CPT/HCPC Code | Modifier | Medicare Location | Global Surgery Indicator | Multiple Surgery Indicator | Prevailing Charge Amount | Fee Schedule Amount | Site of Service Amount |
---|---|---|---|---|---|---|---|
99348 | 001 | XXX | 0 | X | 177.51 | X | |
99348 | 002 | XXX | 0 | X | 162.90 | X | |
99348 | 003 | XXX | 0 | X | 162.90 | X | |
99348 | 004 | XXX | 0 | X | 162.90 | X | |
99349 | 001 | XXX | 0 | X | 257.26 | X | |
99349 | 004 | XXX | 0 | X | 238.47 | X | |
99349 | 003 | XXX | 0 | X | 238.47 | X | |
99349 | 002 | XXX | 0 | X | 238.47 | X | |
99350 | XXX | 0 | X | * | X | ||
99358 | XXX | 0 | X | * | X | ||
99359 | ZZZ | 0 | X | * | X | ||
99360 | XXX | 9 | X | * | X | ||
99366 | XXX | 9 | X | * | X | ||
99367 | XXX | 9 | X | * | X | ||
99368 | XXX | 9 | X | * | X | ||
99374 | XXX | 9 | X | * | X | ||
99375 | 004 | XXX | 9 | X | 163.99 | X | |
99375 | 002 | XXX | 9 | X | 173.98 | X | |
99375 | 003 | XXX | 9 | X | 166.03 | X | |
99375 | 001 | XXX | 9 | X | 177.59 | X | |
99377 | XXX | 9 | X | * | X | ||
99378 | 001 | XXX | 9 | X | 218.70 | X | |
99378 | 002 | XXX | 9 | X | 202.89 | X | |
99378 | 003 | XXX | 9 | X | 202.89 | X | |
99378 | 004 | XXX | 9 | X | 202.89 | X | |
99379 | XXX | 9 | X | * | X | ||
99380 | 003 | XXX | 9 | X | 166.03 | X | |
99380 | 004 | XXX | 9 | X | 163.99 | X | |
99380 | 001 | XXX | 9 | X | 177.59 | X | |
99380 | 002 | XXX | 9 | X | 173.98 | X | |
99381 | XXX | 9 | X | * | X | ||
99382 | XXX | 9 | X | * | X | ||
99383 | XXX | 9 | X | * | X | ||
99384 | XXX | 9 | X | * | X | ||
99385 | XXX | 9 | X | * | X | ||
99386 | XXX | 9 | X | * | X | ||
99387 | XXX | 9 | X | * | X | ||
99391 | XXX | 9 | X | * | X | ||
99392 | XXX | 9 | X | * | X | ||
99394 | XXX | 9 | X | * | X | ||
99395 | XXX | 9 | X | * | X | ||
99396 | XXX | 9 | X | * | X | ||
99397 | XXX | 9 | X | * | X | ||
99401 | XXX | 9 | X | * | X | ||
99402 | XXX | 9 | X | * | X | ||
99403 | XXX | 9 | X | * | X | ||
99404 | XXX | 9 | X | * | X | ||
99406 | 003 | XXX | 0 | X | 21.98 | 20.68 | |
99406 | 004 | XXX | 0 | X | 21.98 | 20.68 | |
99406 | 002 | XXX | 0 | X | 21.98 | 20.68 | |
99406 | 001 | XXX | 0 | X | 23.93 | 22.36 | |
99407 | 004 | XXX | 0 | X | 43.36 | 41.44 | |
99407 | 002 | XXX | 0 | X | 43.36 | 41.44 | |
99407 | 003 | XXX | 0 | X | 43.36 | 41.44 | |
99407 | 001 | XXX | 0 | X | 46.65 | 44.31 | |
99408 | XXX | 9 | X | * | X | ||
99409 | XXX | 9 | X | * | X | ||
99411 | XXX | 9 | X | * | X | ||
99412 | XXX | 9 | X | * | X | ||
99415 | 002 | ZZZ | 0 | X | 12.76 | X | |
99415 | 003 | ZZZ | 0 | X | 12.76 | X | |
99415 | 004 | ZZZ | 0 | X | 12.76 | X | |
99415 | 001 | ZZZ | 0 | X | 14.99 | X | |
99416 | 003 | ZZZ | 0 | X | 7.17 | X | |
99416 | 004 | ZZZ | 0 | X | 7.17 | X | |
99416 | 001 | ZZZ | 0 | X | 8.46 | X | |
99416 | 002 | ZZZ | 0 | X | 7.17 | X | |
99417 | XXX | 9 | X | * | X | ||
99418 | X | * | X | ||||
99421 | 001 | XXX | 0 | X | 22.69 | 19.47 | |
99421 | 004 | XXX | 0 | X | 20.85 | 18.05 | |
99421 | 003 | XXX | 0 | X | 20.85 | 18.05 | |
99421 | 002 | XXX | 0 | X | 20.85 | 18.05 | |
99422 | 001 | XXX | 0 | X | 45.49 | 40.09 | |
99422 | 003 | XXX | 0 | X | 41.74 | 37.06 | |
99422 | 002 | XXX | 0 | X | 41.74 | 37.06 | |
99422 | 004 | XXX | 0 | X | 41.74 | 37.06 | |
99423 | 001 | XXX | 0 | X | 73.53 | 63.84 | |
99423 | 002 | XXX | 0 | X | 67.44 | 59.00 | |
99423 | 003 | XXX | 0 | X | 67.44 | 59.00 | |
99423 | 004 | XXX | 0 | X | 67.44 | 59.00 | |
99424 | 002 | XXX | 0 | X | 97.93 | 88.92 | |
99424 | 003 | XXX | 0 | X | 97.93 | 88.92 | |
99424 | 004 | XXX | 0 | X | 97.93 | 88.92 | |
99424 | 001 | XXX | 0 | X | 105.72 | 95.33 | |
99425 | 004 | ZZZ | 0 | X | 70.57 | 61.94 | |
99425 | 002 | ZZZ | 0 | X | 70.57 | 61.94 | |
99425 | 003 | ZZZ | 0 | X | 70.57 | 61.94 | |
99425 | 001 | ZZZ | 0 | X | 76.50 | 66.54 | |
99426 | 002 | XXX | 0 | X | 76.33 | 61.37 | |
99426 | 003 | XXX | 0 | X | 76.33 | 61.37 | |
99426 | 004 | XXX | 0 | X | 76.33 | 61.37 | |
99426 | 001 | XXX | 0 | X | 82.97 | 65.75 | |
99427 | 001 | ZZZ | 0 | X | 61.71 | 44.99 | |
99427 | 003 | ZZZ | 0 | X | 56.57 | 42.06 | |
99427 | 002 | ZZZ | 0 | X | 56.57 | 42.06 | |
99427 | 004 | ZZZ | 0 | X | 56.57 | 42.06 | |
99429 | XXX | 9 | X | # | X | ||
99437 | 003 | ZZZ | 0 | X | 71.74 | 61.55 | |
99437 | 002 | ZZZ | 0 | X | 71.74 | 61.55 | |
99437 | 004 | ZZZ | 0 | X | 71.74 | 61.55 | |
99437 | 001 | ZZZ | 0 | X | 77.85 | 66.10 | |
99439 | 004 | ZZZ | 0 | X | 48.28 | 36.58 | |
99439 | 003 | ZZZ | 0 | X | 48.28 | 36.58 | |
99439 | 002 | ZZZ | 0 | X | 48.28 | 36.58 | |
99439 | 001 | ZZZ | 0 | X | 52.73 | 39.22 | |
99441 | XXX | 0 | X | * | X | ||
99442 | XXX | 0 | X | * | X | ||
99443 | XXX | 0 | X | * | X | ||
99446 | XXX | 0 | X | * | X | ||
99447 | XXX | 0 | X | * | X | ||
99448 | XXX | 0 | X | * | X | ||
99449 | XXX | 0 | X | * | X | ||
99450 | XXX | 9 | X | * | X | ||
99451 | 001 | XXX | 0 | X | 54.69 | X | |
99451 | 002 | XXX | 0 | X | 51.07 | X | |
99451 | 003 | XXX | 0 | X | 51.07 | X | |
99451 | 004 | XXX | 0 | X | 51.07 | X | |
99452 | 001 | XXX | 0 | X | 54.69 | X | |
99452 | 002 | XXX | 0 | X | 51.07 | X | |
99452 | 003 | XXX | 0 | X | 51.07 | X | |
99452 | 004 | XXX | 0 | X | 51.07 | X | |
99453 | 001 | XXX | 0 | X | 29.10 | X | |
99453 | 002 | XXX | 0 | X | 25.27 | X | |
99453 | 003 | XXX | 0 | X | 25.27 | X | |
99453 | 004 | XXX | 0 | X | 25.27 | X | |
99454 | 004 | XXX | 0 | X | 83.21 | X | |
99454 | 002 | XXX | 0 | X | 83.21 | X | |
99454 | 003 | XXX | 0 | X | 83.21 | X | |
99454 | 001 | XXX | 0 | X | 95.59 | X | |
99455 | XXX | 0 | X | * | X | ||
99456 | XXX | 0 | X | * | X | ||
99457 | 003 | XXX | 0 | X | 68.95 | 44.20 | |
99457 | 002 | XXX | 0 | X | 68.95 | 44.20 | |
99457 | 001 | XXX | 0 | X | 75.68 | 47.27 | |
99457 | 004 | XXX | 0 | X | 68.95 | 44.20 | |
99458 | 004 | ZZZ | 0 | X | 56.57 | 44.40 | |
99458 | 003 | ZZZ | 0 | X | 56.57 | 44.40 | |
99458 | 002 | ZZZ | 0 | X | 56.57 | 44.40 | |
99458 | 001 | ZZZ | 0 | X | 61.89 | 47.87 | |
99459 | 004 | ZZZ | 0 | X | 23.32 | X | |
99459 | 003 | ZZZ | 0 | X | 23.32 | X | |
99459 | 002 | ZZZ | 0 | X | 23.32 | X | |
99459 | 001 | ZZZ | 0 | X | 26.50 | X | |
99460 | 002 | XXX | 0 | X | 99.36 | X | |
99460 | 004 | XXX | 0 | X | 99.36 | X | |
99460 | 003 | XXX | 0 | X | 99.36 | X | |
99460 | 001 | XXX | 0 | X | 106.07 | X | |
99461 | 002 | XXX | 0 | X | 146.56 | 111.32 | |
99461 | 003 | XXX | 0 | X | 146.56 | 111.32 | |
99461 | 004 | XXX | 0 | X | 146.56 | 111.32 | |
99461 | 001 | XXX | 0 | X | 161.50 | 119.71 | |
99462 | 004 | XXX | 0 | X | 52.78 | X | |
99462 | 003 | XXX | 0 | X | 52.78 | X | |
99462 | 002 | XXX | 0 | X | 52.78 | X | |
99462 | 001 | XXX | 0 | X | 56.21 | X | |
99463 | 001 | XXX | 0 | X | 142.22 | X | |
99463 | 004 | XXX | 0 | X | 132.72 | X | |
99463 | 003 | XXX | 0 | X | 132.72 | X | |
99463 | 002 | XXX | 0 | X | 132.72 | X | |
99464 | 001 | XXX | 0 | X | 133.00 | X | |
99464 | 004 | XXX | 0 | X | 124.92 | X | |
99464 | 003 | XXX | 0 | X | 124.92 | X | |
99464 | 002 | XXX | 0 | X | 124.92 | X | |
99465 | 001 | XXX | 0 | X | 273.47 | X | |
99465 | 003 | XXX | 0 | X | 255.52 | X | |
99465 | 002 | XXX | 0 | X | 255.52 | X | |
99465 | 004 | XXX | 0 | X | 255.52 | X | |
99466 | 001 | XXX | 0 | X | 438.50 | X | |
99466 | 004 | XXX | 0 | X | 409.66 | X | |
99466 | 003 | XXX | 0 | X | 409.66 | X | |
99466 | 002 | XXX | 0 | X | 409.66 | X | |
99467 | 001 | ZZZ | 0 | X | 218.83 | X | |
99467 | 003 | ZZZ | 0 | X | 204.59 | X | |
99467 | 002 | ZZZ | 0 | X | 204.59 | X | |
99467 | 004 | ZZZ | 0 | X | 204.59 | X | |
99468 | 004 | XXX | 0 | X | 1,542.93 | X | |
99468 | 001 | XXX | 0 | X | 1,652.36 | X | |
99468 | 002 | XXX | 0 | X | 1,542.93 | X | |
99468 | 003 | XXX | 0 | X | 1,542.93 | X | |
99469 | 002 | XXX | 0 | X | 670.25 | X | |
99469 | 001 | XXX | 0 | X | 714.13 | X | |
99469 | 004 | XXX | 0 | X | 670.25 | X | |
99469 | 003 | XXX | 0 | X | 670.25 | X | |
99471 | 002 | XXX | 0 | X | 1,377.04 | X | |
99471 | 004 | XXX | 0 | X | 1,377.04 | X | |
99471 | 003 | XXX | 0 | X | 1,377.04 | X | |
99471 | 001 | XXX | 0 | X | 1,481.91 | X | |
99472 | 003 | XXX | 0 | X | 679.38 | X | |
99472 | 002 | XXX | 0 | X | 679.38 | X | |
99472 | 001 | XXX | 0 | X | 727.73 | X | |
99472 | 004 | XXX | 0 | X | 679.38 | X | |
99473 | 001 | XXX | 0 | X | 16.83 | X | |
99473 | 002 | XXX | 0 | X | 14.53 | X | |
99473 | 003 | XXX | 0 | X | 14.53 | X | |
99473 | 004 | XXX | 0 | X | 14.53 | X | |
99474 | 004 | XXX | 0 | X | 20.19 | 12.23 | |
99474 | 002 | XXX | 0 | X | 20.19 | 12.23 | |
99474 | 003 | XXX | 0 | X | 20.19 | 12.23 | |
99474 | 001 | XXX | 0 | X | 22.24 | 13.08 | |
99475 | 001 | XXX | 0 | X | 1,021.01 | X | |
99475 | 003 | XXX | 0 | X | 950.59 | X | |
99475 | 002 | XXX | 0 | X | 950.59 | X | |
99475 | 004 | XXX | 0 | X | 950.59 | X | |
99476 | 001 | XXX | 0 | X | 602.94 | X | |
99476 | 004 | XXX | 0 | X | 563.93 | X | |
99476 | 003 | XXX | 0 | X | 563.93 | X | |
99476 | 002 | XXX | 0 | X | 563.93 | X | |
99477 | 001 | XXX | 0 | X | 629.99 | X | |
99477 | 002 | XXX | 0 | X | 584.18 | X | |
99477 | 003 | XXX | 0 | X | 584.18 | X | |
99477 | 004 | XXX | 0 | X | 584.18 | X | |
99478 | 002 | XXX | 0 | X | 243.78 | X | |
99478 | 003 | XXX | 0 | X | 243.78 | X | |
99478 | 004 | XXX | 0 | X | 243.78 | X | |
99478 | 001 | XXX | 0 | X | 262.63 | X | |
99479 | 002 | XXX | 0 | X | 214.99 | X | |
99479 | 004 | XXX | 0 | X | 214.99 | X | |
99479 | 003 | XXX | 0 | X | 214.99 | X | |
99479 | 001 | XXX | 0 | X | 231.00 | X | |
99480 | 002 | XXX | 0 | X | 206.67 | X | |
99480 | 001 | XXX | 0 | X | 221.98 | X | |
99480 | 004 | XXX | 0 | X | 206.67 | X | |
99480 | 003 | XXX | 0 | X | 206.67 | X | |
99483 | 004 | XXX | 0 | X | 343.40 | 257.24 | |
99483 | 002 | XXX | 0 | X | 343.40 | 257.24 | |
99483 | 003 | XXX | 0 | X | 343.40 | 257.24 | |
99483 | 001 | XXX | 0 | X | 373.37 | 274.50 | |
99484 | 004 | XXX | 0 | X | 68.70 | 47.06 | |
99484 | 002 | XXX | 0 | X | 68.70 | 47.06 | |
99484 | 003 | XXX | 0 | X | 68.70 | 47.06 | |
99484 | 001 | XXX | 0 | X | 75.22 | 50.38 | |
99485 | XXX | 9 | X | * | X | ||
99486 | XXX | 9 | X | * | X | ||
99487 | XXX | 0 | X | * | X | ||
99489 | ZZZ | 0 | X | * | X | ||
99490 | 003 | XXX | 0 | X | 64.86 | X | |
99490 | 002 | XXX | 0 | X | 64.86 | X | |
99490 | 001 | XXX | 0 | X | 71.04 | X | |
99490 | 004 | XXX | 0 | X | 64.86 | X | |
99491 | 002 | XXX | 0 | X | 113.94 | X | |
99491 | 001 | XXX | 0 | X | 122.52 | X | |
99491 | 004 | XXX | 0 | X | 113.94 | X | |
99491 | 003 | XXX | 0 | X | 113.94 | X | |
99492 | 004 | XXX | 0 | X | 226.80 | 129.82 | |
99492 | 003 | XXX | 0 | X | 226.80 | 129.82 | |
99492 | 002 | XXX | 0 | X | 226.80 | 129.82 | |
99492 | 001 | XXX | 0 | X | 250.16 | 138.88 | |
99493 | 001 | XXX | 0 | X | 199.62 | 125.65 | |
99493 | 002 | XXX | 0 | X | 181.88 | 117.41 | |
99493 | 003 | XXX | 0 | X | 181.88 | 117.41 | |
99493 | 004 | XXX | 0 | X | 181.88 | 117.41 | |
99494 | 001 | ZZZ | 0 | X | 103.04 | 66.90 | |
99494 | 002 | ZZZ | 0 | X | 94.08 | 62.60 | |
99494 | 003 | ZZZ | 0 | X | 94.08 | 62.60 | |
99494 | 004 | ZZZ | 0 | X | 94.08 | 62.60 | |
99495 | 001 | XXX | 0 | X | 282.54 | 231.96 | |
99495 | 002 | XXX | 0 | X | 256.15 | 212.56 | |
99495 | 003 | XXX | 0 | X | 256.15 | 212.56 | |
99495 | 004 | XXX | 0 | X | 256.15 | 212.56 | |
99496 | 001 | XXX | 0 | X | 398.44 | 340.26 | |
99496 | 004 | XXX | 0 | X | 361.77 | 311.54 | |
99496 | 002 | XXX | 0 | X | 361.77 | 311.54 | |
99496 | 003 | XXX | 0 | X | 361.77 | 311.54 | |
99497 | XXX | 0 | X | * | X | ||
99498 | ZZZ | 0 | X | * | X | ||
99499 | XXX | 0 | X | # | X | ||
99500 | XXX | 9 | X | * | X | ||
99501 | XXX | 9 | X | * | X | ||
99502 | XXX | 9 | X | * | X | ||
99503 | XXX | 9 | X | * | X | ||
99504 | XXX | 9 | X | * | X | ||
99505 | XXX | 9 | X | * | X | ||
99506 | XXX | 9 | X | * | X | ||
99507 | XXX | 9 | X | * | X | ||
99509 | XXX | 9 | X | * | X | ||
99510 | XXX | 9 | X | * | X | ||
99511 | XXX | 9 | X | * | X | ||
99512 | XXX | 9 | X | * | X | ||
99600 | XXX | 9 | X | # | X | ||
99601 | XXX | 9 | X | * | X | ||
99602 | XXX | 9 | X | * | X | ||
99605 | XXX | 9 | X | * | X | ||
99606 | XXX | 9 | X | * | X | ||
99607 | XXX | 9 | X | * | X | ||
A0021 | XXX | 9 | X | # | X | ||
A0080 | XXX | 9 | X | * | X | ||
A0090 | XXX | 9 | X | * | X | ||
A0100 | XXX | 9 | X | * | X | ||
A0110 | XXX | 9 | X | * | X | ||
A0120 | XXX | 9 | X | * | X | ||
A0130 | XXX | 9 | X | * | X | ||
A0140 | XXX | 9 | X | * | X | ||
A0160 | XXX | 9 | X | * | X | ||
A0170 | XXX | 9 | X | * | X | ||
A0180 | XXX | 9 | X | * | X | ||
A0190 | XXX | 9 | X | * | X | ||
A0200 | XXX | 9 | X | * | X | ||
A0210 | XXX | 9 | X | * | X | ||
A0225 | XXX | 9 | X | * | X | ||
A0380 | XXX | 9 | X | * | X | ||
A0382 | XXX | 9 | X | * | X | ||
A0384 | XXX | 9 | X | * | X | ||
A0390 | XXX | 9 | X | * | X | ||
A0392 | XXX | 9 | X | * | X | ||
A0394 | XXX | 9 | X | * | X | ||
A0396 | XXX | 9 | X | * | X | ||
A0398 | XXX | 9 | X | * | X | ||
A0420 | XXX | 9 | X | # | X | ||
A0422 | XXX | 9 | X | * | X | ||
A0424 | XXX | 9 | X | # | X | ||
A0425 | XXX | 9 | X | * | X | ||
A0426 | 004 | XXX | 9 | X | 440.14 | X | |
A0426 | 002 | XXX | 9 | X | 440.14 | X | |
A0426 | 003 | XXX | 9 | X | 440.14 | X | |
A0426 | 001 | XXX | 9 | X | 492.94 | X | |
A0427 | 002 | XXX | 9 | X | 696.81 | X | |
A0427 | 003 | XXX | 9 | X | 696.81 | X | |
A0427 | 004 | XXX | 9 | X | 696.81 | X | |
A0427 | 001 | XXX | 9 | X | 780.49 | X | |
A0428 | 003 | XXX | 9 | X | 366.69 | X | |
A0428 | 001 | XXX | 9 | X | 410.79 | X | |
A0428 | 002 | XXX | 9 | X | 366.69 | X | |
A0428 | 004 | XXX | 9 | X | 366.69 | X | |
A0429 | 004 | XXX | 9 | X | 586.80 | X | |
A0429 | 003 | XXX | 9 | X | 586.80 | X | |
A0429 | 002 | XXX | 9 | X | 586.80 | X | |
A0429 | 001 | XXX | 9 | X | 657.23 | X | |
A0430 | XXX | 9 | X | * | X | ||
A0431 | XXX | 9 | X | * | X | ||
A0432 | 004 | XXX | 9 | X | 641.83 | X | |
A0432 | 002 | XXX | 9 | X | 641.83 | X | |
A0432 | 001 | XXX | 9 | X | 718.88 | X | |
A0432 | 003 | XXX | 9 | X | 641.83 | X | |
A0433 | 001 | XXX | 9 | X | 1,129.63 | X | |
A0433 | 004 | XXX | 9 | X | 1,008.52 | X | |
A0433 | 002 | XXX | 9 | X | 1,008.52 | X | |
A0433 | 003 | XXX | 9 | X | 1,008.52 | X | |
A0434 | 004 | XXX | 9 | X | 1,191.92 | X | |
A0434 | 003 | XXX | 9 | X | 1,191.92 | X | |
A0434 | 002 | XXX | 9 | X | 1,191.92 | X | |
A0434 | 001 | XXX | 9 | X | 1,335.02 | X | |
A0435 | XXX | 9 | X | * | X | ||
A0436 | XXX | 9 | X | * | X | ||
A0888 | XXX | 9 | X | # | X | ||
A0998 | XXX | 9 | X | * | X | ||
A0999 | XXX | 9 | X | # | X | ||
A2001 | X | * | X | ||||
A2002 | X | # | X | ||||
A2003 | X | # | X | ||||
A2004 | X | # | X | ||||
A2005 | X | * | X | ||||
A2006 | X | # | X | ||||
A2007 | X | # | X | ||||
A2008 | X | # | X | ||||
A2009 | X | # | X | ||||
A2010 | X | # | X | ||||
A2019 | XXX | 9 | X | # | X | ||
A2020 | XXX | 9 | X | # | X | ||
A2022 | XXX | 9 | X | # | X | ||
A2023 | XXX | 9 | X | # | X | ||
A2024 | XXX | 9 | X | # | X | ||
A2025 | XXX | 9 | X | # | X | ||
A4206 | XXX | 9 | X | * | X | ||
A4207 | XXX | 9 | X | * | X | ||
A4208 | XXX | 9 | X | * | X | ||
A4209 | XXX | 9 | X | * | X | ||
A4210 | XXX | 9 | X | * | X | ||
A4211 | XXX | 9 | X | # | X | ||
A4212 | XXX | 9 | X | 15.63 | X | ||
A4213 | XXX | 9 | X | * | X | ||
A4215 | XXX | 9 | X | * | X | ||
A4216 | XXX | 9 | X | * | X | ||
A4217 | XXX | 9 | X | * | X | ||
A4218 | XXX | 9 | X | * | X | ||
A4220 | XXX | 9 | X | * | X | ||
A4221 | XXX | 9 | X | 59.64 | X | ||
A4222 | XXX | 9 | X | 123.10 | X | ||
A4223 | XXX | 9 | X | * | X | ||
A4224 | XXX | 9 | X | 29.19 | X | ||
A4225 | XXX | 9 | X | 3.92 | X | ||
A4226 | XXX | 9 | X | # | X | ||
A4230 | XXX | 9 | X | * | X | ||
A4231 | XXX | 9 | X | * | X | ||
A4232 | XXX | 9 | X | * | X | ||
A4233 | NU | XXX | 9 | X | 1.60 | X | |
A4234 | NU | XXX | 9 | X | 7.28 | X | |
A4235 | NU | XXX | 9 | X | 4.69 | X | |
A4236 | NU | XXX | 9 | X | 3.37 | X | |
A4239 | XXX | 9 | X | 299.69 | X | ||
A4239 | KF | XXX | 9 | X | 348.70 | X | |
A4244 | XXX | 9 | X | * | X | ||
A4245 | XXX | 9 | X | * | X | ||
A4246 | XXX | 9 | X | * | X | ||
A4247 | XXX | 9 | X | * | X | ||
A4248 | XXX | 9 | X | # | X | ||
A4250 | XXX | 9 | X | * | X | ||
A4252 | XXX | 9 | X | * | X | ||
A4253 | XXX | 9 | X | 113.45 | X | ||
A4255 | XXX | 9 | X | 10.00 | X | ||
A4256 | XXX | 9 | X | 25.97 | X | ||
A4257 | XXX | 9 | X | 28.72 | X | ||
A4258 | XXX | 9 | X | 47.59 | X | ||
A4259 | XXX | 9 | X | 28.87 | X | ||
A4261 | XXX | 9 | X | # | X | ||
A4262 | XXX | 9 | X | * | X | ||
A4263 | XXX | 9 | X | 95.86 | X | ||
A4264 | XXX | 9 | X | * | X | ||
A4265 | XXX | 9 | X | * | X | ||
A4266 | XXX | 9 | X | * | X | ||
A4267 | XXX | 9 | X | * | X | ||
A4268 | XXX | 9 | X | * | X | ||
A4269 | XXX | 9 | X | * | X | ||
A4270 | XXX | 9 | X | * | X | ||
A4280 | XXX | 9 | X | 11.18 | X | ||
A4281 | XXX | 9 | X | * | X | ||
A4282 | XXX | 9 | X | * | X | ||
A4283 | XXX | 9 | X | * | X | ||
A4284 | XXX | 9 | X | * | X | ||
A4285 | XXX | 9 | X | * | X | ||
A4286 | XXX | 9 | X | * | X | ||
A4290 | XXX | 9 | X | 234.72 | X | ||
A4300 | XXX | 9 | X | 95.86 | X | ||
A4301 | XXX | 9 | X | * | X | ||
A4305 | XXX | 9 | X | * | X | ||
A4306 | XXX | 9 | X | * | X | ||
A4310 | XXX | 9 | X | 19.06 | X | ||
A4311 | XXX | 9 | X | 33.60 | X | ||
A4312 | XXX | 9 | X | 40.86 | X | ||
A4313 | XXX | 9 | X | 48.40 | X | ||
A4314 | XXX | 9 | X | 64.02 | X | ||
A4315 | XXX | 9 | X | 68.82 | X | ||
A4316 | XXX | 9 | X | 71.92 | X | ||
A4320 | XXX | 9 | X | 13.43 | X | ||
A4321 | XXX | 9 | X | * | X | ||
A4322 | XXX | 9 | X | 7.87 | X | ||
A4326 | XXX | 9 | X | 30.56 | X | ||
A4327 | XXX | 9 | X | 107.55 | X | ||
A4328 | XXX | 9 | X | 27.86 | X | ||
A4330 | XXX | 9 | X | 19.06 | X | ||
A4331 | XXX | 9 | X | * | X | ||
A4332 | XXX | 9 | X | # | X | ||
A4333 | XXX | 9 | X | * | X | ||
A4334 | XXX | 9 | X | * | X | ||
A4335 | XXX | 9 | X | # | X | ||
A4336 | XXX | 9 | X | * | X | ||
A4337 | XXX | 9 | X | # | X | ||
A4338 | XXX | 9 | X | 28.88 | X | ||
A4340 | XXX | 9 | X | 55.23 | X | ||
A4341 | XXX | 9 | X | 376.22 | X | ||
A4342 | XXX | 9 | X | 949.95 | X | ||
A4344 | XXX | 9 | X | 36.32 | X | ||
A4346 | XXX | 9 | X | 45.51 | X | ||
A4349 | XXX | 9 | X | 2.19 | X | ||
A4351 | XXX | 9 | X | 4.59 | X | ||
A4352 | XXX | 9 | X | 17.06 | X | ||
A4353 | XXX | 9 | X | 17.77 | X | ||
A4354 | XXX | 9 | X | 31.20 | X | ||
A4355 | XXX | 9 | X | 23.72 | X | ||
A4356 | XXX | 9 | X | 121.66 | X | ||
A4357 | XXX | 9 | X | 24.47 | X | ||
A4358 | XXX | 9 | X | 17.69 | X | ||
A4360 | XXX | 9 | X | 0.90 | X | ||
A4361 | XXX | 9 | X | 48.76 | X | ||
A4362 | XXX | 9 | X | 9.22 | X | ||
A4363 | XXX | 9 | X | 9.78 | X | ||
A4364 | XXX | 9 | X | 7.85 | X | ||
A4366 | XXX | 9 | X | 27.99 | X | ||
A4367 | XXX | 9 | X | 19.66 | X | ||
A4368 | XXX | 9 | X | 0.69 | X | ||
A4369 | XXX | 9 | X | 5.64 | X | ||
A4371 | XXX | 9 | X | 8.54 | X | ||
A4372 | XXX | 9 | X | 9.76 | X | ||
A4373 | XXX | 9 | X | 14.66 | X | ||
A4375 | XXX | 9 | X | 40.09 | X | ||
A4376 | XXX | 9 | X | 111.16 | X | ||
A4377 | XXX | 9 | X | 10.05 | X | ||
A4378 | XXX | 9 | X | 71.88 | X | ||
A4379 | XXX | 9 | X | 35.10 | X | ||
A4380 | XXX | 9 | X | 87.29 | X | ||
A4381 | XXX | 9 | X | 10.76 | X | ||
A4382 | XXX | 9 | X | 57.51 | X | ||
A4383 | XXX | 9 | X | 65.87 | X | ||
A4384 | XXX | 9 | X | 22.50 | X | ||
A4385 | XXX | 9 | X | 11.90 | X | ||
A4387 | XXX | 9 | X | 9.41 | X | ||
A4388 | XXX | 9 | X | 10.17 | X | ||
A4389 | XXX | 9 | X | 14.55 | X | ||
A4390 | XXX | 9 | X | 22.47 | X | ||
A4391 | XXX | 9 | X | 16.46 | X | ||
A4392 | XXX | 9 | X | 15.51 | X | ||
A4393 | XXX | 9 | X | 21.41 | X | ||
A4394 | XXX | 9 | X | 6.06 | X | ||
A4395 | XXX | 9 | X | # | X | ||
A4396 | XXX | 9 | X | * | X | ||
A4398 | XXX | 9 | X | 30.69 | X | ||
A4399 | XXX | 9 | X | 31.65 | X | ||
A4400 | XXX | 9 | X | 130.32 | X | ||
A4402 | XXX | 9 | X | 3.65 | X | ||
A4404 | XXX | 9 | X | 4.25 | X | ||
A4405 | XXX | 9 | X | 7.50 | X | ||
A4406 | XXX | 9 | X | 12.75 | X | ||
A4407 | XXX | 9 | X | 19.44 | X | ||
A4408 | XXX | 9 | X | 21.88 | X | ||
A4409 | XXX | 9 | X | 13.77 | X | ||
A4410 | XXX | 9 | X | 20.04 | X | ||
A4411 | XXX | 9 | X | 10.22 | X | ||
A4412 | XXX | 9 | X | 5.41 | X | ||
A4413 | XXX | 9 | X | 12.23 | X | ||
A4414 | XXX | 9 | X | 10.94 | X | ||
A4415 | XXX | 9 | X | 13.31 | X | ||
A4416 | XXX | 9 | X | 5.97 | X | ||
A4417 | XXX | 9 | X | 8.07 | X | ||
A4418 | XXX | 9 | X | 3.96 | X | ||
A4419 | XXX | 9 | X | 3.79 | X | ||
A4420 | XXX | 9 | X | * | X | ||
A4421 | XXX | 9 | X | # | X | ||
A4422 | XXX | 9 | X | 0.31 | X | ||
A4423 | XXX | 9 | X | 4.04 | X | ||
A4424 | XXX | 9 | X | 10.31 | X | ||
A4425 | XXX | 9 | X | 7.76 | X | ||
A4426 | XXX | 9 | X | 5.92 | X | ||
A4427 | XXX | 9 | X | 6.06 | X | ||
A4428 | XXX | 9 | X | 14.15 | X | ||
A4429 | XXX | 9 | X | 17.89 | X | ||
A4430 | XXX | 9 | X | 18.53 | X | ||
A4431 | XXX | 9 | X | 13.52 | X | ||
A4432 | XXX | 9 | X | 7.78 | X | ||
A4433 | XXX | 9 | X | 7.24 | X | ||
A4434 | XXX | 9 | X | 8.17 | X | ||
A4435 | XXX | 9 | X | 10.19 | X | ||
A4436 | X | 29.14 | X | ||||
A4437 | X | 29.14 | X | ||||
A4450 | XXX | 9 | X | 0.12 | X | ||
A4452 | XXX | 9 | X | 0.83 | X | ||
A4453 | X | * | X | ||||
A4455 | XXX | 9 | X | 3.70 | X | ||
A4456 | XXX | 9 | X | 0.46 | X | ||
A4458 | XXX | 9 | X | * | X | ||
A4459 | XXX | 9 | X | * | X | ||
A4461 | XXX | 9 | X | 6.31 | X | ||
A4463 | XXX | 9 | X | 25.57 | X | ||
A4465 | XXX | 9 | X | * | X | ||
A4467 | XXX | 9 | X | * | X | ||
A4470 | XXX | 9 | X | # | X | ||
A4480 | XXX | 9 | X | * | X | ||
A4481 | XXX | 9 | X | 150.94 | X | ||
A4483 | XXX | 9 | X | * | X | ||
A4490 | XXX | 9 | X | * | X | ||
A4495 | XXX | 9 | X | * | X | ||
A4500 | XXX | 9 | X | * | X | ||
A4510 | XXX | 9 | X | * | X | ||
A4520 | XXX | 9 | X | * | X | ||
A4550 | XXX | 9 | X | 95.86 | X | ||
A4553 | XXX | 9 | X | * | X | ||
A4554 | XXX | 9 | X | * | X | ||
A4555 | XXX | 9 | X | * | X | ||
A4556 | NU | XXX | 9 | X | 27.45 | X | |
A4556 | RR | XXX | 9 | X | 2.74 | X | |
A4556 | UE | XXX | 9 | X | 20.61 | X | |
A4557 | NU | XXX | 9 | X | 47.87 | X | |
A4557 | RR | XXX | 9 | X | 4.75 | X | |
A4557 | UE | XXX | 9 | X | 35.92 | X | |
A4558 | NU | XXX | 9 | X | 12.27 | X | |
A4558 | RR | XXX | 9 | X | 1.25 | X | |
A4558 | UE | XXX | 9 | X | 9.12 | X | |
A4559 | XXX | 9 | X | 0.15 | X | ||
A4560 | XXX | 9 | X | # | X | ||
A4561 | XXX | 9 | X | * | X | ||
A4562 | XXX | 9 | X | * | X | ||
A4563 | XXX | 9 | X | 173.04 | X | ||
A4565 | XXX | 9 | X | * | X | ||
A4566 | XXX | 9 | X | * | X | ||
A4570 | XXX | 9 | X | * | X | ||
A4575 | XXX | 9 | X | * | X | ||
A4580 | XXX | 9 | X | # | X | ||
A4590 | XXX | 9 | X | * | X | ||
A4595 | XXX | 9 | X | 75.94 | X | ||
A4600 | XXX | 9 | X | * | X | ||
A4601 | XXX | 9 | X | * | X | ||
A4602 | XXX | 9 | X | * | X | ||
A4604 | RR | XXX | 9 | X | # | X | |
A4604 | UE | XXX | 9 | X | # | X | |
A4604 | NU | XXX | 9 | X | 134.28 | X | |
A4605 | NU | XXX | 9 | X | 34.30 | X | |
A4606 | XXX | 9 | X | * | X | ||
A4608 | XXX | 9 | X | * | X | ||
A4611 | NU | XXX | 9 | X | 523.82 | X | |
A4611 | RR | XXX | 9 | X | 54.30 | X | |
A4611 | UE | XXX | 9 | X | 392.89 | X | |
A4612 | NU | XXX | 9 | X | 181.12 | X | |
A4612 | RR | XXX | 9 | X | 18.41 | X | |
A4612 | UE | XXX | 9 | X | 138.12 | X | |
A4613 | NU | XXX | 9 | X | 384.50 | X | |
A4613 | RR | XXX | 9 | X | 38.42 | X | |
A4613 | UE | XXX | 9 | X | 278.11 | X | |
A4614 | XXX | 9 | X | 55.60 | X | ||
A4615 | XXX | 9 | X | * | X | ||
A4616 | XXX | 9 | X | # | X | ||
A4617 | XXX | 9 | X | * | X | ||
A4618 | NU | XXX | 9 | X | 23.68 | X | |
A4618 | RR | XXX | 9 | X | 2.71 | X | |
A4618 | UE | XXX | 9 | X | 17.77 | X | |
A4619 | XXX | 9 | X | * | X | ||
A4620 | XXX | 9 | X | * | X | ||
A4623 | XXX | 9 | X | 17.50 | X | ||
A4624 | XXX | 9 | X | 6.24 | X | ||
A4625 | XXX | 9 | X | 18.48 | X | ||
A4626 | XXX | 9 | X | 8.53 | X | ||
A4627 | XXX | 9 | X | * | X | ||
A4628 | XXX | 9 | X | 9.66 | X | ||
A4629 | XXX | 9 | X | 12.23 | X | ||
A4630 | XXX | 9 | X | 14.74 | X | ||
A4633 | NU | XXX | 9 | X | 91.03 | X | |
A4634 | XXX | 9 | X | # | X | ||
A4635 | NU | XXX | 9 | X | 11.69 | X | |
A4635 | RR | XXX | 9 | X | 1.53 | X | |
A4635 | UE | XXX | 9 | X | 7.70 | X | |
A4636 | NU | XXX | 9 | X | 9.58 | X | |
A4636 | RR | XXX | 9 | X | 0.95 | X | |
A4636 | UE | XXX | 9 | X | 6.97 | X | |
A4637 | NU | XXX | 9 | X | 5.64 | X | |
A4637 | RR | XXX | 9 | X | 0.76 | X | |
A4637 | UE | XXX | 9 | X | 3.93 | X | |
A4638 | XXX | 9 | X | # | X | ||
A4639 | NU | XXX | 9 | X | 637.21 | X | |
A4640 | NU | XXX | 9 | X | 143.51 | X | |
A4640 | RR | XXX | 9 | X | 14.62 | X | |
A4640 | UE | XXX | 9 | X | 101.72 | X | |
A4641 | XXX | 0 | X | # | X | ||
A4642 | XXX | 0 | X | # | X | ||
A4648 | XXX | 9 | X | * | X | ||
A4649 | XXX | 9 | X | # | X | ||
A4650 | XXX | 9 | X | # | X | ||
A4651 | XXX | 9 | X | * | X | ||
A4652 | XXX | 9 | X | * | X | ||
A4653 | XXX | 9 | X | # | X | ||
A4657 | XXX | 9 | X | * | X | ||
A4660 | XXX | 9 | X | * | X | ||
A4663 | XXX | 9 | X | * | X | ||
A4670 | XXX | 9 | X | * | X | ||
A4671 | XXX | 9 | X | * | X | ||
A4672 | XXX | 9 | X | * | X | ||
A4673 | XXX | 9 | X | * | X | ||
A4674 | XXX | 9 | X | * | X | ||
A4680 | XXX | 9 | X | 241.69 | X | ||
A4690 | XXX | 9 | X | 177.21 | X | ||
A4706 | XXX | 9 | X | * | X | ||
A4707 | XXX | 9 | X | # | X | ||
A4708 | XXX | 9 | X | # | X |
PART B FEE SCHEDULES