PART B FEE SCHEDULES

Fee Schedule 97018-99347

CPT/HCPC Code	Medicare Location	Global Surgery Indicator	Multiple Surgery Indicator	Prevailing Charge Amount	Fee Schedule Amount	Site of Service Amount
97018	001	XXX	5	X	53.06	X
97018	003	XXX	5	X	47.59	X
97018	002	XXX	5	X	51.62	X
97018	004	XXX	5	X	48.62	X
97022	001	XXX	5	X	42.55	X
97022	002	XXX	5	X	42.01	X
97022	003	XXX	5	X	38.30	X
97022	004	XXX	5	X	39.06	X
97024	001	XXX	5	X	46.08	X
97024	002	XXX	5	X	41.01	X
97024	003	XXX	5	X	40.46	X
97024	004	XXX	5	X	38.00	X
97026	004	XXX	5	X	40.01	X
97026	002	XXX	5	X	42.95	X
97026	003	XXX	5	X	40.52	X
97026	001	XXX	5	X	54.40	X
97028	002	XXX	5	X	37.59	X
97028	004	XXX	5	X	43.20	X
97028	003	XXX	5	X	35.71	X
97028	001	XXX	5	X	35.09	X
97032	002	XXX	5	X	41.13	X
97032	003	XXX	5	X	39.21	X
97032	004	XXX	5	X	38.72	X
97032	001	XXX	5	X	42.01	X
97033	001	XXX	5	X	44.42	X
97033	002	XXX	5	X	43.34	X
97033	004	XXX	5	X	46.31	X
97033	003	XXX	5	X	41.02	X
97034	004	XXX	5	X	35.05	X
97034	003	XXX	5	X	42.50	X
97034	002	XXX	5	X	41.61	X
97034	001	XXX	5	X	38.57	X
97035	002	XXX	5	X	33.98	X
97035	003	XXX	5	X	32.34	X
97035	004	XXX	5	X	31.95	X
97035	001	XXX	5	X	34.74	X
97036	002	XXX	5	X	44.46	X
97036	004	XXX	5	X	58.96	X
97036	003	XXX	5	X	59.66	X
97036	001	XXX	5	X	45.27	X
97037		XXX	9	X	#	X
97039	002	XXX	0	X	57.50	X
97039	003	XXX	0	X	54.13	X
97039	004	XXX	0	X	53.45	X
97039	001	XXX	0	X	58.28	X
97110	003	XXX	5	X	52.18	X
97110	004	XXX	5	X	49.65	X
97110	002	XXX	5	X	53.46	X
97110	001	XXX	5	X	54.26	X
97112	001	XXX	5	X	50.64	X
97112	004	XXX	5	X	46.71	X
97112	003	XXX	5	X	47.30	X
97112	002	XXX	5	X	50.79	X
97113	001	XXX	5	X	69.35	X
97113	002	XXX	5	X	47.12	X
97113	003	XXX	5	X	48.07	X
97113	004	XXX	5	X	63.94	X
97116	004	XXX	5	X	41.05	X
97116	003	XXX	5	X	46.90	X
97116	002	XXX	5	X	44.01	X
97116	001	XXX	5	X	50.32	X
97124	002	XXX	5	X	42.01	X
97124	001	XXX	5	X	42.55	X
97124	004	XXX	5	X	39.14	X
97124	003	XXX	5	X	39.59	X
97129	003	XXX	0	X	33.26	32.80
97129	002	XXX	0	X	33.26	32.80
97129	001	XXX	0	X	35.46	34.92
97129	004	XXX	0	X	33.26	32.80
97130	001	ZZZ	0	X	33.90	X
97130	004	ZZZ	0	X	31.81	X
97130	003	ZZZ	0	X	31.81	X
97130	002	ZZZ	0	X	31.81	X
97139	002	XXX	0	X	67.53	X
97139	003	XXX	0	X	63.77	X
97139	004	XXX	0	X	63.01	X
97139	001	XXX	0	X	68.40	X
97140	001	XXX	5	X	58.43	44.92
97140	003	XXX	5	X	53.56	42.07
97140	004	XXX	5	X	53.56	42.07
97140	002	XXX	5	X	53.56	42.07
97150	003	XXX	5	X	47.75	X
97150	004	XXX	5	X	47.09	X
97150	002	XXX	5	X	50.48	X
97150	001	XXX	5	X	51.79	X
97151		XXX	0	X	*	X
97152		XXX	0	X	*	X
97153		XXX	0	X	*	X
97154		XXX	0	X	*	X
97155		XXX	0	X	*	X
97156		XXX	0	X	*	X
97157		XXX	0	X	*	X
97158		XXX	0	X	*	X
97161	001	XXX	5	X	161.44	X
97161	002	XXX	5	X	145.95	X
97161	003	XXX	5	X	145.95	X
97161	004	XXX	5	X	145.95	X
97162	002	XXX	5	X	145.95	X
97162	003	XXX	5	X	145.95	X
97162	004	XXX	5	X	145.95	X
97162	001	XXX	5	X	161.44	X
97163	002	XXX	5	X	145.95	X
97163	004	XXX	5	X	145.95	X
97163	003	XXX	5	X	145.95	X
97163	001	XXX	5	X	161.44	X
97164	004	XXX	5	X	57.66	X
97164	003	XXX	5	X	57.66	X
97164	002	XXX	5	X	57.66	X
97164	001	XXX	5	X	60.73	X
97165	001	XXX	5	X	126.48	X
97165	004	XXX	5	X	116.12	X
97165	003	XXX	5	X	116.12	X
97165	002	XXX	5	X	116.12	X
97166	003	XXX	5	X	116.12	X
97166	004	XXX	5	X	116.12	X
97166	002	XXX	5	X	116.12	X
97166	001	XXX	5	X	126.48	X
97167	003	XXX	5	X	116.12	X
97167	001	XXX	5	X	126.48	X
97167	002	XXX	5	X	116.12	X
97167	004	XXX	5	X	116.12	X
97168	004	XXX	5	X	76.52	X
97168	002	XXX	5	X	76.52	X
97168	003	XXX	5	X	76.52	X
97168	001	XXX	5	X	83.62	X
97169		XXX	9	X	*	X
97170		XXX	9	X	*	X
97171		XXX	9	X	*	X
97172		XXX	9	X	*	X
97530	003	XXX	5	X	69.08	X
97530	004	XXX	5	X	68.72	X
97530	001	XXX	5	X	72.44	X
97530	002	XXX	5	X	70.66	X
97533	001	XXX	5	X	69.35	48.99
97533	002	XXX	5	X	63.38	46.02
97533	003	XXX	5	X	63.38	46.02
97533	004	XXX	5	X	63.38	46.02
97535	001	XXX	5	X	53.08	X
97535	002	XXX	5	X	51.21	X
97535	003	XXX	5	X	48.72	X
97535	004	XXX	5	X	48.04	X
97537	002	XXX	5	X	51.21	X
97537	003	XXX	5	X	48.72	X
97537	004	XXX	5	X	48.04	X
97537	001	XXX	5	X	53.08	X
97542	004	XXX	5	X	40.39	X
97542	003	XXX	5	X	40.98	X
97542	002	XXX	5	X	43.34	X
97542	001	XXX	5	X	44.96	X
97545	001	XXX	0	X	238.10	X
97545	004	XXX	0	X	230.33	X
97545	003	XXX	0	X	240.24	X
97545	002	XXX	0	X	223.51	X
97546	004	ZZZ	0	X	115.17	X
97546	003	ZZZ	0	X	120.16	X
97546	002	ZZZ	0	X	119.18	X
97546	001	ZZZ	0	X	111.73	X
97550	002	XXX	5	X	56.79	X
97550	003	XXX	5	X	56.79	X
97550	004	XXX	5	X	56.79	X
97550	001	XXX	5	X	61.01	X
97551	003	ZZZ	0	X	28.32	26.26
97551	002	ZZZ	0	X	28.32	26.26
97551	001	ZZZ	0	X	30.25	27.91
97551	004	ZZZ	0	X	28.32	26.26
97552	003	XXX	5	X	23.50	X
97552	002	XXX	5	X	23.50	X
97552	001	XXX	5	X	25.90	X
97552	004	XXX	5	X	23.50	X
97597	002	0	0	X	97.07	X
97597	001	0	0	X	109.80	X
97597	004	0	0	X	97.07	X
97597	003	0	0	X	97.07	X
97598	004	ZZZ	0	X	123.96	X
97598	003	ZZZ	0	X	123.96	X
97598	002	ZZZ	0	X	123.96	X
97598	001	ZZZ	0	X	138.88	X
97602		XXX	9	X	*	X
97605		XXX	0	X	*	X
97606		XXX	0	X	*	X
97607		XXX	0	X	*	X
97608		XXX	0	X	*	X
97610		XXX	0	X	*	X
97750	002	XXX	5	X	78.27	X
97750	003	XXX	5	X	70.42	X
97750	004	XXX	5	X	75.99	X
97750	001	XXX	5	X	82.07	X
97755	001	XXX	5	X	79.37	X
97755	002	XXX	5	X	73.35	X
97755	003	XXX	5	X	73.35	X
97755	004	XXX	5	X	73.35	X
97760	004	XXX	5	X	56.77	47.61
97760	003	XXX	5	X	56.77	47.61
97760	002	XXX	5	X	56.77	47.61
97760	001	XXX	5	X	63.53	52.32
97761	004	XXX	5	X	52.27	46.33
97761	001	XXX	5	X	57.73	50.53
97761	002	XXX	5	X	52.27	46.33
97761	003	XXX	5	X	52.27	46.33
97763	002	XXX	5	X	69.17	X
97763	003	XXX	5	X	69.17	X
97763	004	XXX	5	X	69.17	X
97763	001	XXX	5	X	76.39	X
97799		XXX	0	X	#	X
97802		XXX	0	X	*	X
97803		XXX	0	X	*	X
97804		XXX	0	X	*	X
97810		XXX	0	X	*	X
97811		ZZZ	0	X	*	X
97813		XXX	0	X	*	X
97814		ZZZ	0	X	*	X
98925	001	0	0	X	64.28	X
98925	002	0	0	X	67.12	X
98925	004	0	0	X	55.96	X
98925	003	0	0	X	63.77	X
98926	001	0	0	X	88.74	X
98926	004	0	0	X	79.10	X
98926	003	0	0	X	78.68	X
98926	002	0	0	X	87.55	X
98927	002	0	0	X	107.54	X
98927	003	0	0	X	102.42	X
98927	004	0	0	X	101.84	X
98927	001	0	0	X	107.92	X
98928	001	0	0	X	135.36	X
98928	004	0	0	X	116.12	X
98928	003	0	0	X	122.84	X
98928	002	0	0	X	132.84	X
98929	004	0	0	X	155.90	X
98929	002	0	0	X	153.25	X
98929	003	0	0	X	137.01	X
98929	001	0	0	X	131.27	X
98940	001	0	0	X	69.26	54.69
98940	002	0	0	X	64.69	52.02
98940	003	0	0	X	67.17	54.00
98940	004	0	0	X	62.96	50.61
98941	001	0	0	X	86.57	72.00
98941	004	0	0	X	79.65	67.31
98941	003	0	0	X	85.02	71.87
98941	002	0	0	X	81.82	69.17
98942	001	0	0	X	105.62	91.03
98942	002	0	0	X	100.71	88.06
98942	003	0	0	X	104.64	91.47
98942	004	0	0	X	98.00	85.76
98943		XXX	9	X	*	X
98960		XXX	9	X	*	X
98961		XXX	9	X	*	X
98962		XXX	9	X	*	X
98966		XXX	0	X	*	X
98967		XXX	0	X	*	X
98968		XXX	0	X	*	X
98970		XXX	0	X	*	X
98971		XXX	0	X	*	X
98972		XXX	0	X	*	X
98975	004	XXX	0	X	21.90	X
98975	002	XXX	0	X	21.90	X
98975	003	XXX	0	X	21.90	X
98975	001	XXX	0	X	25.41	X
98976	002	XXX	0	X	63.08	X
98976	004	XXX	0	X	63.08	X
98976	003	XXX	0	X	63.08	X
98976	001	XXX	0	X	72.82	X
98977	001	XXX	0	X	72.82	X
98977	004	XXX	0	X	63.08	X
98977	003	XXX	0	X	63.08	X
98977	002	XXX	0	X	63.08	X
98978				X	*	X
98980	004	XXX	0	X	58.31	37.16
98980	002	XXX	0	X	58.31	37.16
98980	003	XXX	0	X	58.31	37.16
98980	001	XXX	0	X	64.16	39.75
98981	004	ZZZ	0	X	47.68	37.10
98981	003	ZZZ	0	X	47.68	37.10
98981	002	ZZZ	0	X	47.68	37.10
98981	001	ZZZ	0	X	52.02	39.83
99000		XXX	9	X	*	X
99001		XXX	9	X	*	X
99002		XXX	9	X	*	X
99024		XXX	9	X	*	X
99026		XXX	9	X	*	X
99027		XXX	9	X	*	X
99050		XXX	9	X	*	X
99051		XXX	9	X	*	X
99053		XXX	9	X	*	X
99056		XXX	9	X	*	X
99058		XXX	9	X	*	X
99060		XXX	9	X	*	X
99070		XXX	9	X	#	X
99071		XXX	9	X	#	X
99072		XXX	9	X	*	X
99075		XXX	9	X	#	X
99078		XXX	9	X	#	X
99080		XXX	9	X	#	X
99082		XXX	0	X	#	X
99091		XXX	0	X	*	X
99100		ZZZ	9	X	*	X
99116		ZZZ	9	X	*	X
99135		ZZZ	9	X	*	X
99140		ZZZ	9	X	*	X
99151	002	XXX	9	X	111.85	35.77
99151	001	XXX	9	X	126.32	38.18
99151	004	XXX	9	X	111.85	35.77
99151	003	XXX	9	X	111.85	35.77
99152	004	XXX	9	X	74.06	18.64
99152	003	XXX	9	X	74.06	18.64
99152	002	XXX	9	X	74.06	18.64
99152	001	XXX	9	X	84.13	19.90
99153	003	ZZZ	9	X	15.65	X
99153	002	ZZZ	9	X	15.65	X
99153	004	ZZZ	9	X	15.65	X
99153	001	ZZZ	9	X	18.21	X
99155	004	XXX	9	X	140.09	X
99155	003	XXX	9	X	140.09	X
99155	002	XXX	9	X	140.09	X
99155	001	XXX	9	X	149.68	X
99156	002	XXX	9	X	114.91	X
99156	003	XXX	9	X	114.91	X
99156	004	XXX	9	X	114.91	X
99156	001	XXX	9	X	122.20	X
99157	001	ZZZ	9	X	92.61	X
99157	002	ZZZ	9	X	87.12	X
99157	003	ZZZ	9	X	87.12	X
99157	004	ZZZ	9	X	87.12	X
99170	004	0	2	X	313.48	218.32
99170	003	0	2	X	313.48	218.32
99170	002	0	2	X	313.48	218.32
99170	001	0	2	X	350.41	239.03
99172		XXX	9	X	*	X
99173		XXX	9	X	*	X
99174		XXX	9	X	*	X
99175	004	XXX	0	X	134.10	X
99175	002	XXX	0	X	148.31	X
99175	001	XXX	0	X	151.17	X
99175	003	XXX	0	X	136.24	X
99177		XXX	9	X	*	X
99183	002	XXX	0	X	423.24	X
99183	003	XXX	0	X	403.10	X
99183	004	XXX	0	X	398.35	X
99183	001	XXX	0	X	428.10	X
99184	001	XXX	0	X	391.48	X
99184	003	XXX	0	X	364.89	X
99184	002	XXX	0	X	364.89	X
99184	004	XXX	0	X	364.89	X
99188		XXX	0	X	*	X
99190		XXX	9	X	*	X
99191		XXX	9	X	*	X
99192		XXX	9	X	*	X
99195	003	XXX	0	X	42.55	X
99195	004	XXX	0	X	41.90	X
99195	002	XXX	0	X	42.31	X
99195	001	XXX	0	X	36.63	X
99199		XXX	0	X	#	X
99202	002	XXX	0	X	125.82	103.43
99202	003	XXX	0	X	115.15	94.53
99202	004	XXX	0	X	115.15	94.59
99202	001	XXX	0	X	132.29	108.68
99203	002	XXX	0	X	159.26	135.03
99203	001	XXX	0	X	161.28	136.54
99203	003	XXX	0	X	149.13	126.55
99203	004	XXX	0	X	144.81	123.21
99204	003	XXX	0	X	224.98	191.56
99204	002	XXX	0	X	250.73	212.92
99204	004	XXX	0	X	221.53	188.56
99204	001	XXX	0	X	269.07	227.72
99205	001	XXX	0	X	321.15	278.62
99205	004	XXX	0	X	269.87	234.44
99205	003	XXX	0	X	275.56	239.56
99205	002	XXX	0	X	302.35	261.47
99211	003	XXX	0	X	41.63	31.94
99211	002	XXX	0	X	47.16	36.17
99211	001	XXX	0	X	50.02	38.41
99211	004	XXX	0	X	37.03	27.96
99212	001	XXX	0	X	71.62	57.15
99212	002	XXX	0	X	70.79	56.48
99212	003	XXX	0	X	67.33	53.77
99212	004	XXX	0	X	66.54	53.24
99213	002	XXX	0	X	101.07	81.65
99213	001	XXX	0	X	102.27	82.53
99213	004	XXX	0	X	93.82	76.29
99213	003	XXX	0	X	96.63	78.24
99214	002	XXX	0	X	154.99	127.99
99214	003	XXX	0	X	139.52	115.69
99214	004	XXX	0	X	139.79	116.23
99214	001	XXX	0	X	157.82	131.37
99215	004	XXX	0	X	214.58	180.18
99215	002	XXX	0	X	241.61	201.62
99215	003	XXX	0	X	216.18	181.11
99215	001	XXX	0	X	249.71	209.80
99221	004	XXX	0	X	173.14	X
99221	003	XXX	0	X	175.24	X
99221	002	XXX	0	X	184.25	X
99221	001	XXX	0	X	186.47	X
99222	003	XXX	0	X	290.65	X
99222	002	XXX	0	X	305.08	X
99222	004	XXX	0	X	287.29	X
99222	001	XXX	0	X	308.55	X
99223	001	XXX	0	X	391.01	X
99223	002	XXX	0	X	377.10	X
99223	003	XXX	0	X	343.70	X
99223	004	XXX	0	X	343.87	X
99231	001	XXX	0	X	101.76	X
99231	002	XXX	0	X	94.59	X
99231	003	XXX	0	X	89.95	X
99231	004	XXX	0	X	88.84	X
99232	004	XXX	0	X	130.84	X
99232	003	XXX	0	X	131.28	X
99232	002	XXX	0	X	141.00	X
99232	001	XXX	0	X	141.87	X
99233	003	XXX	0	X	186.24	X
99233	004	XXX	0	X	187.90	X
99233	002	XXX	0	X	194.96	X
99233	001	XXX	0	X	197.07	X
99234	002	XXX	0	X	293.49	X
99234	003	XXX	0	X	293.49	X
99234	004	XXX	0	X	293.49	X
99234	001	XXX	0	X	315.67	X
99235	004	XXX	0	X	405.64	X
99235	003	XXX	0	X	405.64	X
99235	002	XXX	0	X	405.64	X
99235	001	XXX	0	X	438.10	X
99236	004	XXX	0	X	489.38	X
99236	003	XXX	0	X	489.38	X
99236	002	XXX	0	X	489.38	X
99236	001	XXX	0	X	525.94	X
99238	001	XXX	0	X	167.16	X
99238	002	XXX	0	X	165.40	X
99238	004	XXX	0	X	156.30	X
99238	003	XXX	0	X	161.86	X
99239	004	XXX	0	X	215.39	X
99239	002	XXX	0	X	227.12	X
99239	003	XXX	0	X	218.09	X
99239	001	XXX	0	X	233.79	X
99242	001	XXX	9	X	206.29	166.84
99242	002	XXX	9	X	197.45	159.63
99242	003	XXX	9	X	189.50	153.24
99242	004	XXX	9	X	189.06	153.12
99243	002	XXX	9	X	242.20	196.97
99243	003	XXX	9	X	229.37	186.71
99243	004	XXX	9	X	227.73	185.65
99243	001	XXX	9	X	256.38	208.46
99244	001	XXX	9	X	370.31	307.61
99244	004	XXX	9	X	336.96	280.79
99244	002	XXX	9	X	366.15	304.21
99244	003	XXX	9	X	345.68	287.75
99245	004	XXX	9	X	398.70	330.74
99245	002	XXX	9	X	439.22	363.40
99245	003	XXX	9	X	415.54	344.40
99245	001	XXX	9	X	441.03	364.76
99252	003	XXX	9	X	191.30	X
99252	002	XXX	9	X	199.36	X
99252	004	XXX	9	X	190.94	X
99252	001	XXX	9	X	207.07	X
99253	002	XXX	9	X	247.38	X
99253	003	XXX	9	X	234.32	X
99253	004	XXX	9	X	232.67	X
99253	001	XXX	9	X	261.57	X
99254	003	XXX	9	X	347.70	X
99254	002	XXX	9	X	368.22	X
99254	004	XXX	9	X	339.00	X
99254	001	XXX	9	X	372.40	X
99255	001	XXX	9	X	444.39	X
99255	004	XXX	9	X	402.63	X
99255	003	XXX	9	X	419.44	X
99255	002	XXX	9	X	442.81	X
99281	001	XXX	0	X	59.64	X
99281	003	XXX	0	X	58.61	X
99281	002	XXX	0	X	59.00	X
99281	004	XXX	0	X	55.61	X
99282	004	XXX	0	X	85.10	X
99282	002	XXX	0	X	91.25	X
99282	003	XXX	0	X	83.69	X
99282	001	XXX	0	X	96.17	X
99283	004	XXX	0	X	130.75	X
99283	003	XXX	0	X	129.48	X
99283	002	XXX	0	X	137.32	X
99283	001	XXX	0	X	142.65	X
99284	002	XXX	0	X	198.89	X
99284	003	XXX	0	X	186.08	X
99284	004	XXX	0	X	192.08	X
99284	001	XXX	0	X	206.82	X
99285	001	XXX	0	X	331.83	X
99285	004	XXX	0	X	295.19	X
99285	003	XXX	0	X	303.86	X
99285	002	XXX	0	X	331.59	X
99288		XXX	9	X	#	X
99291	002	XXX	0	X	443.60	X
99291	003	XXX	0	X	406.85	X
99291	004	XXX	0	X	392.86	X
99291	001	XXX	0	X	460.09	X
99292	004	ZZZ	0	X	193.01	X
99292	003	ZZZ	0	X	196.80	X
99292	002	ZZZ	0	X	219.59	X
99292	001	ZZZ	0	X	225.77	X
99304	004	XXX	0	X	122.34	X
99304	002	XXX	0	X	122.34	X
99304	003	XXX	0	X	122.34	X
99304	001	XXX	0	X	133.02	X
99305	001	XXX	0	X	176.59	X
99305	002	XXX	0	X	162.49	X
99305	003	XXX	0	X	162.49	X
99305	004	XXX	0	X	162.49	X
99306	004	XXX	0	X	200.63	X
99306	002	XXX	0	X	200.63	X
99306	003	XXX	0	X	200.63	X
99306	001	XXX	0	X	217.76	X
99307	001	XXX	0	X	69.00	X
99307	004	XXX	0	X	63.09	X
99307	003	XXX	0	X	63.09	X
99307	002	XXX	0	X	63.09	X
99308	001	XXX	0	X	113.99	X
99308	002	XXX	0	X	104.55	X
99308	003	XXX	0	X	104.55	X
99308	004	XXX	0	X	104.55	X
99309	001	XXX	0	X	160.70	X
99309	004	XXX	0	X	147.40	X
99309	003	XXX	0	X	147.40	X
99309	002	XXX	0	X	147.40	X
99310	004	XXX	0	X	184.57	X
99310	003	XXX	0	X	184.57	X
99310	002	XXX	0	X	184.57	X
99310	001	XXX	0	X	201.45	X
99315	002	XXX	0	X	149.54	X
99315	003	XXX	0	X	149.54	X
99315	004	XXX	0	X	149.54	X
99315	001	XXX	0	X	163.39	X
99316	004	XXX	0	X	182.47	X
99316	002	XXX	0	X	182.47	X
99316	003	XXX	0	X	182.47	X
99316	001	XXX	0	X	197.49	X
99341	004	XXX	0	X	141.33	X
99341	003	XXX	0	X	141.33	X
99341	002	XXX	0	X	141.33	X
99341	001	XXX	0	X	155.78	X
99342	001	XXX	0	X	210.20	X
99342	002	XXX	0	X	193.07	X
99342	003	XXX	0	X	193.07	X
99342	004	XXX	0	X	193.07	X
99344	004	XXX	0	X	352.76	X
99344	003	XXX	0	X	352.76	X
99344	002	XXX	0	X	352.76	X
99344	001	XXX	0	X	380.83	X
99345	001	XXX	0	X	450.79	X
99345	004	XXX	0	X	420.37	X
99345	003	XXX	0	X	420.37	X
99345	002	XXX	0	X	420.37	X
99347	004	XXX	0	X	111.16	X
99347	003	XXX	0	X	111.16	X
99347	002	XXX	0	X	111.16	X
99347	001	XXX	0	X	122.94	X

Fee Schedule 97018-99347

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