Part B Fee Schedules

Fee Schedule 19105-21014

CPT/HCPC Code	Medicare Location	Global Surgery Indicator	Multiple Surgery Indicator	Prevailing Charge Amount	Fee Schedule Amount	Site of Service Amount
19105	002	0	2	X	3,115.22	306.69
19105	003	0	2	X	3,115.22	306.69
19105	004	0	2	X	3,115.22	306.69
19105	001	0	2	X	3,774.12	338.05
19110	002	90	2	X	797.35	X
19110	003	90	2	X	746.66	X
19110	001	90	2	X	870.06	X
19110	004	90	2	X	738.29	X
19112	004	90	2	X	641.93	X
19112	003	90	2	X	697.86	X
19112	002	90	2	X	750.30	X
19112	001	90	2	X	699.45	X
19120	004	90	2	X	798.41	X
19120	002	90	2	X	798.41	X
19120	003	90	2	X	798.41	X
19120	001	90	2	X	895.60	X
19125	001	90	2	X	1,058.31	X
19125	004	90	2	X	884.59	X
19125	002	90	2	X	1,043.16	X
19125	003	90	2	X	890.98	X
19126	003	ZZZ	0	X	729.39	X
19126	002	ZZZ	0	X	522.84	X
19126	004	ZZZ	0	X	724.78	X
19126	001	ZZZ	0	X	530.54	X
19281	002	0	2	X	374.09	165.82
19281	003	0	2	X	374.09	165.82
19281	004	0	2	X	374.09	165.82
19281	001	0	2	X	421.25	178.61
19282	001	ZZZ	0	X	291.34	83.91
19282	004	ZZZ	0	X	257.03	78.95
19282	002	ZZZ	0	X	257.03	78.95
19282	003	ZZZ	0	X	257.03	78.95
19283	004	0	2	X	423.37	167.41
19283	002	0	2	X	423.37	167.41
19283	003	0	2	X	423.37	167.41
19283	001	0	2	X	478.66	180.49
19284	004	ZZZ	0	X	307.35	79.48
19284	001	ZZZ	0	X	349.98	84.51
19284	003	ZZZ	0	X	307.35	79.48
19284	002	ZZZ	0	X	307.35	79.48
19285	002	0	2	X	707.37	141.97
19285	003	0	2	X	707.37	141.97
19285	004	0	2	X	707.37	141.97
19285	001	0	2	X	811.72	152.98
19286	002	ZZZ	0	X	589.64	68.21
19286	003	ZZZ	0	X	589.64	68.21
19286	004	ZZZ	0	X	589.64	68.21
19286	001	ZZZ	0	X	680.13	72.64
19287	004	0	2	X	1,309.86	232.04
19287	003	0	2	X	1,309.86	232.04
19287	002	0	2	X	1,309.86	232.04
19287	001	0	2	X	1,511.29	255.56
19288	001	ZZZ	0	X	1,196.98	108.54
19288	004	ZZZ	0	X	1,036.28	102.04
19288	003	ZZZ	0	X	1,036.28	102.04
19288	002	ZZZ	0	X	1,036.28	102.04
19294	001	ZZZ	0	X	267.36	X
19294	002	ZZZ	0	X	245.30	X
19294	003	ZZZ	0	X	245.30	X
19294	004	ZZZ	0	X	245.30	X
19296	001	0	2	X	11,245.01	466.13
19296	004	0	2	X	9,413.97	421.79
19296	003	0	2	X	9,413.97	421.79
19296	002	0	2	X	9,413.97	421.79
19297	004	ZZZ	0	X	193.64	X
19297	002	ZZZ	0	X	193.64	X
19297	001	ZZZ	0	X	213.43	X
19297	003	ZZZ	0	X	193.64	X
19298	002	0	2	X	3,563.84	677.96
19298	003	0	2	X	3,563.84	677.96
19298	004	0	2	X	3,563.84	677.96
19298	001	0	2	X	4,201.25	741.99
19300	001	90	2	X	955.19	661.54
19300	004	90	2	X	817.69	577.64
19300	003	90	2	X	817.69	577.64
19300	002	90	2	X	817.69	577.64
19301	003	90	2	X	632.00	X
19301	002	90	2	X	632.00	X
19301	004	90	2	X	632.00	X
19301	001	90	2	X	720.69	X
19302	001	90	2	X	1,527.57	X
19302	003	90	2	X	1,347.94	X
19302	002	90	2	X	1,347.94	X
19302	004	90	2	X	1,347.94	X
19303	003	90	2	X	1,376.25	X
19303	002	90	2	X	1,376.25	X
19303	004	90	2	X	1,376.25	X
19303	001	90	2	X	1,523.33	X
19305	004	90	2	X	1,669.72	X
19305	001	90	2	X	1,883.56	X
19305	003	90	2	X	1,669.72	X
19305	002	90	2	X	1,669.72	X
19306	001	90	2	X	1,960.80	X
19306	002	90	2	X	1,735.71	X
19306	003	90	2	X	1,735.71	X
19306	004	90	2	X	1,735.71	X
19307	003	90	2	X	1,745.24	X
19307	002	90	2	X	1,745.24	X
19307	004	90	2	X	1,745.24	X
19307	001	90	2	X	1,972.60	X
19316		90	2	X	*	X
19318	001	90	2	X	4,108.80	X
19318	004	90	2	X	3,945.84	X
19318	002	90	2	X	4,080.12	X
19318	003	90	2	X	3,926.23	X
19325	002	90	2	X	1,684.76	X
19325	003	90	2	X	2,204.70	X
19325	004	90	2	X	1,555.16	X
19325	001	90	2	X	1,711.79	X
19328	002	90	2	X	953.28	X
19328	003	90	2	X	891.83	X
19328	001	90	2	X	1,115.52	X
19328	004	90	2	X	1,013.98	X
19330	003	90	2	X	1,237.19	X
19330	002	90	2	X	1,315.98	X
19330	004	90	2	X	1,223.53	X
19330	001	90	2	X	1,335.17	X
19340	001	90	2	X	3,316.93	X
19340	003	90	2	X	3,224.38	X
19340	002	90	2	X	3,298.89	X
19340	004	90	2	X	1,861.59	X
19342	001	90	2	X	2,944.44	X
19342	003	90	2	X	2,446.93	X
19342	002	90	2	X	2,924.86	X
19342	004	90	2	X	2,417.98	X
19350	004	90	2	X	1,720.17	X
19350	002	90	2	X	1,934.75	X
19350	003	90	2	X	1,879.39	X
19350	001	90	2	X	1,904.09	X
19355	001	90	2	X	1,500.99	X
19355	004	90	2	X	1,364.32	X
19355	002	90	2	X	1,477.25	X
19355	003	90	2	X	1,379.80	X
19357	004	90	2	X	3,229.19	X
19357	001	90	2	X	3,555.93	X
19357	003	90	2	X	3,266.41	X
19357	002	90	2	X	3,499.39	X
19361	001	90	2	X	4,799.49	X
19361	003	90	2	X	3,563.84	X
19361	002	90	2	X	3,792.33	X
19361	004	90	2	X	4,303.33	X
19364	003	90	2	X	5,011.15	X
19364	002	90	2	X	5,358.66	X
19364	004	90	2	X	4,955.57	X
19364	001	90	2	X	5,443.17	X
19367	002	90	2	X	4,911.55	X
19367	003	90	2	X	4,628.86	X
19367	001	90	2	X	4,964.34	X
19367	004	90	2	X	5,225.93	X
19368	001	90	2	X	4,964.34	X
19368	004	90	2	X	5,225.93	X
19368	003	90	2	X	4,628.86	X
19368	002	90	2	X	4,911.55	X
19369	003	90	2	X	4,628.86	X
19369	002	90	2	X	4,911.55	X
19369	001	90	2	X	4,964.34	X
19369	004	90	2	X	5,225.93	X
19370	002	90	2	X	2,082.01	X
19370	003	90	2	X	2,033.70	X
19370	004	90	2	X	1,542.38	X
19370	001	90	2	X	2,093.70	X
19371	001	90	2	X	2,256.28	X
19371	004	90	2	X	1,886.78	X
19371	003	90	2	X	2,180.09	X
19371	002	90	2	X	2,241.45	X
19380	004	90	2	X	1,887.90	X
19380	002	90	2	X	2,058.60	X
19380	003	90	2	X	1,910.30	X
19380	001	90	2	X	2,094.58	X
19396		0	2	X	*	X
19499		YYY	2	X	#	X
20100	004	10	2	X	1,685.82	X
20100	001	10	2	X	1,892.80	X
20100	002	10	2	X	1,810.58	X
20100	003	10	2	X	1,709.44	X
20101	004	10	2	X	532.72	X
20101	003	10	2	X	540.17	X
20101	002	10	2	X	572.21	X
20101	001	10	2	X	598.32	X
20102	002	10	2	X	700.81	X
20102	003	10	2	X	661.68	X
20102	004	10	2	X	652.57	X
20102	001	10	2	X	732.72	X
20103	004	10	2	X	878.05	X
20103	002	10	2	X	943.04	X
20103	003	10	2	X	890.38	X
20103	001	10	2	X	985.72	X
20150	001	90	2	X	3,165.92	X
20150	002	90	2	X	2,832.26	X
20150	003	90	2	X	2,756.16	X
20150	004	90	2	X	2,756.16	X
20200	001	0	2	X	401.41	X
20200	003	0	2	X	381.52	X
20200	002	0	2	X	394.06	X
20200	004	0	2	X	377.05	X
20205	003	0	2	X	637.34	X
20205	002	0	2	X	648.29	X
20205	004	0	2	X	599.71	X
20205	001	0	2	X	660.28	X
20206	004	0	2	X	353.96	X
20206	001	0	2	X	375.07	X
20206	002	0	2	X	362.42	X
20206	003	0	2	X	359.04	X
20220	001	0	2	X	310.37	X
20220	003	0	2	X	276.38	X
20220	002	0	2	X	308.33	X
20220	004	0	2	X	312.71	X
20225	004	0	2	X	499.08	X
20225	002	0	2	X	472.33	X
20225	003	0	2	X	554.59	X
20225	001	0	2	X	479.75	X
20240	002	0	2	X	564.12	X
20240	003	0	2	X	535.89	X
20240	004	0	2	X	529.64	X
20240	001	0	2	X	561.70	X
20245	003	0	2	X	1,120.07	X
20245	002	0	2	X	1,211.18	X
20245	001	0	2	X	1,106.02	X
20245	004	0	2	X	1,190.58	X
20250	001	10	2	X	1,325.74	X
20250	004	10	2	X	1,076.17	X
20250	003	10	2	X	1,340.66	X
20250	002	10	2	X	1,218.21	X
20251	001	10	2	X	1,452.93	X
20251	004	10	2	X	1,327.10	X
20251	003	10	2	X	1,242.73	X
20251	002	10	2	X	1,374.94	X
20500	003	10	2	X	154.77	137.86
20500	002	10	2	X	157.10	139.88
20500	004	10	2	X	153.18	136.50
20500	001	10	2	X	163.12	144.90
20501	001	0	2	X	111.39	X
20501	004	0	2	X	104.74	X
20501	002	0	2	X	110.38	X
20501	003	0	2	X	105.91	X
20520	004	10	2	X	213.05	185.38
20520	002	10	2	X	241.59	208.28
20520	003	10	2	X	238.13	206.60
20520	001	10	2	X	210.03	181.13
20525	004	10	2	X	564.80	X
20525	002	10	2	X	642.56	X
20525	003	10	2	X	566.92	X
20525	001	10	2	X	603.84	X
20526	004	0	2	X	132.84	103.18
20526	002	0	2	X	132.84	103.18
20526	003	0	2	X	132.84	103.18
20526	001	0	2	X	148.78	113.89
20527	004	0	2	X	123.59	98.50
20527	002	0	2	X	123.59	98.50
20527	003	0	2	X	123.59	98.50
20527	001	0	2	X	137.79	108.61
20550	003	0	2	X	114.19	99.22
20550	001	0	2	X	112.82	97.98
20550	002	0	2	X	118.24	102.82
20550	004	0	2	X	111.73	96.88
20551	004	0	2	X	132.84	103.18
20551	002	0	2	X	132.84	103.18
20551	003	0	2	X	132.84	103.18
20551	001	0	2	X	148.78	113.89
20552	004	0	2	X	132.84	103.18
20552	003	0	2	X	132.84	103.18
20552	002	0	2	X	132.84	103.18
20552	001	0	2	X	148.78	113.89
20553	003	0	2	X	132.84	103.18
20553	002	0	2	X	132.84	103.18
20553	001	0	2	X	148.78	113.89
20553	004	0	2	X	132.84	103.18
20555	001	0	2	X	594.01	X
20555	004	0	2	X	542.26	X
20555	002	0	2	X	542.26	X
20555	003	0	2	X	542.26	X
20560		XXX	0	X	*	X
20561		XXX	0	X	*	X
20600	003	0	2	X	115.09	92.84
20600	002	0	2	X	120.52	96.90
20600	001	0	2	X	119.50	95.89
20600	004	0	2	X	114.04	91.86
20604	001	0	2	X	121.16	76.42
20604	003	0	2	X	109.58	71.35
20604	002	0	2	X	109.58	71.35
20604	004	0	2	X	109.58	71.35
20605	001	0	2	X	132.65	107.78
20605	004	0	2	X	122.62	99.83
20605	002	0	2	X	130.96	106.41
20605	003	0	2	X	124.08	100.91
20606	004	0	2	X	120.49	80.70
20606	003	0	2	X	120.49	80.70
20606	002	0	2	X	120.49	80.70
20606	001	0	2	X	133.02	86.46
20610	002	0	2	X	133.70	110.69
20610	003	0	2	X	126.92	105.25
20610	004	0	2	X	125.54	104.17
20610	001	0	2	X	134.89	111.34
20611	001	0	2	X	153.25	102.40
20611	004	0	2	X	138.32	94.85
20611	003	0	2	X	138.32	94.85
20611	002	0	2	X	138.32	94.85
20612	001	0	2	X	133.98	90.32
20612	004	0	2	X	118.65	81.53
20612	002	0	2	X	118.65	81.53
20612	003	0	2	X	118.65	81.53
20615	002	10	2	X	242.04	220.47
20615	003	10	2	X	236.29	216.27
20615	001	10	2	X	244.10	222.40
20615	004	10	2	X	234.72	214.21
20650	004	10	2	X	383.82	X
20650	003	10	2	X	371.95	X
20650	002	10	2	X	395.41	X
20650	001	10	2	X	603.57	X
20660	001	0	2	X	580.65	X
20660	003	0	2	X	573.90	X
20660	002	0	2	X	579.21	X
20660	004	0	2	X	541.65	X
20661	002	90	2	X	1,042.61	X
20661	003	90	2	X	1,020.53	X
20661	004	90	2	X	1,016.05	X
20661	001	90	2	X	1,054.96	X
20662	001	90	2	X	1,490.78	X
20662	002	90	2	X	1,465.58	X
20662	003	90	2	X	1,361.47	X
20662	004	90	2	X	1,344.84	X
20663	001	90	2	X	1,168.11	X
20663	003	90	2	X	1,071.27	X
20663	002	90	2	X	1,149.25	X
20663	004	90	2	X	1,058.57	X
20664	003	90	2	X	1,107.65	X
20664	002	90	2	X	1,107.65	X
20664	004	90	2	X	1,107.65	X
20664	001	90	2	X	1,230.17	X
20665	001	10	2	X	284.58	X
20665	004	10	2	X	190.01	X
20665	003	10	2	X	192.09	X
20665	002	10	2	X	305.25	X
20670	001	10	2	X	499.34	X
20670	004	10	2	X	495.83	X
20670	003	10	2	X	446.92	X
20670	002	10	2	X	452.80	X
20680	001	90	2	X	806.48	X
20680	003	90	2	X	739.82	X
20680	002	90	2	X	793.52	X
20680	004	90	2	X	730.86	X
20690	003	90	2	X	808.77	X
20690	002	90	2	X	857.72	X
20690	004	90	2	X	798.96	X
20690	001	90	2	X	865.97	X
20692	004	90	2	X	1,122.85	X
20692	002	90	2	X	1,186.35	X
20692	003	90	2	X	1,132.03	X
20692	001	90	2	X	1,199.53	X
20693	003	90	2	X	873.44	X
20693	002	90	2	X	922.88	X
20693	001	90	2	X	934.94	X
20693	004	90	2	X	863.89	X
20694	001	90	2	X	768.83	X
20694	003	90	2	X	712.36	X
20694	002	90	2	X	757.81	X
20694	004	90	2	X	704.17	X
20696	004	90	2	X	1,793.46	X
20696	001	90	2	X	1,998.74	X
20696	002	90	2	X	1,793.46	X
20696	003	90	2	X	1,793.46	X
20697	001	0	0	X	2,344.31	X
20697	004	0	0	X	1,976.51	X
20697	002	0	0	X	1,976.51	X
20697	003	0	0	X	1,976.51	X
20700	002	ZZZ	0	X	118.80	X
20700	003	ZZZ	0	X	118.80	X
20700	004	ZZZ	0	X	118.80	X
20700	001	ZZZ	0	X	130.18	X
20701	004	ZZZ	0	X	88.64	X
20701	002	ZZZ	0	X	88.64	X
20701	003	ZZZ	0	X	88.64	X
20701	001	ZZZ	0	X	96.95	X
20702	003	ZZZ	0	X	197.68	X
20702	002	ZZZ	0	X	197.68	X
20702	004	ZZZ	0	X	197.68	X
20702	001	ZZZ	0	X	216.68	X
20703	001	ZZZ	0	X	155.06	X
20703	004	ZZZ	0	X	141.70	X
20703	003	ZZZ	0	X	141.70	X
20703	002	ZZZ	0	X	141.70	X
20704	004	ZZZ	0	X	205.95	X
20704	002	ZZZ	0	X	205.95	X
20704	003	ZZZ	0	X	205.95	X
20704	001	ZZZ	0	X	225.78	X
20705	001	ZZZ	0	X	185.56	X
20705	004	ZZZ	0	X	169.45	X
20705	003	ZZZ	0	X	169.45	X
20705	002	ZZZ	0	X	169.45	X
20802	004	90	2	X	9,077.03	X
20802	002	90	2	X	9,853.86	X
20802	003	90	2	X	9,203.73	X
20802	001	90	2	X	10,161.72	X
20805	001	90	2	X	12,437.93	X
20805	003	90	2	X	11,264.91	X
20805	002	90	2	X	12,060.99	X
20805	004	90	2	X	11,109.88	X
20808	003	90	2	X	14,005.64	X
20808	002	90	2	X	14,995.36	X
20808	004	90	2	X	13,812.92	X
20808	001	90	2	X	15,464.05	X
20816	001	90	2	X	7,622.87	X
20816	003	90	2	X	6,904.09	X
20816	002	90	2	X	7,391.92	X
20816	004	90	2	X	6,809.07	X
20822	002	90	2	X	6,110.75	X
20822	003	90	2	X	5,707.52	X
20822	004	90	2	X	5,628.92	X
20822	001	90	2	X	6,301.74	X
20824	001	90	2	X	7,622.87	X
20824	002	90	2	X	7,391.92	X
20824	003	90	2	X	6,904.09	X
20824	004	90	2	X	6,809.07	X
20827	002	90	2	X	6,283.27	X
20827	003	90	2	X	5,868.50	X
20827	001	90	2	X	6,479.65	X
20827	004	90	2	X	5,787.76	X
20838	004	90	2	X	9,077.03	X
20838	001	90	2	X	10,161.72	X
20838	003	90	2	X	9,203.73	X
20838	002	90	2	X	9,853.86	X
20900	001	0	2	X	931.23	X
20900	003	0	2	X	1,138.57	X
20900	002	0	2	X	1,184.51	X
20900	004	0	2	X	1,293.23	X
20902	002	0	2	X	1,392.77	X
20902	003	0	2	X	1,306.14	X
20902	004	0	2	X	1,291.11	X
20902	001	0	2	X	1,413.76	X
20910	001	90	2	X	453.99	X
20910	003	90	2	X	436.44	X
20910	002	90	2	X	450.76	X
20910	004	90	2	X	618.23	X
20912	004	90	2	X	1,166.70	X
20912	002	90	2	X	1,255.58	X
20912	003	90	2	X	1,180.54	X
20912	001	90	2	X	1,273.68	X
20920	002	90	2	X	1,031.34	X
20920	003	90	2	X	970.28	X
20920	001	90	2	X	1,554.92	X
20920	004	90	2	X	958.83	X
20922	002	90	2	X	1,545.27	X
20922	003	90	2	X	1,164.68	X
20922	004	90	2	X	1,839.04	X
20922	001	90	2	X	1,260.38	X
20924	004	90	2	X	1,272.03	X
20924	001	90	2	X	1,966.00	X
20924	002	90	2	X	1,956.83	X
20924	003	90	2	X	1,287.27	X
20930		XXX	9	X	*	X
20931	004	ZZZ	0	X	407.69	X
20931	002	ZZZ	0	X	442.29	X
20931	003	ZZZ	0	X	413.90	X
20931	001	ZZZ	0	X	463.29	X
20932	002	ZZZ	0	X	1,011.17	X
20932	003	ZZZ	0	X	1,011.17	X
20932	004	ZZZ	0	X	1,011.17	X
20932	001	ZZZ	0	X	1,098.61	X
20933	004	ZZZ	0	X	927.46	X
20933	002	ZZZ	0	X	927.46	X
20933	001	ZZZ	0	X	1,007.50	X
20933	003	ZZZ	0	X	927.46	X
20934	001	ZZZ	0	X	1,098.12	X
20934	002	ZZZ	0	X	1,010.67	X
20934	003	ZZZ	0	X	1,010.67	X
20934	004	ZZZ	0	X	1,010.67	X
20936		XXX	9	X	*	X
20937	002	ZZZ	0	X	681.94	X
20937	003	ZZZ	0	X	638.07	X
20937	001	ZZZ	0	X	714.59	X
20937	004	ZZZ	0	X	628.43	X
20938	003	ZZZ	0	X	690.22	X
20938	002	ZZZ	0	X	737.54	X
20938	001	ZZZ	0	X	772.70	X
20938	004	ZZZ	0	X	679.82	X
20939	004	ZZZ	0	X	100.37	X
20939	002	ZZZ	0	X	100.37	X
20939	003	ZZZ	0	X	100.37	X
20939	001	ZZZ	0	X	109.44	X
20950	001	0	2	X	284.51	X
20950	004	0	2	X	259.00	X
20950	002	0	2	X	327.50	X
20950	003	0	2	X	278.69	X
20955	001	90	2	X	9,826.43	X
20955	003	90	2	X	9,826.43	X
20955	002	90	2	X	9,826.43	X
20955	004	90	2	X	9,826.43	X
20956	004	90	2	X	6,938.59	X
20956	001	90	2	X	7,914.78	X
20956	003	90	2	X	6,938.59	X
20956	002	90	2	X	7,130.27	X
20957	002	90	2	X	7,386.98	X
20957	003	90	2	X	7,188.37	X
20957	001	90	2	X	8,199.69	X
20957	004	90	2	X	7,188.37	X
20962	002	90	2	X	7,130.27	X
20962	003	90	2	X	6,938.59	X
20962	004	90	2	X	6,938.59	X
20962	001	90	2	X	7,914.78	X
20969	002	90	2	X	9,166.91	X
20969	003	90	2	X	8,920.55	X
20969	004	90	2	X	8,920.55	X
20969	001	90	2	X	10,246.76	X
20970	002	90	2	X	9,826.43	X
20970	003	90	2	X	9,826.43	X
20970	004	90	2	X	9,826.43	X
20970	001	90	2	X	9,826.43	X
20972	004	90	2	X	9,826.43	X
20972	002	90	2	X	9,826.43	X
20972	003	90	2	X	9,826.43	X
20972	001	90	2	X	9,826.43	X
20973	001	90	2	X	9,826.43	X
20973	004	90	2	X	9,826.43	X
20973	002	90	2	X	9,826.43	X
20973	003	90	2	X	9,826.43	X
20974	004	0	0	X	465.20	X
20974	001	0	0	X	531.79	X
20974	002	0	0	X	520.15	X
20974	003	0	0	X	471.74	X
20975	004	0	0	X	667.46	X
20975	002	0	0	X	730.16	X
20975	003	0	0	X	675.76	X
20975	001	0	0	X	743.35	X
20979	001	0	0	X	41.11	23.57
20979	003	0	0	X	36.50	21.54
20979	002	0	0	X	36.50	21.54
20979	004	0	0	X	36.50	21.54
20982	001	0	2	X	10,005.65	945.77
20982	004	0	2	X	8,566.11	858.57
20982	003	0	2	X	8,566.11	858.57
20982	002	0	2	X	8,566.11	858.57
20983	004	0	2	X	10,315.99	628.21
20983	003	0	2	X	10,315.99	628.21
20983	002	0	2	X	10,315.99	628.21
20983	001	0	2	X	12,015.54	680.13
20985	001	ZZZ	0	X	285.53	X
20985	003	ZZZ	0	X	251.12	X
20985	002	ZZZ	0	X	251.12	X
20985	004	ZZZ	0	X	251.12	X
20999		YYY	2	X	#	X
21010	004	90	2	X	2,077.33	X
21010	001	90	2	X	2,266.05	X
21010	002	90	2	X	2,234.60	X
21010	003	90	2	X	2,103.80	X
21011	004	90	2	X	518.02	408.66
21011	001	90	2	X	590.29	460.61
21011	002	90	2	X	518.02	408.66
21011	003	90	2	X	518.02	408.66
21012	004	90	2	X	561.81	X
21012	002	90	2	X	561.81	X
21012	003	90	2	X	561.81	X
21012	001	90	2	X	631.47	X
21013	001	90	2	X	915.12	740.59
21013	004	90	2	X	808.37	661.20
21013	002	90	2	X	808.37	661.20
21013	003	90	2	X	808.37	661.20
21014	004	90	2	X	868.35	X
21014	002	90	2	X	868.35	X
21014	003	90	2	X	868.35	X
21014	001	90	2	X	973.50	X

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