
Microsoft Certified Master: SQL Server, MVP, M.Sc (Comp Sci)
SQL In The Wild: Discussions on DB performance with occasional diversions into recoverability