Part B Fee Schedules

Fee Schedule 22850-24073

CPT/HCPC Code	Medicare Location	Global Surgery Indicator	Multiple Surgery Indicator	Prevailing Charge Amount	Fee Schedule Amount	Site of Service Amount
22850	004	90	2	X	2,022.96	X
22850	003	90	2	X	2,047.57	X
22850	002	90	2	X	2,052.32	X
22850	001	90	2	X	2,236.59	X
22852	001	90	2	X	2,083.28	X
22852	004	90	2	X	2,032.43	X
22852	003	90	2	X	2,057.45	X
22852	002	90	2	X	2,061.42	X
22853	003	ZZZ	0	X	405.97	X
22853	002	ZZZ	0	X	405.97	X
22853	001	ZZZ	0	X	450.13	X
22853	004	ZZZ	0	X	405.97	X
22854	003	ZZZ	0	X	525.51	X
22854	002	ZZZ	0	X	525.51	X
22854	004	ZZZ	0	X	525.51	X
22854	001	ZZZ	0	X	582.73	X
22855	001	90	2	X	2,019.39	X
22855	003	90	2	X	1,858.38	X
22855	002	90	2	X	1,987.98	X
22855	004	90	2	X	1,836.65	X
22856	002	90	2	X	2,749.66	X
22856	003	90	2	X	2,749.66	X
22856	004	90	2	X	2,749.66	X
22856	001	90	2	X	3,120.22	X
22857	001	90	2	X	2,710.31	X
22857	004	90	2	X	2,406.64	X
22857	002	90	2	X	2,406.64	X
22857	003	90	2	X	2,406.64	X
22858	001	ZZZ	0	X	1,187.50	X
22858	004	ZZZ	0	X	1,039.13	X
22858	003	ZZZ	0	X	1,039.13	X
22858	002	ZZZ	0	X	1,039.13	X
22859	001	ZZZ	0	X	582.73	X
22859	004	ZZZ	0	X	525.51	X
22859	003	ZZZ	0	X	525.51	X
22859	002	ZZZ	0	X	525.51	X
22860				X	#	X
22861	001	90	2	X	3,711.06	X
22861	004	90	2	X	3,336.34	X
22861	002	90	2	X	3,336.34	X
22861	003	90	2	X	3,336.34	X
22862	001	90	2	X	3,324.95	X
22862	003	90	2	X	2,924.27	X
22862	002	90	2	X	2,924.27	X
22862	004	90	2	X	2,924.27	X
22864	002	90	2	X	3,110.00	X
22864	003	90	2	X	3,110.00	X
22864	004	90	2	X	3,110.00	X
22864	001	90	2	X	3,519.59	X
22865	002	90	2	X	2,847.72	X
22865	003	90	2	X	2,847.72	X
22865	004	90	2	X	2,847.72	X
22865	001	90	2	X	3,237.21	X
22867	001	90	2	X	1,679.16	X
22867	004	90	2	X	1,505.05	X
22867	003	90	2	X	1,505.05	X
22867	002	90	2	X	1,505.05	X
22868	004	ZZZ	0	X	379.29	X
22868	001	ZZZ	0	X	419.92	X
22868	003	ZZZ	0	X	379.29	X
22868	002	ZZZ	0	X	379.29	X
22869	002	90	2	X	824.61	X
22869	003	90	2	X	824.61	X
22869	001	90	2	X	919.60	X
22869	004	90	2	X	824.61	X
22870	003	ZZZ	0	X	220.94	X
22870	002	ZZZ	0	X	220.94	X
22870	004	ZZZ	0	X	220.94	X
22870	001	ZZZ	0	X	244.36	X
22899		YYY	2	X	#	X
22900	001	90	2	X	1,144.61	X
22900	003	90	2	X	1,073.66	X
22900	002	90	2	X	1,123.44	X
22900	004	90	2	X	926.34	X
22901	003	90	2	X	1,120.34	X
22901	002	90	2	X	1,120.34	X
22901	004	90	2	X	1,120.34	X
22901	001	90	2	X	1,256.17	X
22902	002	90	2	X	693.88	559.74
22902	003	90	2	X	693.88	559.74
22902	004	90	2	X	693.88	559.74
22902	001	90	2	X	787.96	628.85
22903	001	90	2	X	828.29	X
22903	002	90	2	X	738.56	X
22903	003	90	2	X	738.56	X
22903	004	90	2	X	738.56	X
22904	001	90	2	X	1,968.53	X
22904	004	90	2	X	1,759.77	X
22904	003	90	2	X	1,759.77	X
22904	002	90	2	X	1,759.77	X
22905	001	90	2	X	2,553.47	X
22905	004	90	2	X	2,282.03	X
22905	003	90	2	X	2,282.03	X
22905	002	90	2	X	2,282.03	X
22999		YYY	2	X	#	X
23000	003	90	2	X	818.91	X
23000	002	90	2	X	908.08	X
23000	004	90	2	X	878.70	X
23000	001	90	2	X	885.37	X
23020	003	90	2	X	1,732.10	X
23020	002	90	2	X	1,850.62	X
23020	004	90	2	X	1,711.54	X
23020	001	90	2	X	1,879.31	X
23030	001	10	2	X	639.95	X
23030	003	10	2	X	582.99	X
23030	002	10	2	X	630.69	X
23030	004	10	2	X	585.73	X
23031	003	10	2	X	299.84	X
23031	002	10	2	X	313.60	X
23031	004	10	2	X	300.66	X
23031	001	10	2	X	357.61	X
23035	001	90	2	X	1,707.70	X
23035	002	90	2	X	1,681.39	X
23035	003	90	2	X	1,572.73	X
23035	004	90	2	X	1,554.42	X
23040	004	90	2	X	1,967.33	X
23040	001	90	2	X	2,177.55	X
23040	003	90	2	X	1,991.43	X
23040	002	90	2	X	2,141.29	X
23044	004	90	2	X	1,490.85	X
23044	001	90	2	X	1,652.98	X
23044	002	90	2	X	1,844.82	X
23044	003	90	2	X	1,731.08	X
23065	004	10	2	X	310.93	X
23065	003	10	2	X	278.79	X
23065	002	10	2	X	276.44	X
23065	001	10	2	X	331.83	X
23066	002	90	2	X	418.36	X
23066	003	90	2	X	405.19	X
23066	001	90	2	X	425.07	X
23066	004	90	2	X	387.41	X
23071	004	90	2	X	701.57	X
23071	001	90	2	X	789.43	X
23071	003	90	2	X	701.57	X
23071	002	90	2	X	701.57	X
23073	002	90	2	X	1,163.90	X
23073	003	90	2	X	1,163.90	X
23073	001	90	2	X	1,306.94	X
23073	004	90	2	X	1,163.90	X
23075	001	90	2	X	488.30	X
23075	004	90	2	X	422.25	X
23075	003	90	2	X	450.67	X
23075	002	90	2	X	483.10	X
23076	002	90	2	X	1,153.98	X
23076	003	90	2	X	1,121.01	X
23076	004	90	2	X	1,108.59	X
23076	001	90	2	X	1,223.98	X
23077	004	90	2	X	2,426.96	X
23077	002	90	2	X	1,872.08	X
23077	003	90	2	X	1,784.28	X
23077	001	90	2	X	1,883.76	X
23078	004	90	2	X	2,375.24	X
23078	001	90	2	X	2,657.20	X
23078	002	90	2	X	2,375.24	X
23078	003	90	2	X	2,375.24	X
23100	004	90	2	X	1,447.73	X
23100	003	90	2	X	1,608.20	X
23100	002	90	2	X	1,729.37	X
23100	001	90	2	X	1,613.18	X
23101	003	90	2	X	1,570.24	X
23101	002	90	2	X	1,689.37	X
23101	001	90	2	X	1,703.32	X
23101	004	90	2	X	1,358.31	X
23105	001	90	2	X	2,389.43	X
23105	004	90	2	X	1,991.45	X
23105	002	90	2	X	2,332.83	X
23105	003	90	2	X	2,168.60	X
23106	001	90	2	X	2,340.24	X
23106	004	90	2	X	1,145.44	X
23106	002	90	2	X	1,241.28	X
23106	003	90	2	X	2,196.20	X
23107	002	90	2	X	2,168.54	X
23107	003	90	2	X	2,011.11	X
23107	004	90	2	X	1,986.65	X
23107	001	90	2	X	2,206.64	X
23120	004	90	2	X	1,470.58	X
23120	002	90	2	X	1,510.78	X
23120	003	90	2	X	1,476.61	X
23120	001	90	2	X	1,519.00	X
23125	003	90	2	X	1,944.33	X
23125	002	90	2	X	2,368.50	X
23125	004	90	2	X	1,921.06	X
23125	001	90	2	X	2,113.54	X
23130	001	90	2	X	1,738.27	X
23130	003	90	2	X	1,593.40	X
23130	002	90	2	X	1,710.11	X
23130	004	90	2	X	1,594.68	X
23140	004	90	2	X	1,171.15	X
23140	002	90	2	X	1,262.16	X
23140	003	90	2	X	1,184.51	X
23140	001	90	2	X	1,280.98	X
23145	001	90	2	X	2,044.52	X
23145	003	90	2	X	1,875.45	X
23145	002	90	2	X	2,011.62	X
23145	004	90	2	X	1,853.23	X
23146	002	90	2	X	1,519.46	X
23146	003	90	2	X	1,419.48	X
23146	004	90	2	X	1,403.29	X
23146	001	90	2	X	1,543.73	X
23150	001	90	2	X	1,748.19	X
23150	004	90	2	X	2,028.45	X
23150	003	90	2	X	2,036.42	X
23150	002	90	2	X	2,082.48	X
23155	004	90	2	X	2,036.01	X
23155	001	90	2	X	2,241.01	X
23155	002	90	2	X	2,205.86	X
23155	003	90	2	X	2,060.56	X
23156	001	90	2	X	1,918.78	X
23156	003	90	2	X	1,760.01	X
23156	002	90	2	X	1,887.84	X
23156	004	90	2	X	1,739.06	X
23170	001	90	2	X	1,342.33	X
23170	002	90	2	X	1,322.07	X
23170	003	90	2	X	1,238.49	X
23170	004	90	2	X	1,224.19	X
23172	001	90	2	X	1,369.73	X
23172	004	90	2	X	1,251.41	X
23172	003	90	2	X	1,266.45	X
23172	002	90	2	X	1,216.27	X
23174	001	90	2	X	2,090.60	X
23174	003	90	2	X	1,925.14	X
23174	002	90	2	X	2,058.48	X
23174	004	90	2	X	1,901.87	X
23180	001	90	2	X	1,438.79	X
23180	004	90	2	X	1,325.33	X
23180	002	90	2	X	1,419.56	X
23180	003	90	2	X	1,198.43	X
23182	004	90	2	X	1,560.12	X
23182	002	90	2	X	1,692.81	X
23182	003	90	2	X	1,578.70	X
23182	001	90	2	X	1,720.40	X
23184	002	90	2	X	2,120.60	X
23184	003	90	2	X	1,972.29	X
23184	004	90	2	X	1,471.32	X
23184	001	90	2	X	2,156.45	X
23190	003	90	2	X	1,443.15	X
23190	002	90	2	X	1,526.40	X
23190	004	90	2	X	1,426.12	X
23190	001	90	2	X	1,570.12	X
23195	004	90	2	X	1,993.96	X
23195	002	90	2	X	2,166.51	X
23195	003	90	2	X	2,018.15	X
23195	001	90	2	X	2,202.30	X
23200	003	90	2	X	2,240.64	X
23200	002	90	2	X	2,385.14	X
23200	001	90	2	X	2,421.30	X
23200	004	90	2	X	2,214.05	X
23210	003	90	2	X	2,278.03	X
23210	002	90	2	X	2,431.21	X
23210	001	90	2	X	4,006.58	X
23210	004	90	2	X	2,251.52	X
23220	003	90	2	X	3,037.32	X
23220	002	90	2	X	3,124.02	X
23220	001	90	2	X	3,112.88	X
23220	004	90	2	X	2,822.67	X
23330	004	10	2	X	252.18	X
23330	001	10	2	X	269.10	X
23330	003	10	2	X	254.90	X
23330	002	10	2	X	266.28	X
23333	004	90	2	X	725.32	X
23333	001	90	2	X	808.11	X
23333	003	90	2	X	725.32	X
23333	002	90	2	X	725.32	X
23334	001	90	2	X	1,908.77	X
23334	003	90	2	X	1,720.14	X
23334	002	90	2	X	1,720.14	X
23334	004	90	2	X	1,720.14	X
23335	002	90	2	X	2,054.27	X
23335	003	90	2	X	2,054.27	X
23335	004	90	2	X	2,054.27	X
23335	001	90	2	X	2,276.44	X
23350	002	0	2	X	161.84	X
23350	003	0	2	X	154.14	X
23350	004	0	2	X	152.40	X
23350	001	0	2	X	163.62	X
23395	001	90	2	X	2,883.48	X
23395	004	90	2	X	2,616.88	X
23395	003	90	2	X	2,648.14	X
23395	002	90	2	X	2,837.65	X
23397	004	90	2	X	3,251.31	X
23397	002	90	2	X	3,528.91	X
23397	003	90	2	X	3,290.26	X
23397	001	90	2	X	3,586.65	X
23400	004	90	2	X	2,527.41	X
23400	001	90	2	X	2,774.78	X
23400	002	90	2	X	2,732.30	X
23400	003	90	2	X	2,556.96	X
23405	003	90	2	X	1,714.35	X
23405	002	90	2	X	1,828.65	X
23405	001	90	2	X	1,856.28	X
23405	004	90	2	X	1,693.69	X
23406	001	90	2	X	2,422.91	X
23406	003	90	2	X	2,222.90	X
23406	002	90	2	X	2,383.91	X
23406	004	90	2	X	2,196.65	X
23410	001	90	2	X	2,790.69	X
23410	004	90	2	X	2,533.48	X
23410	003	90	2	X	2,564.00	X
23410	002	90	2	X	2,746.55	X
23412	002	90	2	X	3,142.08	X
23412	003	90	2	X	2,971.54	X
23412	004	90	2	X	2,903.64	X
23412	001	90	2	X	3,299.63	X
23415	002	90	2	X	2,224.65	X
23415	003	90	2	X	2,196.96	X
23415	004	90	2	X	2,207.09	X
23415	001	90	2	X	2,202.56	X
23420	002	90	2	X	3,238.37	X
23420	003	90	2	X	3,055.67	X
23420	004	90	2	X	3,049.21	X
23420	001	90	2	X	3,258.44	X
23430	004	90	2	X	1,867.35	X
23430	001	90	2	X	2,047.29	X
23430	002	90	2	X	2,016.54	X
23430	003	90	2	X	1,889.27	X
23440	002	90	2	X	2,051.20	X
23440	003	90	2	X	1,924.66	X
23440	004	90	2	X	1,902.49	X
23440	001	90	2	X	2,081.86	X
23450	001	90	2	X	2,991.38	X
23450	002	90	2	X	3,102.52	X
23450	003	90	2	X	2,879.69	X
23450	004	90	2	X	2,845.17	X
23455	004	90	2	X	3,278.06	X
23455	001	90	2	X	3,631.57	X
23455	002	90	2	X	3,570.56	X
23455	003	90	2	X	3,318.29	X
23460	004	90	2	X	3,189.39	X
23460	003	90	2	X	3,227.92	X
23460	002	90	2	X	3,460.31	X
23460	001	90	2	X	3,516.52	X
23462	001	90	2	X	3,669.33	X
23462	003	90	2	X	3,357.89	X
23462	002	90	2	X	3,608.66	X
23462	004	90	2	X	3,317.53	X
23465	001	90	2	X	3,491.99	X
23465	004	90	2	X	3,252.53	X
23465	002	90	2	X	3,444.62	X
23465	003	90	2	X	3,025.17	X
23466	001	90	2	X	3,747.34	X
23466	003	90	2	X	3,417.11	X
23466	002	90	2	X	3,682.98	X
23466	004	90	2	X	3,375.39	X
23470	001	90	2	X	4,079.67	X
23470	004	90	2	X	3,657.05	X
23470	002	90	2	X	3,974.36	X
23470	003	90	2	X	3,701.55	X
23472	004	90	2	X	4,913.40	X
23472	002	90	2	X	6,269.32	X
23472	003	90	2	X	6,097.50	X
23472	001	90	2	X	5,526.54	X
23473	004	90	2	X	2,624.47	X
23473	002	90	2	X	2,624.47	X
23473	003	90	2	X	2,624.47	X
23473	001	90	2	X	2,928.68	X
23474	003	90	2	X	2,837.41	X
23474	002	90	2	X	2,837.41	X
23474	004	90	2	X	2,837.41	X
23474	001	90	2	X	3,166.35	X
23480	003	90	2	X	1,900.82	X
23480	002	90	2	X	2,017.77	X
23480	001	90	2	X	2,046.28	X
23480	004	90	2	X	1,879.19	X
23485	001	90	2	X	2,941.47	X
23485	002	90	2	X	2,839.25	X
23485	003	90	2	X	2,701.84	X
23485	004	90	2	X	2,669.89	X
23490	002	90	2	X	2,432.05	X
23490	003	90	2	X	2,092.66	X
23490	004	90	2	X	2,274.98	X
23490	001	90	2	X	2,463.03	X
23491	003	90	2	X	2,833.74	X
23491	002	90	2	X	3,180.07	X
23491	001	90	2	X	3,232.15	X
23491	004	90	2	X	2,929.76	X
23500	004	90	2	X	414.60	X
23500	002	90	2	X	479.87	X
23500	003	90	2	X	409.22	X
23500	001	90	2	X	428.51	X
23505	004	90	2	X	669.95	X
23505	001	90	2	X	685.30	X
23505	003	90	2	X	665.56	X
23505	002	90	2	X	721.00	X
23515	004	90	2	X	1,550.97	X
23515	002	90	2	X	1,684.53	X
23515	003	90	2	X	1,569.83	X
23515	001	90	2	X	1,712.29	X
23520	001	90	2	X	404.59	X
23520	004	90	2	X	371.95	X
23520	002	90	2	X	399.14	X
23520	003	90	2	X	372.20	X
23525	004	90	2	X	584.40	X
23525	001	90	2	X	633.12	X
23525	002	90	2	X	624.98	X
23525	003	90	2	X	591.09	X
23530	002	90	2	X	1,614.87	X
23530	003	90	2	X	1,512.48	X
23530	001	90	2	X	1,639.63	X
23530	004	90	2	X	1,494.23	X
23532	001	90	2	X	1,819.07	X
23532	002	90	2	X	1,789.64	X
23532	003	90	2	X	1,668.26	X
23532	004	90	2	X	1,648.43	X
23540	002	90	2	X	424.82	X
23540	003	90	2	X	400.76	X
23540	001	90	2	X	430.62	X
23540	004	90	2	X	396.12	X
23545	004	90	2	X	568.63	X
23545	001	90	2	X	661.25	X
23545	002	90	2	X	657.83	X
23545	003	90	2	X	582.12	X
23550	001	90	2	X	1,902.26	X
23550	004	90	2	X	1,706.92	X
23550	003	90	2	X	1,728.04	X
23550	002	90	2	X	1,953.56	X
23552	003	90	2	X	1,698.44	X
23552	002	90	2	X	1,819.88	X
23552	004	90	2	X	1,678.26	X
23552	001	90	2	X	1,849.31	X
23570	001	90	2	X	456.73	X
23570	003	90	2	X	422.20	X
23570	002	90	2	X	449.99	X
23570	004	90	2	X	417.26	X
23575	003	90	2	X	745.88	X
23575	002	90	2	X	784.48	X
23575	004	90	2	X	728.45	X
23575	001	90	2	X	795.95	X
23585	003	90	2	X	1,814.35	X
23585	002	90	2	X	1,945.56	X
23585	001	90	2	X	1,977.33	X
23585	004	90	2	X	1,792.80	X
23600	003	90	2	X	749.08	X
23600	002	90	2	X	743.19	X
23600	004	90	2	X	729.94	X
23600	001	90	2	X	718.22	X
23605	004	90	2	X	1,037.15	X
23605	001	90	2	X	1,222.92	X
23605	003	90	2	X	1,129.95	X
23605	002	90	2	X	1,240.43	X
23615	001	90	2	X	2,637.09	X
23615	003	90	2	X	2,171.17	X
23615	002	90	2	X	2,344.79	X
23615	004	90	2	X	2,257.88	X
23616	001	90	2	X	4,033.71	X
23616	002	90	2	X	5,121.40	X
23616	003	90	2	X	4,761.79	X
23616	004	90	2	X	3,524.59	X
23620	004	90	2	X	741.51	X
23620	001	90	2	X	733.16	X
23620	002	90	2	X	768.12	X
23620	003	90	2	X	747.74	X
23625	001	90	2	X	916.59	X
23625	003	90	2	X	839.59	X
23625	002	90	2	X	901.58	X
23625	004	90	2	X	856.09	X
23630	003	90	2	X	2,139.95	X
23630	002	90	2	X	2,198.64	X
23630	004	90	2	X	2,130.72	X
23630	001	90	2	X	2,212.86	X
23650	004	90	2	X	612.26	X
23650	003	90	2	X	590.95	X
23650	002	90	2	X	637.36	X
23650	001	90	2	X	668.72	X
23655	004	90	2	X	787.95	X
23655	001	90	2	X	859.30	X
23655	002	90	2	X	847.13	X
23655	003	90	2	X	797.07	X
23660	002	90	2	X	2,356.73	X
23660	003	90	2	X	2,234.89	X
23660	001	90	2	X	2,438.05	X
23660	004	90	2	X	2,265.33	X
23665	003	90	2	X	858.18	X
23665	002	90	2	X	894.51	X
23665	004	90	2	X	854.68	X
23665	001	90	2	X	908.19	X
23670	001	90	2	X	2,254.52	X
23670	004	90	2	X	2,015.49	X
23670	002	90	2	X	2,212.86	X
23670	003	90	2	X	2,128.83	X
23675	004	90	2	X	1,047.38	X
23675	002	90	2	X	1,127.82	X
23675	003	90	2	X	1,059.55	X
23675	001	90	2	X	1,144.30	X
23680	004	90	2	X	2,446.27	X
23680	001	90	2	X	2,728.14	X
23680	003	90	2	X	2,476.69	X
23680	002	90	2	X	2,679.19	X
23700	001	10	2	X	724.45	X
23700	004	10	2	X	703.42	X
23700	003	10	2	X	705.94	X
23700	002	10	2	X	718.96	X
23800	004	90	2	X	3,318.99	X
23800	001	90	2	X	3,685.53	X
23800	003	90	2	X	3,360.13	X
23800	002	90	2	X	3,622.16	X
23802	001	90	2	X	3,517.61	X
23802	004	90	2	X	3,190.41	X
23802	002	90	2	X	3,461.40	X
23802	003	90	2	X	3,228.97	X
23900	004	90	2	X	3,449.74	X
23900	003	90	2	X	3,489.36	X
23900	002	90	2	X	3,730.58	X
23900	001	90	2	X	3,789.16	X
23920	002	90	2	X	3,368.35	X
23920	003	90	2	X	3,125.01	X
23920	001	90	2	X	3,427.21	X
23920	004	90	2	X	3,087.94	X
23921	003	90	2	X	1,048.68	X
23921	002	90	2	X	1,123.83	X
23921	004	90	2	X	1,036.40	X
23921	001	90	2	X	1,142.06	X
23929		YYY	2	X	#	X
23930	003	10	2	X	484.53	X
23930	002	10	2	X	513.04	X
23930	004	10	2	X	486.35	X
23930	001	10	2	X	520.03	X
23931	001	10	2	X	278.90	X
23931	004	10	2	X	257.77	X
23931	002	10	2	X	278.29	X
23931	003	10	2	X	261.39	X
23935	003	90	2	X	1,150.88	X
23935	002	90	2	X	1,231.85	X
23935	004	90	2	X	1,137.38	X
23935	001	90	2	X	1,251.39	X
24000	002	90	2	X	1,821.07	X
24000	003	90	2	X	1,888.42	X
24000	004	90	2	X	1,513.88	X
24000	001	90	2	X	1,697.74	X
24006	004	90	2	X	1,754.92	X
24006	001	90	2	X	1,928.28	X
24006	003	90	2	X	1,775.68	X
24006	002	90	2	X	1,898.50	X
24065	001	10	2	X	324.85	X
24065	004	10	2	X	303.05	X
24065	003	10	2	X	274.29	X
24065	002	10	2	X	321.26	X
24066	002	90	2	X	586.86	X
24066	003	90	2	X	569.51	X
24066	001	90	2	X	602.71	X
24066	004	90	2	X	835.73	X
24071	004	90	2	X	680.08	X
24071	002	90	2	X	680.08	X
24071	003	90	2	X	680.08	X
24071	001	90	2	X	764.99	X
24073	004	90	2	X	1,169.58	X
24073	001	90	2	X	1,313.30	X
24073	003	90	2	X	1,169.58	X
24073	002	90	2	X	1,169.58	X

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