CPT/HCPC Code | Modifier | Medicare Location | Global Surgery Indicator | Multiple Surgery Indicator | Prevailing Charge Amount | Fee Schedule Amount | Site of Service Amount |
---|---|---|---|---|---|---|---|
01829 | 004 | XXX | 9 | 68.46 | X | X | |
01829 | 002 | XXX | 9 | 76.34 | X | X | |
01829 | 003 | XXX | 9 | 73.48 | X | X | |
01829 | 001 | XXX | 9 | 76.85 | X | X | |
0182U | X | 340.53 | X | ||||
01830 | 002 | XXX | 9 | 76.34 | X | X | |
01830 | 003 | XXX | 9 | 73.48 | X | X | |
01830 | 001 | XXX | 9 | 76.85 | X | X | |
01830 | 004 | XXX | 9 | 68.46 | X | X | |
01832 | 002 | XXX | 9 | 76.34 | X | X | |
01832 | 003 | XXX | 9 | 73.48 | X | X | |
01832 | 001 | XXX | 9 | 76.85 | X | X | |
01832 | 004 | XXX | 9 | 68.46 | X | X | |
0183U | X | 209.28 | X | ||||
01840 | 001 | XXX | 9 | 76.85 | X | X | |
01840 | 004 | XXX | 9 | 68.46 | X | X | |
01840 | 003 | XXX | 9 | 73.48 | X | X | |
01840 | 002 | XXX | 9 | 76.34 | X | X | |
01842 | 001 | XXX | 9 | 76.85 | X | X | |
01842 | 004 | XXX | 9 | 68.46 | X | X | |
01842 | 003 | XXX | 9 | 73.48 | X | X | |
01842 | 002 | XXX | 9 | 76.34 | X | X | |
01844 | 002 | XXX | 9 | 76.34 | X | X | |
01844 | 003 | XXX | 9 | 73.48 | X | X | |
01844 | 004 | XXX | 9 | 68.46 | X | X | |
01844 | 001 | XXX | 9 | 76.85 | X | X | |
0184U | X | 209.28 | X | ||||
01850 | 002 | XXX | 9 | 76.34 | X | X | |
01850 | 003 | XXX | 9 | 73.48 | X | X | |
01850 | 001 | XXX | 9 | 76.85 | X | X | |
01850 | 004 | XXX | 9 | 68.46 | X | X | |
01852 | 001 | XXX | 9 | 76.85 | X | X | |
01852 | 004 | XXX | 9 | 68.46 | X | X | |
01852 | 003 | XXX | 9 | 73.48 | X | X | |
01852 | 002 | XXX | 9 | 76.34 | X | X | |
0185U | X | 209.28 | X | ||||
01860 | 004 | XXX | 9 | 68.46 | X | X | |
01860 | 001 | XXX | 9 | 76.85 | X | X | |
01860 | 003 | XXX | 9 | 73.48 | X | X | |
01860 | 002 | XXX | 9 | 76.34 | X | X | |
0186U | X | 209.28 | X | ||||
0187U | X | 310.56 | X | ||||
0188U | X | 310.56 | X | ||||
0189U | X | 310.56 | X | ||||
0190U | X | 310.56 | X | ||||
01916 | 002 | XXX | 9 | 76.34 | X | X | |
01916 | 003 | XXX | 9 | 73.48 | X | X | |
01916 | 004 | XXX | 9 | 68.46 | X | X | |
01916 | 001 | XXX | 9 | 76.85 | X | X | |
0191U | X | 310.56 | X | ||||
01920 | 001 | XXX | 9 | 76.85 | X | X | |
01920 | 004 | XXX | 9 | 68.46 | X | X | |
01920 | 002 | XXX | 9 | 76.34 | X | X | |
01920 | 003 | XXX | 9 | 73.48 | X | X | |
01922 | 001 | XXX | 9 | 76.85 | X | X | |
01922 | 004 | XXX | 9 | 68.46 | X | X | |
01922 | 002 | XXX | 9 | 76.34 | X | X | |
01922 | 003 | XXX | 9 | 73.48 | X | X | |
01924 | 002 | XXX | 9 | 76.34 | X | X | |
01924 | 003 | XXX | 9 | 73.48 | X | X | |
01924 | 004 | XXX | 9 | 68.46 | X | X | |
01924 | 001 | XXX | 9 | 76.85 | X | X | |
01925 | 002 | XXX | 9 | 76.34 | X | X | |
01925 | 003 | XXX | 9 | 73.48 | X | X | |
01925 | 004 | XXX | 9 | 68.46 | X | X | |
01925 | 001 | XXX | 9 | 76.85 | X | X | |
01926 | 003 | XXX | 9 | 73.48 | X | X | |
01926 | 002 | XXX | 9 | 76.34 | X | X | |
01926 | 004 | XXX | 9 | 68.46 | X | X | |
01926 | 001 | XXX | 9 | 76.85 | X | X | |
0192U | X | 310.56 | X | ||||
01930 | 003 | XXX | 9 | 73.48 | X | X | |
01930 | 002 | XXX | 9 | 76.34 | X | X | |
01930 | 004 | XXX | 9 | 68.46 | X | X | |
01930 | 001 | XXX | 9 | 76.85 | X | X | |
01931 | 004 | XXX | 9 | 68.46 | X | X | |
01931 | 001 | XXX | 9 | 76.85 | X | X | |
01931 | 002 | XXX | 9 | 76.34 | X | X | |
01931 | 003 | XXX | 9 | 73.48 | X | X | |
01932 | 001 | XXX | 9 | 76.85 | X | X | |
01932 | 003 | XXX | 9 | 73.48 | X | X | |
01932 | 002 | XXX | 9 | 76.34 | X | X | |
01932 | 004 | XXX | 9 | 68.46 | X | X | |
01933 | 001 | XXX | 9 | 76.85 | X | X | |
01933 | 004 | XXX | 9 | 68.46 | X | X | |
01933 | 002 | XXX | 9 | 76.34 | X | X | |
01933 | 003 | XXX | 9 | 73.48 | X | X | |
01937 | 001 | XXX | 9 | 76.85 | X | X | |
01937 | 004 | XXX | 9 | 68.46 | X | X | |
01937 | 003 | XXX | 9 | 73.48 | X | X | |
01937 | 002 | XXX | 9 | 76.34 | X | X | |
01938 | 003 | XXX | 9 | 73.48 | X | X | |
01938 | 002 | XXX | 9 | 76.34 | X | X | |
01938 | 004 | XXX | 9 | 68.46 | X | X | |
01938 | 001 | XXX | 9 | 76.85 | X | X | |
01939 | 002 | XXX | 9 | 76.34 | X | X | |
01939 | 003 | XXX | 9 | 73.48 | X | X | |
01939 | 001 | XXX | 9 | 76.85 | X | X | |
01939 | 004 | XXX | 9 | 68.46 | X | X | |
0193U | X | 319.65 | X | ||||
01940 | 003 | XXX | 9 | 73.48 | X | X | |
01940 | 002 | XXX | 9 | 76.34 | X | X | |
01940 | 001 | XXX | 9 | 76.85 | X | X | |
01940 | 004 | XXX | 9 | 68.46 | X | X | |
01941 | 003 | XXX | 9 | 73.48 | X | X | |
01941 | 002 | XXX | 9 | 76.34 | X | X | |
01941 | 001 | XXX | 9 | 76.85 | X | X | |
01941 | 004 | XXX | 9 | 68.46 | X | X | |
01942 | 001 | XXX | 9 | 76.85 | X | X | |
01942 | 003 | XXX | 9 | 73.48 | X | X | |
01942 | 002 | XXX | 9 | 76.34 | X | X | |
01942 | 004 | XXX | 9 | 68.46 | X | X | |
0194U | X | 209.28 | X | ||||
01951 | 003 | XXX | 9 | 73.48 | X | X | |
01951 | 002 | XXX | 9 | 76.34 | X | X | |
01951 | 004 | XXX | 9 | 68.46 | X | X | |
01951 | 001 | XXX | 9 | 76.85 | X | X | |
01952 | 004 | XXX | 9 | 68.46 | X | X | |
01952 | 001 | XXX | 9 | 76.85 | X | X | |
01952 | 003 | XXX | 9 | 73.48 | X | X | |
01952 | 002 | XXX | 9 | 76.34 | X | X | |
01953 | 001 | XXX | 9 | 76.85 | X | X | |
01953 | 004 | XXX | 9 | 68.46 | X | X | |
01953 | 002 | XXX | 9 | 76.34 | X | X | |
01953 | 003 | XXX | 9 | 73.48 | X | X | |
01958 | 004 | XXX | 9 | 68.46 | X | X | |
01958 | 003 | XXX | 9 | 73.48 | X | X | |
01958 | 002 | XXX | 9 | 76.34 | X | X | |
01958 | 001 | XXX | 9 | 76.85 | X | X | |
0195U | X | 424.03 | X | ||||
01960 | 001 | XXX | 9 | 76.85 | X | X | |
01960 | 004 | XXX | 9 | 68.46 | X | X | |
01960 | 003 | XXX | 9 | 73.48 | X | X | |
01960 | 002 | XXX | 9 | 76.34 | X | X | |
01961 | 001 | XXX | 9 | 76.85 | X | X | |
01961 | 002 | XXX | 9 | 76.34 | X | X | |
01961 | 003 | XXX | 9 | 73.48 | X | X | |
01961 | 004 | XXX | 9 | 68.46 | X | X | |
01962 | 004 | XXX | 9 | 68.46 | X | X | |
01962 | 001 | XXX | 9 | 76.85 | X | X | |
01962 | 003 | XXX | 9 | 73.48 | X | X | |
01962 | 002 | XXX | 9 | 76.34 | X | X | |
01963 | 004 | XXX | 9 | 68.46 | X | X | |
01963 | 001 | XXX | 9 | 76.85 | X | X | |
01963 | 002 | XXX | 9 | 76.34 | X | X | |
01963 | 003 | XXX | 9 | 73.48 | X | X | |
01965 | 001 | XXX | 9 | 76.85 | X | X | |
01965 | 004 | XXX | 9 | 68.46 | X | X | |
01965 | 002 | XXX | 9 | 76.34 | X | X | |
01965 | 003 | XXX | 9 | 73.49 | X | X | |
01966 | 001 | XXX | 9 | 76.85 | X | X | |
01966 | 003 | XXX | 9 | 73.49 | X | X | |
01966 | 002 | XXX | 9 | 76.34 | X | X | |
01966 | 004 | XXX | 9 | 68.46 | X | X | |
01967 | 003 | XXX | 9 | 73.48 | X | X | |
01967 | 002 | XXX | 9 | 76.34 | X | X | |
01967 | 004 | XXX | 9 | 68.46 | X | X | |
01967 | 001 | XXX | 9 | 76.85 | X | X | |
01968 | 002 | XXX | 9 | 76.34 | X | X | |
01968 | 003 | XXX | 9 | 73.48 | X | X | |
01968 | 004 | XXX | 9 | 68.46 | X | X | |
01968 | 001 | XXX | 9 | 76.85 | X | X | |
01969 | 001 | XXX | 9 | 76.85 | X | X | |
01969 | 004 | XXX | 9 | 68.46 | X | X | |
01969 | 002 | XXX | 9 | 76.34 | X | X | |
01969 | 003 | XXX | 9 | 73.48 | X | X | |
0196U | X | 209.28 | X | ||||
0197U | X | 209.28 | X | ||||
0198U | X | 319.65 | X | ||||
01990 | 001 | XXX | 9 | 76.85 | X | X | |
01990 | 003 | XXX | 9 | 73.48 | X | X | |
01990 | 002 | XXX | 9 | 76.34 | X | X | |
01990 | 004 | XXX | 9 | 68.46 | X | X | |
01991 | 004 | XXX | 9 | 68.46 | X | X | |
01991 | 003 | XXX | 9 | 73.48 | X | X | |
01991 | 002 | XXX | 9 | 76.34 | X | X | |
01991 | 001 | XXX | 9 | 76.85 | X | X | |
01992 | 001 | XXX | 9 | 76.85 | X | X | |
01992 | 004 | XXX | 9 | 68.46 | X | X | |
01992 | 003 | XXX | 9 | 73.48 | X | X | |
01992 | 002 | XXX | 9 | 76.34 | X | X | |
01996 | 001 | XXX | 9 | 76.85 | X | X | |
01996 | 003 | XXX | 9 | 73.48 | X | X | |
01996 | 002 | XXX | 9 | 76.34 | X | X | |
01996 | 004 | XXX | 9 | 68.46 | X | X | |
01999 | 001 | XXX | 9 | 76.85 | X | X | |
01999 | 004 | XXX | 9 | 68.46 | X | X | |
01999 | 002 | XXX | 9 | 76.34 | X | X | |
01999 | 003 | XXX | 9 | 73.48 | X | X | |
0199U | X | 310.56 | X | ||||
0200U | X | 310.56 | X | ||||
0201U | X | 209.28 | X | ||||
0202U | X | 470.96 | X | ||||
0203U | X | 858.80 | X | ||||
0204U | X | 3,299.15 | X | ||||
0205U | X | 53.11 | X | ||||
0206U | X | 2,503.40 | X | ||||
0207U | X | 577.66 | X | ||||
0209U | X | 889.48 | X | ||||
0210U | X | 21.05 | X | ||||
0211U | X | 9,554.15 | X | ||||
0212U | X | 6,186.98 | X | ||||
0213U | X | 3,062.24 | X | ||||
0214U | X | 5,903.80 | X | ||||
0215U | X | 2,909.35 | X | ||||
0216U | X | 1,736.83 | X | ||||
0217U | X | 2,484.14 | X | ||||
0218U | X | 2,575.27 | X | ||||
0219U | X | 819.25 | X | ||||
0220U | X | 798.06 | X | ||||
0221U | X | 310.56 | X | ||||
0222U | X | 319.65 | X | ||||
0223U | X | 470.96 | X | ||||
0224U | X | 58.12 | X | ||||
0225U | X | 470.96 | X | ||||
0226U | X | 47.78 | X | ||||
0227U | X | 70.22 | X | ||||
0228U | X | 195.52 | X | ||||
0229U | X | 433.92 | X | ||||
0230U | X | 340.53 | X | ||||
0231U | X | 956.29 | X | ||||
0232U | X | 310.56 | X | ||||
0233U | X | 310.56 | X | ||||
0234U | X | 596.49 | X | ||||
0235U | X | 678.00 | X | ||||
0236U | X | 681.05 | X | ||||
0237U | X | 660.94 | X | ||||
0238U | X | 660.94 | X | ||||
0239U | X | 3,955.00 | X | ||||
0240U | X | 161.17 | X | ||||
0241U | X | 161.17 | X | ||||
0242U | X | 5,650.00 | X | ||||
0243U | X | 72.78 | X | ||||
0244U | X | 3,955.00 | X | ||||
0245U | X | 1,430.66 | X | ||||
0246U | X | 813.60 | X | ||||
0247U | X | 847.50 | X | ||||
0248U | X | 3,428.26 | X | ||||
0249U | X | 2,507.62 | X | ||||
0250U | X | 3,299.15 | X | ||||
0251U | X | 19.52 | X | ||||
0252U | X | 857.73 | X | ||||
0253U | X | 3,570.14 | X | ||||
0254U | X | 857.73 | X | ||||
0255U | X | 35.71 | X | ||||
0256U | X | 180.74 | X | ||||
0257U | X | 805.09 | X | ||||
0258U | X | 4,152.75 | X | ||||
0259U | X | 59.56 | X | ||||
0260U | X | 1,427.79 | X | ||||
0261U | X | 5,593.50 | X | ||||
0262U | X | 3,616.00 | X | ||||
0263U | X | 847.50 | X | ||||
0264U | X | 1,427.79 | X | ||||
0265U | X | 6,187.65 | X | ||||
0266U | X | 3,616.00 | X | ||||
0267U | X | 7,615.44 | X | ||||
0268U | X | 687.23 | X | ||||
0269U | X | 687.23 | X | ||||
0270U | X | 687.23 | X | ||||
0271U | X | 687.23 | X | ||||
0272U | X | 687.23 | X | ||||
0273U | X | 687.23 | X | ||||
0274U | X | 687.23 | X | ||||
0275U | X | 20.76 | X | ||||
0276U | X | 2,766.87 | X | ||||
0277U | X | 687.23 | X | ||||
0278U | X | 687.23 | X | ||||
0279U | X | 13.03 | X | ||||
0280U | X | 19.52 | X | ||||
0281U | X | 19.52 | X | ||||
0282U | X | 813.60 | X | ||||
0283U | X | 20.79 | X | ||||
0284U | X | 19.52 | X | ||||
0285U | X | 500.94 | X | ||||
0286U | X | 151.57 | X | ||||
0287U | X | 4,068.00 | X | ||||
0288U | X | 4,376.49 | X | ||||
0289U | X | 858.80 | X | ||||
0290U | X | 858.80 | X | ||||
0291U | X | 1,983.15 | X | ||||
0292U | X | 1,983.15 | X | ||||
0293U | X | 858.80 | X | ||||
0294U | X | 858.80 | X | ||||
0295U | X | 6,141.55 | X | ||||
0296U | X | 2,203.50 | X | ||||
0297U | X | 3,299.15 | X | ||||
0298U | X | 3,299.15 | X | ||||
0299U | X | 2,105.44 | X | ||||
0300U | X | 4,726.94 | X | ||||
0301U | X | 296.87 | X | ||||
0302U | X | 408.35 | X | ||||
0303U | X | 2,487.83 | X | ||||
0304U | X | 2,345.65 | X | ||||
0305U | X | 748.72 | X | ||||
0306U | X | 4,382.65 | X | ||||
0307U | X | 897.77 | X | ||||
0308U | X | 441.55 | X | ||||
0309U | X | 441.55 | X | ||||
0310U | X | 441.55 | X | ||||
0311U | X | 9.13 | X | ||||
0312U | X | 949.93 | X | ||||
0313U | X | 4,068.00 | X | ||||
0314U | X | 2,203.50 | X | ||||
0315U | X | 9,605.00 | X | ||||
0316U | X | 21.09 | X | ||||
0317U | X | 2,293.90 | X | ||||
0318U | X | 2,000.64 | X | ||||
0319U | X | 2,994.50 | X | ||||
0320U | X | 2,994.50 | X | ||||
0321U | X | 717.37 | X | ||||
0322U | X | 847.50 | X | ||||
0323U | X | 2,402.61 | X | ||||
0326U | X | 5,650.00 | X | ||||
0327U | X | 898.35 | X | ||||
0328U | X | 129.31 | X | ||||
0329U | X | 3,884.92 | X | ||||
0330U | X | 470.96 | X | ||||
0331U | X | 2,105.44 | X | ||||
0332U | X | 1,290.53 | X | ||||
0333U | X | 748.42 | X | ||||
0334U | X | # | X | ||||
0335U | X | 5,903.80 | X | ||||
0336U | X | 2,909.35 | X | ||||
0337U | X | 2,751.55 | X | ||||
0338U | X | 2,751.55 | X | ||||
0339U | X | 858.80 | X | ||||
0340U | X | 4,056.70 | X | ||||
0341U | X | 2,147.23 | X | ||||
0342U | X | 1,013.61 | X | ||||
0343U | X | 858.80 | X | ||||
0344U | X | 895.15 | X | ||||
0345U | X | 1,509.78 | X | ||||
0346U | X | 105.38 | X | ||||
0347U | X | 1,509.78 | X | ||||
0348U | X | 838.77 | X | ||||
0349U | X | 838.77 | X | ||||
0350U | X | 1,509.78 | X | ||||
0351U | X | 294.36 | X | ||||
0352U | X | 161.17 | X | ||||
0353U | X | 79.30 | X | ||||
0354U | X | 39.65 | X | ||||
0355U | X | 154.81 | X | ||||
0356U | X | # | X | ||||
0358U | X | 294.36 | X | ||||
0359U | X | 858.80 | X | ||||
0360U | X | 949.93 | X | ||||
0361U | X | # | X | ||||
0363U | X | 858.80 | X | ||||
0364U | X | # | X | ||||
0365U | X | 1,013.61 | X | ||||
0366U | X | 1,013.61 | X | ||||
0367U | X | 1,019.46 | X | ||||
0368U | X | # | X | ||||
0369U | X | 470.96 | X | ||||
0370U | X | 470.96 | X | ||||
0371U | X | 470.96 | X | ||||
0372U | X | 470.96 | X | ||||
0373U | X | 470.96 | X | ||||
0374U | X | 470.96 | X | ||||
0375U | X | 1,013.61 | X | ||||
0376U | X | 798.06 | X | ||||
0377U | X | 53.77 | X | ||||
0378U | X | 154.81 | X | ||||
0379U | X | # | X | ||||
0380U | X | 470.96 | X | ||||
0381U | X | # | X | ||||
0382U | X | # | X | ||||
0383U | X | # | X | ||||
0384U | X | 847.50 | X | ||||
0385U | X | 441.55 | X | ||||
0387U | X | 1,071.80 | X | ||||
0388U | X | # | X | ||||
0389U | X | # | X | ||||
0390U | X | 72.78 | X | ||||
0391U | X | 4,068.00 | X | ||||
0392U | X | 1,509.78 | X | ||||
0393U | X | 611.32 | X | ||||
0394U | X | 224.58 | X | ||||
0395U | X | # | X | ||||
0396U | X | # | X | ||||
0398U | X | # | X | ||||
0399U | X | # | X | ||||
0400U | X | # | X | ||||
0401U | X | # | X | ||||
0402U | X | 161.17 | X | ||||
0403U | X | 858.80 | X | ||||
0404U | X | 364.94 | X | ||||
0405U | X | 2,000.64 | X | ||||
0406U | X | 858.80 | X | ||||
0407U | X | 858.80 | X | ||||
0408U | X | # | X | ||||
0409U | X | 3,299.15 | X | ||||
0410U | X | 1,310.80 | X | ||||
0411U | X | 1,509.78 | X | ||||
0412U | X | # | X | ||||
0413U | X | 1,427.79 | X | ||||
0414U | X | 798.06 | X | ||||
0415U | X | 441.55 | X | ||||
0416U | X | 470.96 | X | ||||
0417U | X | # | X | ||||
0418U | X | 798.06 | X | ||||
0419U | X | 1,509.78 | X | ||||
10004 | 002 | ZZZ | 0 | X | 72.70 | 61.50 | |
10004 | 003 | ZZZ | 0 | X | 72.70 | 61.50 | |
10004 | 004 | ZZZ | 0 | X | 72.70 | 61.50 | |
10004 | 001 | ZZZ | 0 | X | 79.48 | 66.60 | |
10005 | 004 | XXX | 2 | X | 173.13 | 103.50 | |
10005 | 001 | XXX | 2 | X | 190.96 | 111.09 | |
10005 | 003 | XXX | 2 | X | 173.13 | 103.50 | |
10005 | 002 | XXX | 2 | X | 173.13 | 103.50 | |
10006 | 001 | ZZZ | 0 | X | 90.59 | 75.59 | |
10006 | 004 | ZZZ | 0 | X | 83.57 | 70.50 | |
10006 | 003 | ZZZ | 0 | X | 83.57 | 70.50 | |
10006 | 002 | ZZZ | 0 | X | 83.57 | 70.50 | |
10007 | 001 | XXX | 2 | X | 431.92 | 142.94 | |
10007 | 004 | XXX | 2 | X | 384.71 | 132.86 | |
10007 | 003 | XXX | 2 | X | 384.71 | 132.86 | |
10007 | 002 | XXX | 2 | X | 384.71 | 132.86 | |
10008 | 004 | ZZZ | 0 | X | 217.39 | 86.59 | |
10008 | 001 | ZZZ | 0 | X | 243.24 | 93.11 | |
10008 | 003 | ZZZ | 0 | X | 217.39 | 86.59 | |
10008 | 002 | ZZZ | 0 | X | 217.39 | 86.59 | |
10009 | 001 | XXX | 2 | X | 707.28 | 172.79 | |
10009 | 004 | XXX | 2 | X | 626.90 | 161.06 | |
10009 | 003 | XXX | 2 | X | 626.90 | 161.06 | |
10009 | 002 | XXX | 2 | X | 626.90 | 161.06 | |
10010 | 003 | ZZZ | 0 | X | 378.89 | 117.72 | |
10010 | 002 | ZZZ | 0 | X | 378.89 | 117.72 | |
10010 | 004 | ZZZ | 0 | X | 378.89 | 117.72 | |
10010 | 001 | ZZZ | 0 | X | 425.97 | 126.28 | |
10011 | XXX | 2 | X | * | X | ||
10012 | ZZZ | 0 | X | * | X | ||
10021 | 001 | XXX | 2 | X | 209.22 | X | |
10021 | 26 | 001 | XXX | 2 | X | 163.73 | X |
10021 | TC | 001 | XXX | 2 | X | 45.52 | X |
10021 | 004 | XXX | 2 | X | 186.86 | X | |
10021 | 26 | 004 | XXX | 2 | X | 149.16 | X |
10021 | TC | 004 | XXX | 2 | X | 37.65 | X |
10021 | 003 | XXX | 2 | X | 186.86 | X | |
10021 | 26 | 003 | XXX | 2 | X | 149.16 | X |
10021 | TC | 003 | XXX | 2 | X | 37.65 | X |
10021 | 002 | XXX | 2 | X | 186.86 | X | |
10021 | 26 | 002 | XXX | 2 | X | 149.16 | X |
10021 | TC | 002 | XXX | 2 | X | 37.65 | X |
10030 | 003 | 0 | 2 | X | 1,185.25 | 251.52 | |
10030 | 002 | 0 | 2 | X | 1,185.25 | 251.52 | |
10030 | 004 | 0 | 2 | X | 1,185.25 | 251.52 | |
10030 | 001 | 0 | 2 | X | 1,358.79 | 270.99 | |
10035 | 004 | 0 | 2 | X | 779.82 | 134.41 | |
10035 | 001 | 0 | 2 | X | 899.57 | 144.39 | |
10035 | 003 | 0 | 2 | X | 779.82 | 134.41 | |
10035 | 002 | 0 | 2 | X | 779.82 | 134.41 | |
10036 | 004 | ZZZ | 0 | X | 675.47 | 67.71 | |
10036 | 001 | ZZZ | 0 | X | 783.95 | 72.84 | |
10036 | 003 | ZZZ | 0 | X | 675.47 | 67.71 | |
10036 | 002 | ZZZ | 0 | X | 675.47 | 67.71 | |
10040 | 10 | 2 | X | * | X | ||
10060 | 001 | 10 | 2 | X | 168.74 | 146.13 | |
10060 | 004 | 10 | 2 | X | 158.97 | 138.20 | |
10060 | 002 | 10 | 2 | X | 165.43 | 143.15 | |
10060 | 003 | 10 | 2 | X | 161.92 | 140.30 | |
10061 | 003 | 10 | 2 | X | 295.81 | 266.99 | |
10061 | 002 | 10 | 2 | X | 346.40 | 312.37 | |
10061 | 004 | 10 | 2 | X | 252.05 | 227.38 | |
10061 | 001 | 10 | 2 | X | 351.75 | 316.59 | |
10080 | 001 | 10 | 2 | X | 201.41 | 178.54 | |
10080 | 004 | 10 | 2 | X | 179.58 | 159.60 | |
10080 | 002 | 10 | 2 | X | 210.08 | 185.97 | |
10080 | 003 | 10 | 2 | X | 199.21 | 176.86 | |
10081 | 004 | 10 | 2 | X | 396.46 | X | |
10081 | 003 | 10 | 2 | X | 398.29 | X | |
10081 | 002 | 10 | 2 | X | 405.38 | X | |
10081 | 001 | 10 | 2 | X | 410.51 | X | |
10120 | 004 | 10 | 2 | X | 176.66 | 153.38 | |
10120 | 002 | 10 | 2 | X | 186.95 | 161.84 | |
10120 | 003 | 10 | 2 | X | 174.32 | 150.84 | |
10120 | 001 | 10 | 2 | X | 188.90 | 163.52 | |
10121 | 001 | 10 | 2 | X | 417.97 | 363.34 | |
10121 | 004 | 10 | 2 | X | 390.45 | 340.36 | |
10121 | 003 | 10 | 2 | X | 394.70 | 343.80 | |
10121 | 002 | 10 | 2 | X | 413.37 | 359.48 | |
10140 | 002 | 10 | 2 | X | 196.93 | 172.98 | |
10140 | 003 | 10 | 2 | X | 183.96 | 161.62 | |
10140 | 004 | 10 | 2 | X | 175.78 | 154.60 | |
10140 | 001 | 10 | 2 | X | 198.64 | 174.71 | |
10160 | 004 | 10 | 2 | X | 157.92 | 139.67 | |
10160 | 003 | 10 | 2 | X | 165.35 | 146.16 | |
10160 | 002 | 10 | 2 | X | 173.64 | 153.57 | |
10160 | 001 | 10 | 2 | X | 161.65 | 142.53 | |
10180 | 003 | 10 | 2 | X | 448.50 | X | |
10180 | 002 | 10 | 2 | X | 463.86 | X | |
10180 | 004 | 10 | 2 | X | 449.07 | X | |
10180 | 001 | 10 | 2 | X | 464.07 | X | |
11000 | 004 | 0 | 2 | X | 139.52 | 119.72 | |
11000 | 002 | 0 | 2 | X | 147.82 | 126.46 | |
11000 | 003 | 0 | 2 | X | 141.12 | 120.98 | |
11000 | 001 | 0 | 2 | X | 149.40 | 127.80 | |
11001 | 002 | ZZZ | 0 | X | 80.29 | 66.40 | |
11001 | 003 | ZZZ | 0 | X | 76.62 | 63.48 | |
11001 | 004 | ZZZ | 0 | X | 75.72 | 62.90 | |
11001 | 001 | ZZZ | 0 | X | 81.18 | 67.10 | |
11004 | 001 | 0 | 2 | X | 1,246.48 | X | |
11004 | 004 | 0 | 2 | X | 1,143.06 | X | |
11004 | 003 | 0 | 2 | X | 1,143.06 | X | |
11004 | 002 | 0 | 2 | X | 1,143.06 | X | |
11005 | 004 | 0 | 0 | X | 1,554.76 | X | |
11005 | 002 | 0 | 0 | X | 1,554.76 | X | |
11005 | 003 | 0 | 0 | X | 1,554.76 | X | |
11005 | 001 | 0 | 0 | X | 1,700.92 | X | |
11006 | 001 | 0 | 2 | X | 1,582.05 | X | |
11006 | 002 | 0 | 2 | X | 1,433.33 | X | |
11006 | 003 | 0 | 2 | X | 1,433.33 | X | |
11006 | 004 | 0 | 2 | X | 1,433.33 | X | |
11008 | 004 | ZZZ | 0 | X | 581.88 | X | |
11008 | 001 | ZZZ | 0 | X | 646.99 | X | |
11008 | 003 | ZZZ | 0 | X | 581.88 | X | |
11008 | 002 | ZZZ | 0 | X | 581.88 | X | |
11010 | 004 | 10 | 2 | X | 880.15 | X | |
11010 | 002 | 10 | 2 | X | 904.46 | X | |
11010 | 003 | 10 | 2 | X | 880.15 | X | |
11010 | 001 | 10 | 2 | X | 1,011.14 | X | |
11011 | 001 | 0 | 2 | X | 1,204.89 | X | |
11011 | 003 | 0 | 2 | X | 1,049.02 | X | |
11011 | 002 | 0 | 2 | X | 1,078.03 | X | |
11011 | 004 | 0 | 2 | X | 1,049.02 | X | |
11012 | 002 | 0 | 2 | X | 1,498.29 | X | |
11012 | 003 | 0 | 2 | X | 1,458.04 | X | |
11012 | 004 | 0 | 2 | X | 1,458.04 | X | |
11012 | 001 | 0 | 2 | X | 1,674.55 | X | |
11042 | 004 | 0 | 2 | X | 209.10 | X | |
11042 | 001 | 0 | 2 | X | 279.60 | X | |
11042 | 002 | 0 | 2 | X | 246.86 | X | |
11042 | 003 | 0 | 2 | X | 221.02 | X | |
11043 | 004 | 0 | 2 | X | 447.83 | X | |
11043 | 003 | 0 | 2 | X | 512.58 | X | |
11043 | 002 | 0 | 2 | X | 498.35 | X | |
11043 | 001 | 0 | 2 | X | 496.18 | X | |
11044 | 004 | 0 | 2 | X | 575.32 | X | |
11044 | 002 | 0 | 2 | X | 629.54 | X | |
11044 | 003 | 0 | 2 | X | 582.37 | X | |
11044 | 001 | 0 | 2 | X | 640.94 | X | |
11045 | 003 | ZZZ | 0 | X | 53.08 | 31.50 | |
11045 | 002 | ZZZ | 0 | X | 53.08 | 31.50 | |
11045 | 004 | ZZZ | 0 | X | 53.08 | 31.50 | |
11045 | 001 | ZZZ | 0 | X | 59.37 | 34.93 | |
11046 | 002 | ZZZ | 0 | X | 92.49 | 66.37 | |
11046 | 003 | ZZZ | 0 | X | 92.49 | 66.37 | |
11046 | 001 | ZZZ | 0 | X | 102.46 | 72.92 | |
11046 | 004 | ZZZ | 0 | X | 92.49 | 66.37 | |
11047 | 004 | ZZZ | 0 | X | 152.50 | 115.60 | |
11047 | 001 | ZZZ | 0 | X | 169.12 | 127.37 | |
11047 | 003 | ZZZ | 0 | X | 152.50 | 115.60 | |
11047 | 002 | ZZZ | 0 | X | 152.50 | 115.60 | |
11055 | 001 | 0 | 2 | X | 53.85 | 39.96 | |
11055 | 004 | 0 | 2 | X | 48.35 | 36.47 | |
11055 | 002 | 0 | 2 | X | 48.35 | 36.47 | |
11055 | 003 | 0 | 2 | X | 48.35 | 36.47 | |
11056 | 004 | 0 | 2 | X | 67.83 | 51.94 | |
11056 | 001 | 0 | 2 | X | 75.78 | 57.08 | |
11056 | 003 | 0 | 2 | X | 67.83 | 51.94 | |
11056 | 002 | 0 | 2 | X | 67.83 | 51.94 | |
11057 | 002 | 0 | 2 | X | 71.22 | 58.54 | |
11057 | 003 | 0 | 2 | X | 71.22 | 58.54 | |
11057 | 001 | 0 | 2 | X | 78.37 | 63.45 | |
11057 | 004 | 0 | 2 | X | 71.22 | 58.54 | |
11102 | 001 | 0 | 2 | X | 149.78 | 60.77 | |
11102 | 004 | 0 | 2 | X | 133.38 | 55.80 | |
11102 | 003 | 0 | 2 | X | 133.38 | 55.80 | |
11102 | 002 | 0 | 2 | X | 133.38 | 55.80 | |
11103 | 002 | ZZZ | 0 | X | 72.01 | 32.28 | |
11103 | 003 | ZZZ | 0 | X | 72.01 | 32.28 | |
11103 | 004 | ZZZ | 0 | X | 72.01 | 32.28 | |
11103 | 001 | ZZZ | 0 | X | 80.74 | 35.15 | |
11104 | 004 | 0 | 2 | X | 167.65 | 70.00 | |
11104 | 002 | 0 | 2 | X | 167.65 | 70.00 | |
11104 | 003 | 0 | 2 | X | 167.65 | 70.00 | |
11104 | 001 | 0 | 2 | X | 188.23 | 76.18 | |
11105 | 003 | ZZZ | 0 | X | 82.57 | 38.17 | |
11105 | 002 | ZZZ | 0 | X | 82.57 | 38.17 | |
11105 | 004 | ZZZ | 0 | X | 82.57 | 38.17 | |
11105 | 001 | ZZZ | 0 | X | 92.50 | 41.57 | |
11106 | 001 | 0 | 2 | X | 227.90 | 92.79 | |
11106 | 004 | 0 | 2 | X | 202.95 | 85.21 | |
11106 | 003 | 0 | 2 | X | 202.95 | 85.21 | |
11106 | 002 | 0 | 2 | X | 202.95 | 85.21 | |
11107 | 004 | ZZZ | 0 | X | 97.36 | 45.51 | |
11107 | 003 | ZZZ | 0 | X | 97.36 | 45.51 | |
11107 | 002 | ZZZ | 0 | X | 97.36 | 45.51 | |
11107 | 001 | ZZZ | 0 | X | 109.02 | 49.52 | |
11200 | 004 | 10 | 2 | X | 141.97 | 116.76 | |
11200 | 002 | 10 | 2 | X | 141.21 | 115.85 | |
11200 | 003 | 10 | 2 | X | 134.07 | 109.76 | |
11200 | 001 | 10 | 2 | X | 151.63 | 124.24 | |
11201 | 001 | ZZZ | 0 | X | 49.81 | 40.63 | |
11201 | 002 | ZZZ | 0 | X | 49.17 | 40.09 | |
11201 | 003 | ZZZ | 0 | X | 46.58 | 37.93 | |
11201 | 004 | ZZZ | 0 | X | 46.03 | 37.59 | |
11300 | 001 | 0 | 2 | X | 156.61 | 124.88 | |
11300 | 004 | 0 | 2 | X | 138.77 | 110.69 | |
11300 | 003 | 0 | 2 | X | 154.35 | 123.43 | |
11300 | 002 | 0 | 2 | X | 154.63 | 123.28 | |
11301 | 002 | 0 | 2 | X | 174.32 | 138.02 | |
11301 | 003 | 0 | 2 | X | 190.42 | 155.38 | |
11301 | 001 | 0 | 2 | X | 176.54 | 139.79 | |
11301 | 004 | 0 | 2 | X | 163.14 | 129.41 | |
11302 | 002 | 0 | 2 | X | 223.88 | 175.87 | |
11302 | 003 | 0 | 2 | X | 243.55 | 197.33 | |
11302 | 004 | 0 | 2 | X | 208.90 | 164.29 | |
11302 | 001 | 0 | 2 | X | 226.94 | 178.25 | |
11303 | 001 | 0 | 2 | X | 399.19 | X | |
11303 | 004 | 0 | 2 | X | 379.36 | X | |
11303 | 002 | 0 | 2 | X | 392.72 | X | |
11303 | 003 | 0 | 2 | X | 403.08 | X | |
11305 | 001 | 0 | 2 | X | 139.18 | 110.49 | |
11305 | 003 | 0 | 2 | X | 158.63 | 130.14 | |
11305 | 002 | 0 | 2 | X | 137.42 | 109.12 | |
11305 | 004 | 0 | 2 | X | 153.64 | 125.94 | |
11306 | 001 | 0 | 2 | X | 197.65 | 158.66 | |
11306 | 003 | 0 | 2 | X | 184.91 | 148.64 | |
11306 | 002 | 0 | 2 | X | 195.15 | 156.74 | |
11306 | 004 | 0 | 2 | X | 182.77 | 147.04 | |
11307 | 002 | 0 | 2 | X | 240.44 | 189.74 | |
11307 | 003 | 0 | 2 | X | 283.77 | 232.13 | |
11307 | 001 | 0 | 2 | X | 261.33 | 212.15 | |
11307 | 004 | 0 | 2 | X | 224.31 | 177.18 | |
11308 | 001 | 0 | 2 | X | 336.47 | X | |
11308 | 004 | 0 | 2 | X | 420.51 | X | |
11308 | 002 | 0 | 2 | X | 411.14 | X | |
11308 | 003 | 0 | 2 | X | 420.41 | X | |
11310 | 001 | 0 | 2 | X | 209.80 | 167.54 | |
11310 | 004 | 0 | 2 | X | 189.52 | 151.63 | |
11310 | 003 | 0 | 2 | X | 208.46 | 167.01 | |
11310 | 002 | 0 | 2 | X | 204.92 | 163.78 | |
11311 | 003 | 0 | 2 | X | 276.61 | 225.72 | |
11311 | 002 | 0 | 2 | X | 268.29 | 218.34 | |
11311 | 001 | 0 | 2 | X | 274.33 | 223.30 | |
11311 | 004 | 0 | 2 | X | 240.83 | 196.68 | |
11312 | 001 | 0 | 2 | X | 327.04 | 262.55 | |
11312 | 002 | 0 | 2 | X | 331.06 | 264.95 | |
11312 | 003 | 0 | 2 | X | 327.65 | 263.39 | |
11312 | 004 | 0 | 2 | X | 249.43 | 193.38 | |
11313 | 002 | 0 | 2 | X | 427.34 | X | |
11313 | 003 | 0 | 2 | X | 476.41 | X | |
11313 | 001 | 0 | 2 | X | 441.91 | X | |
11313 | 004 | 0 | 2 | X | 443.85 | X | |
11400 | 001 | 10 | 2 | X | 175.32 | 143.60 | |
11400 | 003 | 10 | 2 | X | 172.49 | 141.61 | |
11400 | 002 | 10 | 2 | X | 173.35 | 141.94 | |
11400 | 004 | 10 | 2 | X | 156.72 | 128.65 | |
11401 | 001 | 10 | 2 | X | 221.99 | 185.17 | |
11401 | 003 | 10 | 2 | X | 212.42 | 177.41 | |
11401 | 002 | 10 | 2 | X | 219.42 | 183.16 | |
11401 | 004 | 10 | 2 | X | 206.85 | 173.14 | |
11402 | 003 | 10 | 2 | X | 270.71 | 224.53 | |
11402 | 002 | 10 | 2 | X | 279.78 | 231.76 | |
11402 | 004 | 10 | 2 | X | 263.02 | 218.43 | |
11402 | 001 | 10 | 2 | X | 283.10 | 234.45 | |
11403 | 004 | 10 | 2 | X | 354.08 | 290.48 | |
11403 | 002 | 10 | 2 | X | 371.85 | 304.84 | |
11403 | 003 | 10 | 2 | X | 380.87 | 313.00 | |
11403 | 001 | 10 | 2 | X | 367.65 | 301.23 | |
11404 | 004 | 10 | 2 | X | 435.83 | X | |
11404 | 003 | 10 | 2 | X | 456.99 | X | |
11404 | 002 | 10 | 2 | X | 408.93 | X | |
11404 | 001 | 10 | 2 | X | 428.48 | X | |
11406 | 004 | 10 | 2 | X | 598.17 | X | |
11406 | 002 | 10 | 2 | X | 643.43 | X | |
11406 | 001 | 10 | 2 | X | 669.61 | X | |
11406 | 003 | 10 | 2 | X | 618.35 | X | |
11420 | 004 | 10 | 2 | X | 171.19 | 143.45 | |
11420 | 001 | 10 | 2 | X | 175.96 | 147.26 | |
11420 | 002 | 10 | 2 | X | 173.98 | 145.61 | |
11420 | 003 | 10 | 2 | X | 176.29 | 147.82 | |
11421 | 004 | 10 | 2 | X | 234.73 | 199.07 | |
11421 | 002 | 10 | 2 | X | 248.97 | 210.45 | |
11421 | 003 | 10 | 2 | X | 237.38 | 201.17 | |
11421 | 001 | 10 | 2 | X | 251.71 | 212.83 | |
11422 | 004 | 10 | 2 | X | 284.58 | 237.53 | |
11422 | 002 | 10 | 2 | X | 302.79 | 252.10 | |
11422 | 003 | 10 | 2 | X | 313.93 | 262.27 | |
11422 | 001 | 10 | 2 | X | 292.36 | 243.20 | |
11423 | 004 | 10 | 2 | X | 428.48 | 352.59 | |
11423 | 002 | 10 | 2 | X | 433.72 | 355.49 | |
11423 | 003 | 10 | 2 | X | 449.80 | 368.95 | |
11423 | 001 | 10 | 2 | X | 399.11 | 327.72 | |
11424 | 004 | 10 | 2 | X | 511.65 | X | |
11424 | 001 | 10 | 2 | X | 460.27 | X | |
11424 | 003 | 10 | 2 | X | 443.41 | X | |
11424 | 002 | 10 | 2 | X | 437.08 | X | |
11426 | 004 | 10 | 2 | X | 605.95 | X | |
11426 | 001 | 10 | 2 | X | 655.95 | X | |
11426 | 002 | 10 | 2 | X | 647.54 | X | |
11426 | 003 | 10 | 2 | X | 631.58 | X | |
11440 | 001 | 10 | 2 | X | 229.58 | 187.37 | |
11440 | 004 | 10 | 2 | X | 208.66 | 170.61 | |
11440 | 003 | 10 | 2 | X | 227.69 | 186.23 | |
11440 | 002 | 10 | 2 | X | 224.59 | 183.54 | |
11441 | 001 | 10 | 2 | X | 302.34 | 251.27 | |
11441 | 004 | 10 | 2 | X | 267.70 | 223.60 | |
11441 | 002 | 10 | 2 | X | 296.15 | 246.21 | |
11441 | 003 | 10 | 2 | X | 303.79 | 252.88 | |
11442 | 001 | 10 | 2 | X | 360.80 | 296.30 | |
11442 | 003 | 10 | 2 | X | 360.34 | 296.14 | |
11442 | 002 | 10 | 2 | X | 364.58 | 298.48 | |
11442 | 004 | 10 | 2 | X | 314.94 | 258.94 | |
11443 | 002 | 10 | 2 | X | 475.65 | 391.61 | |
11443 | 003 | 10 | 2 | X | 490.32 | 404.76 | |
11443 | 004 | 10 | 2 | X | 463.37 | 382.84 | |
11443 | 001 | 10 | 2 | X | 468.15 | 384.76 | |
11444 | 004 | 10 | 2 | X | 499.08 | X | |
11444 | 001 | 10 | 2 | X | 470.62 | X | |
11444 | 003 | 10 | 2 | X | 576.92 | X | |
11444 | 002 | 10 | 2 | X | 422.29 | X | |
11446 | 004 | 10 | 2 | X | 810.36 | X | |
11446 | 002 | 10 | 2 | X | 742.10 | X | |
11446 | 003 | 10 | 2 | X | 798.96 | X | |
11446 | 001 | 10 | 2 | X | 840.40 | X | |
11450 | 003 | 90 | 2 | X | 998.93 | X | |
11450 | 001 | 90 | 2 | X | 948.53 | X | |
11450 | 002 | 90 | 2 | X | 973.45 | X | |
11450 | 004 | 90 | 2 | X | 901.44 | X | |
11451 | 002 | 90 | 2 | X | 1,677.51 | X | |
11451 | 003 | 90 | 2 | X | 747.84 | X | |
11451 | 001 | 90 | 2 | X | 1,682.54 | X | |
11451 | 004 | 90 | 2 | X | 739.15 | X | |
11462 | 001 | 90 | 2 | X | 899.60 | X | |
11462 | 002 | 90 | 2 | X | 1,124.13 | X | |
11462 | 003 | 90 | 2 | X | 1,108.13 | X | |
11462 | 004 | 90 | 2 | X | 528.27 | X | |
11463 | 001 | 90 | 2 | X | 690.14 | X | |
11463 | 002 | 90 | 2 | X | 680.84 | X | |
11463 | 003 | 90 | 2 | X | 642.53 | X | |
11463 | 004 | 90 | 2 | X | 1,236.05 | X | |
11470 | 001 | 90 | 2 | X | 1,173.32 | X | |
11470 | 004 | 90 | 2 | X | 1,145.70 | X | |
11470 | 003 | 90 | 2 | X | 1,055.04 | X | |
11470 | 002 | 90 | 2 | X | 1,155.18 | X | |
11471 | 004 | 90 | 2 | X | 746.66 | X | |
11471 | 001 | 90 | 2 | X | 1,686.31 | X | |
11471 | 002 | 90 | 2 | X | 1,681.25 | X | |
11471 | 003 | 90 | 2 | X | 755.01 | X | |
11600 | 003 | 10 | 2 | X | 319.68 | 248.19 | |
11600 | 002 | 10 | 2 | X | 326.57 | 252.97 | |
11600 | 004 | 10 | 2 | X | 319.99 | 248.41 | |
11600 | 001 | 10 | 2 | X | 328.54 | 255.16 | |
11601 | 002 | 10 | 2 | X | 396.05 | 316.56 | |
11601 | 003 | 10 | 2 | X | 383.08 | 306.66 | |
11601 | 004 | 10 | 2 | X | 381.59 | 304.83 | |
11601 | 001 | 10 | 2 | X | 395.27 | 315.68 | |
11602 | 004 | 10 | 2 | X | 421.25 | 329.17 | |
11602 | 001 | 10 | 2 | X | 474.56 | 368.60 | |
11602 | 003 | 10 | 2 | X | 461.14 | 359.61 | |
11602 | 002 | 10 | 2 | X | 466.22 | 362.17 | |
11603 | 004 | 10 | 2 | X | 508.18 | 391.96 | |
11603 | 001 | 10 | 2 | X | 547.97 | 421.75 | |
11603 | 003 | 10 | 2 | X | 560.45 | 431.78 | |
11603 | 002 | 10 | 2 | X | 563.25 | 432.69 | |
11604 | 004 | 10 | 2 | X | 696.87 | X | |
11604 | 002 | 10 | 2 | X | 715.92 | X | |
11604 | 003 | 10 | 2 | X | 682.51 | X | |
11604 | 001 | 10 | 2 | X | 696.27 | X | |
11606 | 004 | 10 | 2 | X | 1,008.47 | X | |
11606 | 001 | 10 | 2 | X | 1,015.92 | X | |
11606 | 002 | 10 | 2 | X | 1,007.95 | X | |
11606 | 003 | 10 | 2 | X | 891.91 | X | |
11620 | 004 | 10 | 2 | X | 354.92 | 270.66 | |
11620 | 002 | 10 | 2 | X | 366.94 | 279.44 | |
11620 | 003 | 10 | 2 | X | 352.33 | 268.12 | |
11620 | 001 | 10 | 2 | X | 374.42 | 285.66 | |
11621 | 003 | 10 | 2 | X | 474.94 | 369.31 | |
11621 | 002 | 10 | 2 | X | 483.70 | 375.41 | |
11621 | 004 | 10 | 2 | X | 413.06 | 321.14 | |
11621 | 001 | 10 | 2 | X | 493.92 | 383.74 | |
11622 | 002 | 10 | 2 | X | 524.30 | 404.25 | |
11622 | 003 | 10 | 2 | X | 516.74 | 397.53 | |
11622 | 004 | 10 | 2 | X | 481.31 | 371.25 | |
11622 | 001 | 10 | 2 | X | 532.23 | 409.57 | |
11623 | 001 | 10 | 2 | X | 638.46 | 497.32 | |
11623 | 004 | 10 | 2 | X | 587.64 | 458.27 | |
11623 | 003 | 10 | 2 | X | 599.36 | 464.60 | |
11623 | 002 | 10 | 2 | X | 630.01 | 490.71 | |
11624 | 004 | 10 | 2 | X | 722.76 | X | |
11624 | 003 | 10 | 2 | X | 746.31 | X | |
11624 | 002 | 10 | 2 | X | 763.94 | X | |
11624 | 001 | 10 | 2 | X | 774.49 | X | |
11626 | 002 | 10 | 2 | X | 905.28 | X | |
11626 | 003 | 10 | 2 | X | 848.64 | X | |
11626 | 001 | 10 | 2 | X | 919.02 | X | |
11626 | 004 | 10 | 2 | X | 888.30 | X | |
11640 | 002 | 10 | 2 | X | 427.73 | 322.47 | |
11640 | 003 | 10 | 2 | X | 396.88 | 299.69 | |
11640 | 001 | 10 | 2 | X | 435.14 | 328.39 | |
11640 | 004 | 10 | 2 | X | 403.36 | 304.18 | |
11641 | 004 | 10 | 2 | X | 482.02 | 374.71 | |
11641 | 001 | 10 | 2 | X | 533.18 | 413.63 | |
11641 | 003 | 10 | 2 | X | 518.25 | 403.14 | |
11641 | 002 | 10 | 2 | X | 534.29 | 414.21 | |
11642 | 004 | 10 | 2 | X | 584.57 | 455.72 | |
11642 | 002 | 10 | 2 | X | 629.42 | 487.78 | |
11642 | 003 | 10 | 2 | X | 632.72 | 490.32 | |
11642 | 001 | 10 | 2 | X | 638.62 | 494.37 | |
11643 | 001 | 10 | 2 | X | 752.68 | 588.27 | |
11643 | 004 | 10 | 2 | X | 693.75 | 543.10 | |
11643 | 003 | 10 | 2 | X | 726.14 | 567.21 | |
11643 | 002 | 10 | 2 | X | 742.87 | 580.65 |
Part B Fee Schedules