Part B Fee Schedules

Fee Schedule 33677-35011

CPT/HCPC Code	Medicare Location	Global Surgery Indicator	Multiple Surgery Indicator	Prevailing Charge Amount	Fee Schedule Amount	Site of Service Amount
33677	004	90	2	X	3,855.02	X
33677	003	90	2	X	3,855.02	X
33677	002	90	2	X	3,855.02	X
33677	001	90	2	X	4,399.45	X
33681	002	90	2	X	8,001.99	X
33681	003	90	2	X	7,405.98	X
33681	004	90	2	X	7,300.01	X
33681	001	90	2	X	8,284.29	X
33684	001	90	2	X	8,514.95	X
33684	004	90	2	X	7,520.22	X
33684	003	90	2	X	7,628.51	X
33684	002	90	2	X	8,229.74	X
33688	002	90	2	X	8,343.03	X
33688	003	90	2	X	7,739.21	X
33688	001	90	2	X	8,629.71	X
33688	004	90	2	X	7,629.82	X
33690	004	90	2	X	4,834.98	X
33690	002	90	2	X	5,297.90	X
33690	003	90	2	X	4,904.24	X
33690	001	90	2	X	5,486.01	X
33692	001	90	2	X	9,261.55	X
33692	004	90	2	X	8,140.82	X
33692	003	90	2	X	8,258.82	X
33692	002	90	2	X	8,937.72	X
33694	003	90	2	X	8,370.62	X
33694	002	90	2	X	9,052.16	X
33694	004	90	2	X	8,251.56	X
33694	001	90	2	X	9,377.46	X
33697	003	90	2	X	8,593.14	X
33697	002	90	2	X	9,279.91	X
33697	004	90	2	X	8,471.86	X
33697	001	90	2	X	9,608.18	X
33702	003	90	2	X	6,719.81	X
33702	002	90	2	X	7,240.70	X
33702	004	90	2	X	6,624.75	X
33702	001	90	2	X	7,487.19	X
33710	001	90	2	X	8,519.73	X
33710	004	90	2	X	7,524.75	X
33710	002	90	2	X	8,234.43	X
33710	003	90	2	X	7,633.08	X
33720	004	90	2	X	6,624.75	X
33720	001	90	2	X	7,487.19	X
33720	003	90	2	X	6,719.81	X
33720	002	90	2	X	7,240.70	X
33724	002	90	2	X	2,579.22	X
33724	003	90	2	X	2,579.22	X
33724	001	90	2	X	2,925.75	X
33724	004	90	2	X	2,579.22	X
33726	001	90	2	X	3,843.94	X
33726	004	90	2	X	3,402.05	X
33726	002	90	2	X	3,402.05	X
33726	003	90	2	X	3,402.05	X
33730	001	90	2	X	9,333.79	X
33730	004	90	2	X	8,209.75	X
33730	003	90	2	X	8,328.37	X
33730	002	90	2	X	9,008.94	X
33732	004	90	2	X	6,910.55	X
33732	001	90	2	X	7,798.07	X
33732	003	90	2	X	7,009.30	X
33732	002	90	2	X	7,544.60	X
33735	004	90	2	X	5,460.38	X
33735	002	90	2	X	5,988.76	X
33735	001	90	2	X	6,203.01	X
33735	003	90	2	X	5,539.29	X
33736	001	90	2	X	5,804.48	X
33736	004	90	2	X	5,188.02	X
33736	003	90	2	X	5,251.72	X
33736	002	90	2	X	5,696.71	X
33737	004	90	2	X	5,520.27	X
33737	001	90	2	X	6,265.69	X
33737	003	90	2	X	5,599.81	X
33737	002	90	2	X	6,050.70	X
33741	002	0	2	X	990.92	X
33741	003	0	2	X	990.92	X
33741	001	0	2	X	1,083.13	X
33741	004	0	2	X	990.92	X
33745	001	0	2	X	1,526.08	X
33745	002	0	2	X	1,400.68	X
33745	003	0	2	X	1,400.68	X
33745	004	0	2	X	1,400.68	X
33746	004	ZZZ	0	X	554.09	X
33746	001	ZZZ	0	X	602.21	X
33746	002	ZZZ	0	X	554.09	X
33746	003	ZZZ	0	X	554.09	X
33750	004	90	2	X	5,042.89	X
33750	001	90	2	X	5,703.63	X
33750	002	90	2	X	5,512.76	X
33750	003	90	2	X	5,114.30	X
33755	003	90	2	X	5,154.17	X
33755	002	90	2	X	5,553.59	X
33755	004	90	2	X	5,082.40	X
33755	001	90	2	X	5,745.11	X
33762	003	90	2	X	5,154.17	X
33762	001	90	2	X	5,745.11	X
33762	002	90	2	X	5,553.59	X
33762	004	90	2	X	5,082.40	X
33764	001	90	2	X	7,216.25	X
33764	004	90	2	X	7,216.25	X
33764	002	90	2	X	7,216.25	X
33764	003	90	2	X	7,216.25	X
33766	002	90	2	X	5,666.87	X
33766	003	90	2	X	5,264.90	X
33766	001	90	2	X	5,859.85	X
33766	004	90	2	X	5,192.03	X
33767	001	90	2	X	6,612.28	X
33767	003	90	2	X	5,934.10	X
33767	002	90	2	X	6,392.90	X
33767	004	90	2	X	5,851.25	X
33768	004	ZZZ	0	X	826.60	X
33768	002	ZZZ	0	X	826.60	X
33768	003	ZZZ	0	X	826.60	X
33768	001	ZZZ	0	X	925.32	X
33770	002	90	2	X	9,250.76	X
33770	003	90	2	X	8,564.58	X
33770	001	90	2	X	9,578.55	X
33770	004	90	2	X	8,443.64	X
33771	001	90	2	X	9,724.11	X
33771	004	90	2	X	8,582.55	X
33771	003	90	2	X	8,705.07	X
33771	002	90	2	X	9,394.40	X
33774	001	90	2	X	8,057.11	X
33774	002	90	2	X	7,800.43	X
33774	003	90	2	X	7,259.19	X
33774	004	90	2	X	7,157.98	X
33775	001	90	2	X	8,201.46	X
33775	004	90	2	X	7,295.75	X
33775	002	90	2	X	7,942.83	X
33775	003	90	2	X	7,398.37	X
33776	002	90	2	X	8,685.23	X
33776	003	90	2	X	8,073.56	X
33776	004	90	2	X	7,960.80	X
33776	001	90	2	X	8,976.35	X
33777	004	90	2	X	7,434.71	X
33777	001	90	2	X	8,346.97	X
33777	003	90	2	X	7,538.78	X
33777	002	90	2	X	8,086.51	X
33778	002	90	2	X	15,353.83	X
33778	003	90	2	X	15,353.83	X
33778	004	90	2	X	15,353.83	X
33778	001	90	2	X	15,353.83	X
33779	001	90	2	X	15,353.83	X
33779	004	90	2	X	15,353.83	X
33779	003	90	2	X	15,353.83	X
33779	002	90	2	X	15,353.83	X
33780	002	90	2	X	15,353.83	X
33780	003	90	2	X	15,353.83	X
33780	001	90	2	X	15,353.83	X
33780	004	90	2	X	15,353.83	X
33781	001	90	2	X	15,353.83	X
33781	004	90	2	X	15,353.83	X
33781	003	90	2	X	15,353.83	X
33781	002	90	2	X	15,353.83	X
33782	001	90	2	X	5,354.34	X
33782	004	90	2	X	5,037.02	X
33782	002	90	2	X	5,037.02	X
33782	003	90	2	X	5,037.02	X
33783	002	90	2	X	5,501.55	X
33783	003	90	2	X	5,501.55	X
33783	004	90	2	X	5,501.55	X
33783	001	90	2	X	5,871.57	X
33786	002	90	2	X	13,511.38	X
33786	003	90	2	X	13,511.38	X
33786	004	90	2	X	13,511.38	X
33786	001	90	2	X	13,511.38	X
33788		90	2	X	*	X
33800	004	90	2	X	2,931.83	X
33800	002	90	2	X	3,177.18	X
33800	003	90	2	X	2,965.67	X
33800	001	90	2	X	3,228.56	X
33802	001	90	2	X	5,283.69	X
33802	002	90	2	X	5,098.12	X
33802	003	90	2	X	4,709.11	X
33802	004	90	2	X	4,641.85	X
33803	004	90	2	X	4,860.95	X
33803	001	90	2	X	5,513.24	X
33803	002	90	2	X	5,324.63	X
33803	003	90	2	X	4,930.58	X
33813	004	90	2	X	7,369.86	X
33813	001	90	2	X	7,369.86	X
33813	003	90	2	X	7,369.86	X
33813	002	90	2	X	7,369.86	X
33814	001	90	2	X	8,598.09	X
33814	004	90	2	X	8,598.09	X
33814	003	90	2	X	8,598.09	X
33814	002	90	2	X	8,598.09	X
33820	004	90	2	X	4,105.32	X
33820	001	90	2	X	4,105.32	X
33820	003	90	2	X	4,105.32	X
33820	002	90	2	X	4,105.32	X
33822	001	90	2	X	5,283.69	X
33822	003	90	2	X	4,709.11	X
33822	002	90	2	X	5,098.12	X
33822	004	90	2	X	4,641.85	X
33824	001	90	2	X	5,513.24	X
33824	004	90	2	X	4,860.95	X
33824	002	90	2	X	5,324.63	X
33824	003	90	2	X	4,930.58	X
33840	002	90	2	X	7,247.00	X
33840	003	90	2	X	7,247.00	X
33840	001	90	2	X	7,247.00	X
33840	004	90	2	X	7,247.00	X
33845	004	90	2	X	8,871.39	X
33845	002	90	2	X	8,871.39	X
33845	003	90	2	X	8,871.39	X
33845	001	90	2	X	8,871.39	X
33851	001	90	2	X	8,598.09	X
33851	004	90	2	X	8,598.09	X
33851	003	90	2	X	8,598.09	X
33851	002	90	2	X	8,598.09	X
33852	004	90	2	X	9,212.33	X
33852	001	90	2	X	9,212.33	X
33852	003	90	2	X	9,212.33	X
33852	002	90	2	X	9,212.33	X
33853	004	90	2	X	10,619.74	X
33853	002	90	2	X	10,619.74	X
33853	001	90	2	X	10,619.74	X
33853	003	90	2	X	10,619.74	X
33858	004	90	2	X	4,809.52	X
33858	001	90	2	X	5,286.22	X
33858	003	90	2	X	4,809.52	X
33858	002	90	2	X	4,809.52	X
33859	003	90	2	X	3,451.44	X
33859	002	90	2	X	3,451.44	X
33859	004	90	2	X	3,451.44	X
33859	001	90	2	X	3,794.55	X
33863	003	90	2	X	9,658.93	X
33863	002	90	2	X	9,718.54	X
33863	001	90	2	X	9,973.17	X
33863	004	90	2	X	9,603.13	X
33864	003	90	2	X	5,477.22	X
33864	002	90	2	X	5,477.22	X
33864	004	90	2	X	5,477.22	X
33864	001	90	2	X	6,067.40	X
33866	002	ZZZ	0	X	1,477.38	X
33866	003	ZZZ	0	X	1,477.38	X
33866	001	ZZZ	0	X	1,610.87	X
33866	004	ZZZ	0	X	1,477.38	X
33871	003	90	2	X	4,624.00	X
33871	002	90	2	X	4,624.00	X
33871	004	90	2	X	4,624.00	X
33871	001	90	2	X	5,083.93	X
33875	004	90	2	X	8,744.34	X
33875	003	90	2	X	8,873.24	X
33875	002	90	2	X	9,331.82	X
33875	001	90	2	X	9,099.84	X
33877	004	90	2	X	10,343.41	X
33877	001	90	2	X	10,804.00	X
33877	003	90	2	X	10,332.86	X
33877	002	90	2	X	10,687.36	X
33880	001	90	2	X	3,798.64	X
33880	004	90	2	X	3,446.25	X
33880	003	90	2	X	3,446.25	X
33880	002	90	2	X	3,446.25	X
33881	003	90	2	X	2,958.37	X
33881	002	90	2	X	2,958.37	X
33881	001	90	2	X	3,264.91	X
33881	004	90	2	X	2,958.37	X
33883	001	90	2	X	2,428.54	X
33883	004	90	2	X	2,181.42	X
33883	003	90	2	X	2,181.42	X
33883	002	90	2	X	2,181.42	X
33884	001	ZZZ	0	X	899.57	X
33884	004	ZZZ	0	X	815.85	X
33884	002	ZZZ	0	X	815.85	X
33884	003	ZZZ	0	X	815.85	X
33886	003	90	2	X	1,882.15	X
33886	002	90	2	X	1,882.15	X
33886	004	90	2	X	1,882.15	X
33886	001	90	2	X	2,098.60	X
33889	002	0	2	X	1,625.18	X
33889	003	0	2	X	1,625.18	X
33889	001	0	2	X	1,811.48	X
33889	004	0	2	X	1,625.18	X
33891	002	0	2	X	2,071.47	X
33891	003	0	2	X	2,071.47	X
33891	004	0	2	X	2,071.47	X
33891	001	0	2	X	2,312.03	X
33894	003	0	2	X	1,154.89	X
33894	002	0	2	X	1,154.89	X
33894	001	0	2	X	1,258.34	X
33894	004	0	2	X	1,154.89	X
33895	002	0	2	X	918.90	X
33895	003	0	2	X	918.90	X
33895	001	0	2	X	1,001.19	X
33895	004	0	2	X	918.90	X
33897	001	0	2	X	745.50	X
33897	004	0	2	X	684.04	X
33897	003	0	2	X	684.04	X
33897	002	0	2	X	684.04	X
33900	002	0	2	X	663.19	X
33900	003	0	2	X	663.19	X
33900	004	0	2	X	663.19	X
33900	001	0	2	X	718.85	X
33901	002	0	2	X	871.61	X
33901	003	0	2	X	871.61	X
33901	004	0	2	X	871.61	X
33901	001	0	2	X	944.70	X
33902	004	0	2	X	842.13	X
33902	001	0	2	X	912.89	X
33902	003	0	2	X	842.13	X
33902	002	0	2	X	842.13	X
33903	002	0	2	X	992.43	X
33903	003	0	2	X	992.43	X
33903	004	0	2	X	992.43	X
33903	001	0	2	X	1,075.78	X
33904	003	ZZZ	0	X	333.10	X
33904	002	ZZZ	0	X	333.10	X
33904	004	ZZZ	0	X	333.10	X
33904	001	ZZZ	0	X	361.17	X
33910	001	90	2	X	4,456.12	X
33910	002	90	2	X	6,166.12	X
33910	003	90	2	X	4,107.32	X
33910	004	90	2	X	4,060.85	X
33915	001	90	2	X	3,745.78	X
33915	004	90	2	X	3,421.09	X
33915	003	90	2	X	3,460.15	X
33915	002	90	2	X	4,499.45	X
33916	004	90	2	X	4,668.03	X
33916	001	90	2	X	5,140.40	X
33916	003	90	2	X	4,721.87	X
33916	002	90	2	X	5,058.63	X
33917	004	90	2	X	6,948.75	X
33917	002	90	2	X	7,638.18	X
33917	003	90	2	X	7,050.91	X
33917	001	90	2	X	7,915.85	X
33920	002	90	2	X	9,109.38	X
33920	003	90	2	X	8,426.60	X
33920	001	90	2	X	9,435.41	X
33920	004	90	2	X	8,306.89	X
33922	001	90	2	X	4,456.12	X
33922	004	90	2	X	4,060.85	X
33922	002	90	2	X	4,387.98	X
33922	003	90	2	X	4,107.32	X
33924	001	ZZZ	0	X	1,246.38	X
33924	004	ZZZ	0	X	1,102.03	X
33924	002	ZZZ	0	X	1,190.37	X
33924	003	ZZZ	0	X	1,118.23	X
33925	004	90	2	X	3,378.81	X
33925	003	90	2	X	3,378.81	X
33925	002	90	2	X	3,378.81	X
33925	001	90	2	X	3,823.04	X
33926	004	90	2	X	4,580.26	X
33926	001	90	2	X	5,151.02	X
33926	003	90	2	X	4,580.26	X
33926	002	90	2	X	4,580.26	X
33927	002	XXX	2	X	3,857.25	X
33927	003	XXX	2	X	3,857.25	X
33927	004	XXX	2	X	3,857.25	X
33927	001	XXX	2	X	4,218.61	X
33928		XXX	2	X	#	X
33929		ZZZ	0	X	#	X
33933		XXX	2	X	*	X
33935	004	90	2	X	14,385.28	X
33935	001	90	2	X	16,217.21	X
33935	002	90	2	X	15,694.88	X
33935	003	90	2	X	14,590.56	X
33944		XXX	2	X	*	X
33945	003	90	2	X	16,652.74	X
33945	002	90	2	X	16,652.74	X
33945	001	90	2	X	16,652.74	X
33945	004	90	2	X	16,652.74	X
33946	002	XXX	0	X	507.43	X
33946	003	XXX	0	X	507.43	X
33946	001	XXX	0	X	551.25	X
33946	004	XXX	0	X	507.43	X
33947	001	XXX	0	X	599.18	X
33947	003	XXX	0	X	552.92	X
33947	002	XXX	0	X	552.92	X
33947	004	XXX	0	X	552.92	X
33948	002	XXX	0	X	387.39	X
33948	003	XXX	0	X	387.39	X
33948	004	XXX	0	X	387.39	X
33948	001	XXX	0	X	418.03	X
33949	002	XXX	0	X	378.00	X
33949	003	XXX	0	X	378.00	X
33949	004	XXX	0	X	378.00	X
33949	001	XXX	0	X	408.06	X
33951	001	0	2	X	665.11	660.84
33951	004	0	2	X	625.07	621.40
33951	003	0	2	X	625.07	621.40
33951	002	0	2	X	625.07	621.40
33952	003	0	2	X	609.89	605.16
33952	001	0	2	X	647.34	641.84
33952	002	0	2	X	609.89	605.16
33952	004	0	2	X	609.89	605.16
33953	004	0	2	X	695.96	692.30
33953	001	0	2	X	739.97	735.72
33953	002	0	2	X	695.96	692.30
33953	003	0	2	X	695.96	692.30
33954	002	0	2	X	679.18	673.96
33954	003	0	2	X	679.18	673.96
33954	001	0	2	X	720.36	714.23
33954	004	0	2	X	679.18	673.96
33955	001	0	2	X	1,563.70	1,558.20
33955	003	0	2	X	1,431.99	1,427.26
33955	002	0	2	X	1,431.99	1,427.26
33955	004	0	2	X	1,431.99	1,427.26
33956	002	0	2	X	1,358.13	1,352.90
33956	003	0	2	X	1,358.13	1,352.90
33956	001	0	2	X	1,477.28	1,471.18
33956	004	0	2	X	1,358.13	1,352.90
33957	001	0	2	X	551.89	546.36
33957	004	0	2	X	477.53	472.83
33957	002	0	2	X	477.53	472.83
33957	003	0	2	X	477.53	472.83
33958	001	0	2	X	540.23	535.94
33958	002	0	2	X	467.56	463.89
33958	003	0	2	X	467.56	463.89
33958	004	0	2	X	467.56	463.89
33959	004	0	2	X	551.01	546.31
33959	003	0	2	X	551.01	546.31
33959	002	0	2	X	551.01	546.31
33959	001	0	2	X	629.83	624.30
33962	001	0	2	X	602.23	596.11
33962	004	0	2	X	527.46	522.23
33962	003	0	2	X	527.46	522.23
33962	002	0	2	X	527.46	522.23
33963	004	0	2	X	896.99	892.30
33963	003	0	2	X	896.99	892.30
33963	002	0	2	X	896.99	892.30
33963	001	0	2	X	996.56	991.05
33964	003	0	2	X	909.49	905.82
33964	002	0	2	X	909.49	905.82
33964	001	0	2	X	1,006.95	1,002.68
33964	004	0	2	X	909.49	905.82
33965	001	0	2	X	546.36	551.89
33965	004	0	2	X	472.83	477.53
33965	002	0	2	X	472.83	477.53
33965	003	0	2	X	472.83	477.53
33966	002	0	2	X	524.43	529.65
33966	003	0	2	X	524.43	529.65
33966	001	0	2	X	598.45	604.58
33966	004	0	2	X	524.43	529.65
33967	001	0	2	X	617.49	613.05
33967	002	0	2	X	563.00	559.22
33967	003	0	2	X	563.00	559.22
33967	004	0	2	X	563.00	559.22
33968	002	0	0	X	93.09	X
33968	003	0	0	X	93.09	X
33968	004	0	0	X	93.09	X
33968	001	0	0	X	112.44	X
33969	003	0	2	X	549.56	545.37
33969	002	0	2	X	549.56	545.37
33969	004	0	2	X	549.56	545.37
33969	001	0	2	X	615.33	610.40
33970	001	0	2	X	2,379.79	X
33970	004	0	2	X	2,294.28	X
33970	002	0	2	X	2,234.61	X
33970	003	0	2	X	2,295.16	X
33971	004	90	2	X	924.98	X
33971	001	90	2	X	992.99	X
33971	003	90	2	X	932.58	X
33971	002	90	2	X	971.33	X
33973	004	0	2	X	2,353.69	X
33973	002	0	2	X	2,296.03	X
33973	003	0	2	X	2,355.08	X
33973	001	0	2	X	2,441.52	X
33974	001	90	2	X	1,319.22	X
33974	004	90	2	X	1,238.08	X
33974	002	90	2	X	1,295.60	X
33974	003	90	2	X	1,248.63	X
33975		XXX	2	X	*	X
33976	001	XXX	2	X	5,657.03	X
33976	004	XXX	2	X	5,137.10	X
33976	003	XXX	2	X	5,196.36	X
33976	002	XXX	2	X	5,567.05	X
33977		XXX	2	X	*	X
33978	001	XXX	2	X	4,151.09	X
33978	004	XXX	2	X	3,769.84	X
33978	003	XXX	2	X	3,813.25	X
33978	002	XXX	2	X	4,085.14	X
33979		XXX	2	X	*	X
33980		XXX	2	X	*	X
33981		XXX	2	X	*	X
33982		XXX	2	X	*	X
33983		XXX	2	X	*	X
33984	001	0	2	X	601.56	595.43
33984	002	0	2	X	539.50	534.29
33984	003	0	2	X	539.50	534.29
33984	004	0	2	X	539.50	534.29
33985	003	0	2	X	1,016.74	1,011.99
33985	002	0	2	X	1,016.74	1,011.99
33985	004	0	2	X	1,016.74	1,011.99
33985	001	0	2	X	1,134.90	1,129.37
33986	003	0	2	X	972.12	966.91
33986	002	0	2	X	972.12	966.91
33986	001	0	2	X	1,081.79	1,075.66
33986	004	0	2	X	972.12	966.91
33987	004	ZZZ	0	X	409.32	X
33987	002	ZZZ	0	X	409.32	X
33987	003	ZZZ	0	X	409.32	X
33987	001	ZZZ	0	X	458.57	X
33988	001	0	2	X	1,283.63	1,276.90
33988	004	0	2	X	1,193.21	1,187.47
33988	002	0	2	X	1,193.21	1,187.47
33988	003	0	2	X	1,193.21	1,187.47
33989	004	0	2	X	796.94	791.72
33989	002	0	2	X	796.94	791.72
33989	001	0	2	X	865.56	859.44
33989	003	0	2	X	796.94	791.72
33990	004	0	2	X	716.00	X
33990	001	0	2	X	796.96	X
33990	003	0	2	X	716.00	X
33990	002	0	2	X	716.00	X
33991	002	0	2	X	1,043.28	X
33991	003	0	2	X	1,043.28	X
33991	004	0	2	X	1,043.28	X
33991	001	0	2	X	1,161.15	X
33992	002	0	2	X	341.43	X
33992	003	0	2	X	341.43	X
33992	004	0	2	X	341.43	X
33992	001	0	2	X	379.50	X
33993	002	0	2	X	299.75	X
33993	003	0	2	X	299.75	X
33993	001	0	2	X	333.18	X
33993	004	0	2	X	299.75	X
33995	004	0	2	X	476.00	X
33995	001	0	2	X	519.50	X
33995	003	0	2	X	476.00	X
33995	002	0	2	X	476.00	X
33997	001	0	2	X	231.11	X
33997	004	0	2	X	211.75	X
33997	003	0	2	X	211.75	X
33997	002	0	2	X	211.75	X
33999		YYY	2	X	#	X
34001	002	90	2	X	3,412.80	X
34001	003	90	2	X	3,227.48	X
34001	004	90	2	X	3,232.02	X
34001	001	90	2	X	3,478.58	X
34051	001	90	2	X	2,719.86	X
34051	004	90	2	X	2,484.54	X
34051	003	90	2	X	2,654.67	X
34051	002	90	2	X	2,679.41	X
34101	004	90	2	X	2,328.14	X
34101	001	90	2	X	2,419.44	X
34101	003	90	2	X	1,958.69	X
34101	002	90	2	X	2,290.05	X
34111	004	90	2	X	2,221.42	X
34111	001	90	2	X	2,304.09	X
34111	003	90	2	X	2,229.88	X
34111	002	90	2	X	2,289.63	X
34151	003	90	2	X	3,356.54	X
34151	002	90	2	X	3,438.47	X
34151	004	90	2	X	3,331.18	X
34151	001	90	2	X	3,480.31	X
34201	002	90	2	X	2,297.43	X
34201	003	90	2	X	1,950.05	X
34201	004	90	2	X	2,458.93	X
34201	001	90	2	X	2,620.80	X
34203	001	90	2	X	2,788.26	X
34203	004	90	2	X	2,681.62	X
34203	003	90	2	X	2,697.21	X
34203	002	90	2	X	2,769.61	X
34401	002	90	2	X	2,386.07	X
34401	003	90	2	X	2,688.87	X
34401	001	90	2	X	2,389.28	X
34401	004	90	2	X	2,181.16	X
34421	003	90	2	X	2,471.02	X
34421	002	90	2	X	2,561.99	X
34421	004	90	2	X	2,428.07	X
34421	001	90	2	X	2,639.95	X
34451	003	90	2	X	2,434.15	X
34451	002	90	2	X	2,491.33	X
34451	004	90	2	X	2,679.78	X
34451	001	90	2	X	2,520.37	X
34471	001	90	2	X	1,474.09	X
34471	004	90	2	X	1,369.68	X
34471	002	90	2	X	1,456.56	X
34471	003	90	2	X	1,384.60	X
34490	001	90	2	X	1,901.39	X
34490	004	90	2	X	1,808.81	X
34490	003	90	2	X	1,898.72	X
34490	002	90	2	X	1,951.50	X
34501	001	90	2	X	3,684.92	X
34501	004	90	2	X	3,684.92	X
34501	002	90	2	X	3,684.92	X
34501	003	90	2	X	3,684.92	X
34502	004	90	2	X	4,954.20	X
34502	001	90	2	X	5,455.33	X
34502	003	90	2	X	5,011.31	X
34502	002	90	2	X	5,368.65	X
34510	001	90	2	X	3,684.92	X
34510	003	90	2	X	3,684.92	X
34510	002	90	2	X	3,684.92	X
34510	004	90	2	X	3,684.92	X
34520	004	90	2	X	4,606.12	X
34520	002	90	2	X	4,606.12	X
34520	003	90	2	X	4,606.12	X
34520	001	90	2	X	4,606.12	X
34530	002	90	2	X	3,684.92	X
34530	003	90	2	X	3,684.92	X
34530	001	90	2	X	3,684.92	X
34530	004	90	2	X	3,684.92	X
34701	004	90	2	X	1,863.16	X
34701	001	90	2	X	2,031.47	X
34701	003	90	2	X	1,863.16	X
34701	002	90	2	X	1,863.16	X
34702	004	90	2	X	2,784.78	X
34702	001	90	2	X	3,031.74	X
34702	003	90	2	X	2,784.78	X
34702	002	90	2	X	2,784.78	X
34703	004	90	2	X	2,100.92	X
34703	001	90	2	X	2,296.32	X
34703	003	90	2	X	2,100.92	X
34703	002	90	2	X	2,100.92	X
34704	002	90	2	X	3,496.64	X
34704	003	90	2	X	3,496.64	X
34704	004	90	2	X	3,496.64	X
34704	001	90	2	X	3,814.34	X
34705	001	90	2	X	2,522.98	X
34705	004	90	2	X	2,313.81	X
34705	002	90	2	X	2,313.81	X
34705	003	90	2	X	2,313.81	X
34706	001	90	2	X	3,797.34	X
34706	004	90	2	X	3,484.68	X
34706	003	90	2	X	3,484.68	X
34706	002	90	2	X	3,484.68	X
34707	004	90	2	X	1,738.18	X
34707	001	90	2	X	1,894.42	X
34707	003	90	2	X	1,738.18	X
34707	002	90	2	X	1,738.18	X
34708	004	90	2	X	2,799.66	X
34708	001	90	2	X	3,047.23	X
34708	003	90	2	X	2,799.66	X
34708	002	90	2	X	2,799.66	X
34709	001	ZZZ	0	X	534.33	X
34709	004	ZZZ	0	X	490.70	X
34709	003	ZZZ	0	X	490.70	X
34709	002	ZZZ	0	X	490.70	X
34710	004	90	2	X	1,211.13	X
34710	002	90	2	X	1,211.13	X
34710	003	90	2	X	1,211.13	X
34710	001	90	2	X	1,323.03	X
34711	004	ZZZ	0	X	453.06	X
34711	003	ZZZ	0	X	453.06	X
34711	002	ZZZ	0	X	453.06	X
34711	001	ZZZ	0	X	493.43	X
34712	001	90	2	X	1,127.65	X
34712	003	90	2	X	1,030.63	X
34712	002	90	2	X	1,030.63	X
34712	004	90	2	X	1,030.63	X
34713	002	ZZZ	0	X	195.11	X
34713	003	ZZZ	0	X	195.11	X
34713	004	ZZZ	0	X	195.11	X
34713	001	ZZZ	0	X	212.58	X
34714	002	ZZZ	0	X	409.32	X
34714	003	ZZZ	0	X	409.32	X
34714	001	ZZZ	0	X	445.55	X
34714	004	ZZZ	0	X	409.32	X
34715	001	ZZZ	0	X	496.92	X
34715	002	ZZZ	0	X	457.61	X
34715	003	ZZZ	0	X	457.61	X
34715	004	ZZZ	0	X	457.61	X
34716	004	ZZZ	0	X	567.39	X
34716	001	ZZZ	0	X	617.88	X
34716	002	ZZZ	0	X	567.39	X
34716	003	ZZZ	0	X	567.39	X
34717	004	ZZZ	0	X	633.66	X
34717	001	ZZZ	0	X	694.12	X
34717	002	ZZZ	0	X	633.66	X
34717	003	ZZZ	0	X	633.66	X
34718	001	90	2	X	1,936.11	X
34718	004	90	2	X	1,763.50	X
34718	002	90	2	X	1,763.50	X
34718	003	90	2	X	1,763.50	X
34808	002	ZZZ	0	X	518.29	X
34808	003	ZZZ	0	X	518.29	X
34808	001	ZZZ	0	X	569.92	X
34808	004	ZZZ	0	X	518.29	X
34812	004	ZZZ	0	X	848.37	X
34812	002	ZZZ	0	X	848.37	X
34812	003	ZZZ	0	X	848.37	X
34812	001	ZZZ	0	X	933.60	X
34813	004	ZZZ	0	X	602.73	X
34813	001	ZZZ	0	X	662.96	X
34813	002	ZZZ	0	X	602.73	X
34813	003	ZZZ	0	X	602.73	X
34820	001	ZZZ	0	X	1,347.67	X
34820	004	ZZZ	0	X	1,224.95	X
34820	002	ZZZ	0	X	1,224.95	X
34820	003	ZZZ	0	X	1,224.95	X
34830	002	90	2	X	4,241.31	X
34830	003	90	2	X	4,241.31	X
34830	001	90	2	X	4,676.81	X
34830	004	90	2	X	4,241.31	X
34831	002	90	2	X	4,585.52	X
34831	003	90	2	X	4,585.52	X
34831	004	90	2	X	4,585.52	X
34831	001	90	2	X	5,055.08	X
34832	002	90	2	X	4,585.52	X
34832	003	90	2	X	4,585.52	X
34832	001	90	2	X	5,055.08	X
34832	004	90	2	X	4,585.52	X
34833	001	ZZZ	0	X	1,526.40	X
34833	003	ZZZ	0	X	1,390.36	X
34833	002	ZZZ	0	X	1,390.36	X
34833	004	ZZZ	0	X	1,390.36	X
34834	002	ZZZ	0	X	650.77	X
34834	003	ZZZ	0	X	650.77	X
34834	004	ZZZ	0	X	650.77	X
34834	001	ZZZ	0	X	724.17	X
34839		YYY	0	X	#	X
34841		YYY	2	X	*	X
34842		YYY	2	X	*	X
34843		YYY	2	X	*	X
34844		YYY	2	X	*	X
34845		YYY	2	X	*	X
34846		YYY	2	X	*	X
34847		YYY	2	X	*	X
34848		YYY	2	X	*	X
35001	001	90	2	X	4,256.34	X
35001	004	90	2	X	3,997.24	X
35001	003	90	2	X	3,884.84	X
35001	002	90	2	X	4,200.12	X
35002	002	90	2	X	3,852.45	X
35002	003	90	2	X	3,607.64	X
35002	004	90	2	X	3,567.00	X
35002	001	90	2	X	5,153.24	X
35005	001	90	2	X	3,307.02	X
35005	004	90	2	X	3,009.51	X
35005	003	90	2	X	3,043.39	X
35005	002	90	2	X	3,255.48	X
35011	002	90	2	X	3,383.88	X
35011	003	90	2	X	3,247.30	X
35011	001	90	2	X	3,493.94	X
35011	004	90	2	X	2,728.68	X

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