Code of Massachusetts Regulations
101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES
Title 101 CMR 317.00 - Rates for Medicine Services
Section 317.04 - Maximum Allowable Fees - Medical Services
Current through Register 1531, September 27, 2024
(1) Drugs, Medications, Supplies, and Laboratory Specimen Collections.
Drugs and/or biologicals available free of charge from the Massachusetts Department of Public Health are not payable items. When an immunization or injection is the primary purpose of an office or other outpatient visit, the provider may bill only for the injectable material and its administration. Payment for both vaccine administration and an office visit is allowable only when the vaccine administration is a medically necessary, separately identifiable service.
(2) Unless otherwise specified, guidelines,
notes, and definitions provided in the 2023 CPT Coding Handbook are applicable
to the use of the procedure codes and modifiers listed below, as well as their
corresponding descriptions. For code descriptions, see the
medicine services code spreadsheet at
(3) Modifiers.
(4) Fee Schedule.
Code |
NFAC |
FAC |
Global |
PC |
TC |
Description (see
medicine services code spreadsheet at
|
90281 |
- |
- |
I.C. |
- |
- | |
90283 |
- |
- |
I.C. |
- |
- | |
90284 |
- |
- |
I.C. |
- |
- | |
90287 |
- |
- |
I.C. |
- |
- | |
90288 |
- |
- |
I.C. |
- |
- | |
90291 |
- |
- |
I.C. |
- |
- | |
90296 |
- |
- |
I.C. |
- |
- | |
90377 |
- |
- |
I.C. |
- |
- | |
90378 |
- |
- |
I.C. |
- |
- | |
90384 |
- |
- |
I.C. |
- |
- | |
90385 |
- |
- |
I.C. |
- |
- | |
90386 |
- |
- |
I.C. |
- |
- | |
90389 |
- |
- |
I.C. |
- |
- | |
90393 |
- |
- |
I.C. |
- |
- | |
90396 |
- |
- |
I.C. |
- |
- | |
90399 |
- |
- |
I.C. |
- |
- | |
90460 |
- |
- |
$20.45 |
- |
- | |
90461 |
- |
- |
$9.84 |
- |
- | |
90471 |
- |
- |
$20.45 |
- |
- | |
90472 |
- |
- |
$9.84 |
- |
- | |
90473 |
- |
- |
$20.45 |
- |
- | |
90474 |
- |
- |
$9.84 |
- |
- | |
90476 |
- |
- |
I.C. |
- |
- | |
90477 |
- |
- |
I.C. |
- |
- | |
90581 |
- |
- |
I.C. |
- |
- | |
90586 |
- |
- |
I.C. |
- |
- | |
90587 |
- |
- |
I.C. |
- |
- | |
90589 |
- |
- |
I.C. |
- |
- | |
90619 |
- |
- |
I.C. |
- |
- | |
90620 |
- |
- |
I.C. |
- |
- | |
90621 |
- |
- |
I.C. |
- |
- | |
90623 |
- |
- |
I.C. |
- |
- | |
90625 |
- |
- |
I.C. |
- |
- | |
90626 |
- |
- |
I.C. |
- |
- | |
90627 |
- |
- |
I.C. |
- |
- | |
90630 |
- |
- |
I.C. |
- |
- | |
90633 |
- |
- |
I.C. |
- |
- | |
90634 |
- |
- |
I.C. |
- |
- | |
90636 |
- |
- |
$122.36 |
- |
- | |
90644 |
- |
- |
I.C. |
- |
- | |
90647 |
- |
- |
I.C. |
- |
- | |
90648 |
- |
- |
I.C. |
- |
- | |
90649 |
- |
- |
I.C. |
- |
- | |
90650 |
- |
- |
I.C. |
- |
- | |
90651 |
- |
- |
I.C. |
- |
- | |
90653 |
- |
- |
I.C. |
- |
- | |
90654 |
- |
- |
I.C. |
- |
- | |
90655 |
- |
- |
I.C. |
- |
- | |
90656 |
- |
- |
I.C. |
- |
- | |
90657 |
- |
- |
I.C. |
- |
- | |
90658 |
- |
- |
I.C. |
- |
- | |
90660 |
- |
- |
I.C. |
- |
- | |
90661 |
- |
- |
I.C. |
- |
- | |
90664 |
- |
- |
I.C. |
- |
- | |
90666 |
- |
- |
I.C. |
- |
- | |
90667 |
- |
- |
I.C. |
- |
- | |
90668 |
- |
- |
I.C. |
- |
- | |
90671 |
- |
- |
I.C. |
- |
- | |
90672 |
- |
- |
I.C. |
- |
- | |
90673 |
- |
- |
I.C. |
- |
- | |
90674 |
- |
- |
I.C. |
- |
- | |
90676 |
- |
- |
I.C. |
- |
- | |
90677 |
- |
- |
I.C. |
- |
- | |
90678 |
- |
- |
I.C. |
- |
- | |
90680 |
- |
- |
I.C. |
- |
- | |
90681 |
- |
- |
I.C. |
- |
- | |
90682 |
- |
- |
I.C. |
- |
- | |
90683 |
- |
- |
I.C. |
- |
- | |
90685 |
- |
- |
I.C. |
- |
- | |
90687 |
- |
- |
I.C. |
- |
- | |
90689 |
- |
- |
I.C. |
- |
- | |
90690 |
- |
- |
I.C. |
- |
- | |
90694 |
- |
- |
I.C. |
- |
- | |
90696 |
- |
- |
I.C. |
- |
- | |
90697 |
- |
- |
I.C. |
- |
- | |
90698 |
- |
- |
I.C. |
- |
- | |
90700 |
- |
- |
I.C. |
- |
- | |
90702 |
- |
- |
I.C. |
- |
- | |
90707 |
- |
- |
I.C. |
- |
- | |
90710 |
- |
- |
I.C. |
- |
- | |
90713 |
- |
- |
I.C. |
- |
- | |
90716 |
- |
- |
I.C. |
- |
- | |
90717 |
- |
- |
I.C. |
- |
- | |
90723 |
- |
- |
I.C. |
- |
- | |
90733 |
- |
- |
I.C. |
- |
- | |
90734 |
- |
- |
I.C. |
- |
- | |
90736 |
- |
- |
I.C. |
- |
- | |
90738 |
- |
- |
I.C. |
- |
- | |
90739 |
- |
- |
I.C. |
- |
- | |
90743 |
- |
- |
I.C. |
- |
- | |
90744 |
- |
- |
I.C. |
- |
- | |
90748 |
- |
- |
I.C. |
- |
- | |
90749 |
- |
- |
I.C. |
- |
- | |
90750 |
- |
- |
I.C. |
- |
- | |
90756 |
- |
- |
I.C. |
- |
- | |
90758 |
- |
- |
I.C. |
- |
- | |
90759 |
- |
- |
I.C. |
- |
- | |
90785 |
$10.96 |
$9.62 |
- |
- |
- | |
90791 |
$128.70 |
$109.68 |
- |
- |
- | |
90792 |
$144.56 |
$125.28 |
- |
- |
- | |
90832 |
$55.55 |
$48.32 |
- |
- |
- | |
90833 |
$51.05 |
$45.16 |
- |
- |
- | |
90834 |
$73.46 |
$64.08 |
- |
- |
- | |
90836 |
$64.73 |
$57.23 |
- |
- |
- | |
90837 |
$108.09 |
$94.16 |
- |
- |
- | |
90838 |
$85.64 |
$76.00 |
- |
- |
- | |
90839 |
$103.82 |
$90.96 |
- |
- |
- | |
90840 |
$51.45 |
$45.56 |
- |
- |
- | |
90845 |
$69.49 |
$60.92 |
- |
- |
- | |
90846 |
$69.54 |
$69.27 |
- |
- |
- | |
90847 |
$72.52 |
$72.26 |
- |
- |
- | |
90849 |
$27.97 |
$21.27 |
- |
- |
- | |
90853 |
$19.67 |
$16.99 |
- |
- |
- | |
90863 |
$18.71 |
$17.64 |
- |
- |
- | |
90865 |
$122.02 |
$89.88 |
- |
- |
- | |
90867 |
- |
- |
I.C. |
- |
- | |
90868 |
- |
- |
I.C. |
- |
- | |
90869 |
- |
- |
I.C. |
- |
- | |
90870 |
$130.44 |
$76.87 |
- |
- |
- | |
90875 |
$43.64 |
$43.10 |
- |
- |
- | |
90876 |
$76.58 |
$68.54 |
- |
- |
- | |
90880 |
$77.05 |
$63.66 |
- |
- |
- | |
90882 |
- |
- |
I.C. |
- |
- | |
90885 |
- |
- |
$35.13 |
- |
- | |
90887 |
$63.68 |
$53.50 |
- |
- |
- | |
90889 |
- |
- |
I.C. |
- |
- | |
90899 |
- |
- |
I.C. |
- |
- | |
90901 |
$31.67 |
$13.99 |
- |
- |
- | |
90912 |
$61.94 |
$31.41 |
- |
- |
- | |
90913 |
$24.29 |
$17.86 |
- |
- |
- | |
90935 |
- |
- |
$52.43 |
- |
- | |
90937 |
- |
- |
$74.69 |
- |
- | |
90940 |
- |
- |
I.C. |
- |
- | |
90945 |
- |
- |
$63.23 |
- |
- | |
90947 |
- |
- |
$89.67 |
- |
- | |
90951 |
- |
- |
$861.41 |
- |
- | |
90952 |
- |
- |
I.C. |
- |
- | |
90953 |
- |
- |
I.C. |
- |
- | |
90954 |
- |
- |
$738.30 |
- |
- | |
90955 |
- |
- |
$383.14 |
- |
- | |
90956 |
- |
- |
$256.16 |
- |
- | |
90957 |
- |
- |
$565.67 |
- |
- | |
90958 |
- |
- |
$368.30 |
- |
- | |
90959 |
- |
- |
$239.78 |
- |
- | |
90960 |
- |
- |
$260.54 |
- |
- | |
90961 |
- |
- |
$216.95 |
- |
- | |
90962 |
- |
- |
$149.93 |
- |
- | |
90963 |
- |
- |
$446.55 |
- |
- | |
90964 |
- |
- |
$383.43 |
- |
- | |
90965 |
- |
- |
$367.46 |
- |
- | |
90966 |
- |
- |
$216.68 |
- |
- | |
90967 |
- |
- |
$12.99 |
- |
- | |
90968 |
- |
- |
$12.74 |
- |
- | |
90969 |
- |
- |
$12.50 |
- |
- | |
90970 |
- |
- |
$7.02 |
- |
- | |
90989 |
- |
- |
I.C. |
- |
- | |
90993 |
- |
- |
I.C. |
- |
- | |
90997 |
- |
- |
$64.39 |
- |
- | |
90999 |
- |
- |
I.C. |
- |
- | |
91010 |
- |
- |
$174.09 |
$47.27 |
$126.82 | |
91013 |
- |
- |
$20.14 |
$6.75 |
$13.39 | |
91020 |
- |
- |
$216.71 |
$53.20 |
$163.51 | |
91022 |
- |
- |
$133.68 |
$53.20 |
$80.48 | |
91030 |
- |
- |
$113.21 |
$33.80 |
$79.41 | |
91034 |
- |
- |
$151.77 |
$36.47 |
$115.30 | |
91035 |
- |
- |
$366.69 |
$59.54 |
$307.14 | |
91037 |
- |
- |
$132.62 |
$35.80 |
$96.82 | |
91038 |
- |
- |
$325.44 |
$40.59 |
$284.85 | |
91040 |
- |
- |
$420.41 |
$36.13 |
$384.28 | |
91065 |
- |
- |
$66.90 |
$7.24 |
$59.66 | |
91110 |
- |
- |
$592.39 |
$82.50 |
$509.90 | |
91111 |
- |
- |
$685.67 |
$33.28 |
$652.39 | |
91112 |
- |
- |
$1,318.43 |
$77.66 |
$1,240.77 | |
91113 |
- |
- |
$726.59 |
$89.00 |
$637.59 | |
91117 |
- |
- |
$100.28 |
- |
- | |
91120 |
- |
- |
$407.76 |
$35.26 |
$372.50 | |
91122 |
- |
- |
$215.28 |
$64.35 |
$150.93 | |
91132 |
- |
- |
$356.43 |
$19.29 |
$337.14 | |
91133 |
- |
- |
$374.86 |
$24.33 |
$350.53 | |
91200 |
- |
- |
$23.75 |
$7.75 |
$16.00 | |
91299 |
- |
- |
I.C. |
- |
- | |
91318 |
- |
- |
I.C. |
- |
- | |
91319 |
- |
- |
I.C. |
- |
- | |
91320 |
- |
- |
I.C. |
- |
- | |
91321 |
- |
- |
I.C. |
- |
- | |
91322 |
- |
- |
I.C. |
- |
- | |
92002 |
$65.87 |
$34.00 |
- |
- |
- | |
92004 |
$114.47 |
$69.74 |
- |
- |
- | |
92012 |
$69.13 |
$37.52 |
- |
- |
- | |
92014 |
$96.90 |
$56.46 |
- |
- |
- | |
92018 |
- |
- |
$102.85 |
- |
- | |
92019 |
- |
- |
$53.23 |
- |
- | |
92020 |
$21.04 |
$15.15 |
- |
- |
- | |
92025 |
- |
- |
$27.99 |
$14.39 |
$13.59 | |
92060 |
- |
- |
$48.63 |
$27.27 |
$21.36 | |
92065 |
- |
- |
$30.91 |
$24.28 |
$6.63 | |
92066 |
- |
- |
$20.56 |
- |
- | |
92071 |
$27.39 |
$23.91 |
- |
- |
- | |
92072 |
$95.78 |
$69.80 |
- |
- |
- | |
92081 |
- |
- |
$25.69 |
$11.83 |
$13.86 | |
92082 |
- |
- |
$36.17 |
$15.35 |
$20.82 | |
92083 |
- |
- |
$48.53 |
$19.94 |
$28.59 | |
92100 |
$66.49 |
$23.91 |
- |
- |
- | |
92132 |
- |
- |
$24.35 |
$12.10 |
$12.25 | |
92133 |
- |
- |
$28.14 |
$15.89 |
$12.25 | |
92134 |
- |
- |
$30.97 |
$18.45 |
$12.52 | |
92136 |
- |
- |
$36.12 |
$22.53 |
$13.59 | |
92145 |
- |
- |
$9.81 |
$3.99 |
$5.82 | |
92201 |
$18.50 |
$16.62 |
- |
- |
- | |
92202 |
$11.66 |
$10.85 |
- |
- |
- | |
92227 |
- |
- |
$13.32 |
- |
- | |
92228 |
- |
- |
$22.43 |
$12.32 |
$10.11 | |
92229 |
- |
- |
$36.09 |
- |
- | |
92230 |
$88.08 |
$25.67 |
- |
- |
- | |
92235 |
- |
- |
$107.69 |
$31.42 |
$76.27 | |
92240 |
- |
- |
$149.95 |
$34.85 |
$115.10 | |
92242 |
- |
- |
$204.25 |
$40.40 |
$163.85 | |
92250 |
- |
- |
$28.67 |
$15.62 |
$13.06 | |
92260 |
$15.27 |
$7.78 |
- |
- |
- | |
92265 |
- |
- |
$67.11 |
$33.96 |
$33.14 | |
92270 |
- |
- |
$84.98 |
$31.01 |
$53.97 | |
92273 |
- |
- |
$99.45 |
$27.01 |
$72.45 | |
92274 |
- |
- |
$69.44 |
$24.51 |
$44.93 | |
92283 |
- |
- |
$42.60 |
$6.51 |
$36.09 | |
92284 |
- |
- |
$36.89 |
- |
- | |
92285 |
- |
- |
$18.23 |
$2.23 |
$16.00 | |
92286 |
- |
- |
$30.01 |
$15.89 |
$14.13 | |
92287 |
- |
- |
$114.38 |
$27.67 |
$86.71 | |
92310 |
$76.65 |
$42.10 |
- |
- |
- | |
92311 |
$81.28 |
$38.43 |
- |
- |
- | |
92312 |
$94.26 |
$44.44 |
- |
- |
- | |
92313 |
$77.37 |
$31.83 |
- |
- |
- | |
92314 |
$67.51 |
$24.93 |
- |
- |
- | |
92315 |
$64.79 |
$15.50 |
- |
- |
- | |
92316 |
$79.79 |
$23.28 |
- |
- |
- | |
92317 |
$68.27 |
$15.50 |
- |
- |
- | |
92325 |
- |
- |
$36.09 |
- |
- | |
92326 |
- |
- |
$31.00 |
- |
- | |
92352 |
$34.37 |
$13.21 |
- |
- |
- | |
92353 |
$39.02 |
$18.13 |
- |
- |
- | |
92354 |
- |
- |
$10.65 |
- |
- | |
92355 |
- |
- |
$16.54 |
- |
- | |
92358 |
- |
- |
$8.77 |
- |
- | |
92371 |
- |
- |
$9.31 |
- |
- | |
92499 |
- |
- |
I.C. |
- |
- | |
92502 |
- |
- |
$71.11 |
- |
- | |
92504 |
$22.82 |
$7.02 |
- |
- |
- | |
92507 |
- |
- |
$57.81 |
- |
- | |
92508 |
- |
- |
$18.19 |
- |
- | |
92511 |
$93.14 |
$28.32 |
- |
- |
- | |
92512 |
$49.09 |
$20.16 |
- |
- |
- | |
92516 |
$55.52 |
$16.95 |
- |
- |
- | |
92517 |
$59.76 |
$31.37 |
- |
- |
- | |
92518 |
$61.90 |
$31.64 |
- |
- |
- | |
92519 |
$103.30 |
$47.59 |
- |
- |
- | |
92520 |
$66.04 |
$29.61 |
- |
- |
- | |
92521 |
- |
- |
$100.51 |
- |
- | |
92522 |
- |
- |
$83.77 |
- |
- | |
92523 |
- |
- |
$172.36 |
- |
- | |
92524 |
- |
- |
$82.70 |
- |
- | |
92526 |
- |
- |
$64.41 |
- |
- | |
92531 |
- |
- |
I.C. |
- |
- | |
92532 |
- |
- |
I.C. |
- |
- | |
92533 |
- |
- |
I.C. |
- |
- | |
92534 |
- |
- |
I.C. |
- |
- | |
92537 |
- |
- |
$30.63 |
$22.93 |
$7.70 | |
92538 |
- |
- |
$17.12 |
$11.83 |
$5.29 | |
92540 |
- |
- |
$82.99 |
$57.62 |
$25.38 | |
92541 |
- |
- |
$19.03 |
$15.62 |
$3.41 | |
92542 |
- |
- |
$21.80 |
$18.38 |
$3.41 | |
92544 |
- |
- |
$13.44 |
$10.56 |
$2.88 | |
92545 |
- |
- |
$12.68 |
$9.80 |
$2.88 | |
92546 |
- |
- |
$100.64 |
$11.05 |
$89.59 | |
92547 |
- |
- |
$8.57 |
- |
- | |
92548 |
- |
- |
$36.02 |
$24.84 |
$11.18 | |
92549 |
- |
- |
$49.56 |
$33.29 |
$16.27 | |
92550 |
- |
- |
$16.81 |
- |
- | |
92551 |
- |
- |
$9.57 |
- |
- | |
92552 |
- |
- |
$28.32 |
- |
- | |
92553 |
- |
- |
$34.75 |
- |
- | |
92555 |
- |
- |
$21.89 |
- |
- | |
92556 |
- |
- |
$33.95 |
- |
- | |
92557 |
$27.95 |
$23.66 |
- |
- |
- | |
92558 |
$7.04 |
$6.24 |
- |
- |
- | |
92562 |
- |
- |
$38.23 |
- |
- | |
92563 |
- |
- |
$26.45 |
- |
- | |
92565 |
- |
- |
$16.00 |
- |
- | |
92567 |
$12.60 |
$8.04 |
- |
- |
- | |
92568 |
$11.52 |
$11.25 |
- |
- |
- | |
92570 |
$24.31 |
$21.63 |
- |
- |
- | |
92571 |
- |
- |
$24.04 |
- |
- | |
92572 |
- |
- |
$37.70 |
- |
- | |
92575 |
- |
- |
$59.59 |
- |
- | |
92576 |
- |
- |
$31.80 |
- |
- | |
92577 |
- |
- |
$16.27 |
- |
- | |
92579 |
$34.15 |
$27.72 |
- |
- |
- | |
92582 |
- |
- |
$65.55 |
- |
- | |
92583 |
- |
- |
$43.32 |
- |
- | |
92584 |
- |
- |
$87.96 |
- |
- | |
92587 |
- |
- |
$16.47 |
$13.32 |
$3.15 | |
92588 |
- |
- |
$25.65 |
$21.43 |
$4.22 | |
92596 |
- |
- |
$58.59 |
- |
- | |
92597 |
- |
- |
$54.15 |
- |
- | |
92601 |
$122.87 |
$91.53 |
- |
- |
- | |
92602 |
$78.16 |
$51.92 |
- |
- |
- | |
92603 |
$114.95 |
$88.97 |
- |
- |
- | |
92604 |
$69.71 |
$49.62 |
- |
- |
- | |
92605 |
$67.81 |
$63.26 |
- |
- |
- | |
92606 |
$59.45 |
$50.34 |
- |
- |
- | |
92607 |
- |
- |
$94.31 |
- |
- | |
92608 |
- |
- |
$37.09 |
- |
- | |
92609 |
- |
- |
$78.78 |
- |
- | |
92610 |
$64.50 |
$52.45 |
- |
- |
- | |
92611 |
- |
- |
$69.50 |
- |
- | |
92612 |
$154.16 |
$49.44 |
- |
- |
- | |
92613 |
- |
- |
$27.29 |
- |
- | |
92614 |
$114.19 |
$48.83 |
- |
- |
- | |
92615 |
- |
- |
$24.26 |
- |
- | |
92616 |
$174.45 |
$73.48 |
- |
- |
- | |
92617 |
$30.32 |
$30.05 |
- |
- |
- | |
92618 |
$23.68 |
$23.41 |
- |
- |
- | |
92620 |
$66.85 |
$59.09 |
- |
- |
- | |
92621 |
$16.54 |
$13.86 |
- |
- |
- | |
92622 |
$60.24 |
$49.28 |
- |
- |
- | |
92623 |
$15.47 |
$13.06 |
- |
- |
- | |
92625 |
$51.46 |
$45.56 |
- |
- |
- | |
92626 |
$65.88 |
$55.70 |
- |
- |
- | |
92627 |
$15.51 |
$13.10 |
- |
- |
- | |
92630 |
- |
- |
I.C. |
- |
- | |
92633 |
- |
- |
I.C. |
- |
- | |
92640 |
$83.27 |
$69.87 |
- |
- |
- | |
92650 |
- |
- |
$21.52 |
- |
- | |
92651 |
- |
- |
$65.19 |
- |
- | |
92652 |
- |
- |
$86.54 |
- |
- | |
92653 |
- |
- |
$64.67 |
- |
- | |
92700 |
- |
- |
I.C. |
- |
- | |
92920 |
- |
- |
$374.88 |
- |
- | |
92921 |
- |
- |
I.C. |
- |
- | |
92924 |
- |
- |
$447.76 |
- |
- | |
92925 |
- |
- |
I.C. |
- |
- | |
92928 |
- |
- |
$417.83 |
- |
- | |
92929 |
- |
- |
I.C. |
- |
- | |
92933 |
- |
- |
$468.25 |
- |
- | |
92934 |
- |
- |
I.C. |
- |
- | |
92937 |
- |
- |
$417.32 |
- |
- | |
92938 |
- |
- |
I.C. |
- |
- | |
92941 |
- |
- |
$468.87 |
- |
- | |
92943 |
- |
- |
$469.21 |
- |
- | |
92944 |
- |
- |
I.C. |
- |
- | |
92950 |
$249.10 |
$132.32 |
- |
- |
- | |
92953 |
- |
- |
$0.71 |
- |
- | |
92960 |
$117.99 |
$79.69 |
- |
- |
- | |
92961 |
- |
- |
$175.61 |
- |
- | |
92970 |
- |
- |
$133.61 |
- |
- | |
92971 |
- |
- |
$71.69 |
- |
- | |
92972 |
- |
- |
$105.80 |
- |
- | |
92973 |
- |
- |
$124.70 |
- |
- | |
92974 |
- |
- |
$114.23 |
- |
- | |
92975 |
- |
- |
$266.55 |
- |
- | |
92977 |
- |
- |
$41.50 |
- |
- | |
92978 |
- |
- |
- |
$67.48 |
- | |
92979 |
- |
- |
- |
$53.85 |
- | |
92986 |
- |
- |
$949.60 |
- |
- | |
92987 |
- |
- |
$982.07 |
- |
- | |
92990 |
- |
- |
$785.14 |
- |
- | |
92997 |
- |
- |
$454.34 |
- |
- | |
92998 |
- |
- |
$225.95 |
- |
- | |
93000 |
- |
- |
$10.99 |
- |
- | |
93005 |
- |
- |
$5.02 |
- |
- | |
93010 |
- |
- |
$5.97 |
- |
- | |
93015 |
- |
- |
$54.25 |
- |
- | |
93016 |
- |
- |
$15.50 |
- |
- | |
93017 |
- |
- |
$28.52 |
- |
- | |
93018 |
- |
- |
$10.22 |
- |
- | |
93024 |
- |
- |
$84.35 |
$40.16 |
$44.19 | |
93025 |
- |
- |
$94.96 |
$27.07 |
$67.90 | |
93040 |
- |
- |
$9.70 |
- |
- | |
93041 |
- |
- |
$4.75 |
- |
- | |
93042 |
- |
- |
$4.94 |
- |
- | |
93050 |
- |
- |
$12.06 |
$5.97 |
$6.09 | |
93150 |
$77.57 |
$31.30 |
- |
- |
- | |
93151 |
$67.52 |
$29.54 |
- |
- |
- | |
93152 |
$121.09 |
$69.20 |
- |
- |
- | |
93153 |
$40.18 |
$15.84 |
- |
- |
- | |
93224 |
- |
- |
$57.02 |
- |
- | |
93225 |
- |
- |
$14.66 |
- |
- | |
93226 |
- |
- |
$28.86 |
- |
- | |
93227 |
- |
- |
$13.50 |
- |
- | |
93228 |
- |
- |
$18.71 |
- |
- | |
93229 |
- |
- |
$670.79 |
- |
- | |
93241 |
- |
- |
$209.90 |
- |
- | |
93242 |
- |
- |
$9.57 |
- |
- | |
93243 |
- |
- |
$183.13 |
- |
- | |
93244 |
- |
- |
$17.20 |
- |
- | |
93245 |
- |
- |
$221.04 |
- |
- | |
93246 |
- |
- |
$9.57 |
- |
- | |
93247 |
- |
- |
$192.51 |
- |
- | |
93248 |
- |
- |
$18.96 |
- |
- | |
93260 |
- |
- |
$59.04 |
$30.99 |
$28.06 | |
93261 |
- |
- |
$54.34 |
$26.55 |
$27.79 | |
93264 |
$38.09 |
$25.77 |
- |
- |
- | |
93268 |
- |
- |
$141.29 |
- |
- | |
93270 |
- |
- |
$6.63 |
- |
- | |
93271 |
- |
- |
$116.98 |
- |
- | |
93272 |
- |
- |
$17.69 |
- |
- | |
93278 |
- |
- |
$22.32 |
$9.00 |
$13.32 | |
93279 |
- |
- |
$52.67 |
$23.01 |
$29.66 | |
93280 |
- |
- |
$61.77 |
$27.29 |
$34.48 | |
93281 |
- |
- |
$65.74 |
$30.72 |
$35.02 | |
93282 |
- |
- |
$62.52 |
$30.72 |
$31.80 | |
93283 |
- |
- |
$76.03 |
$41.28 |
$34.75 | |
93284 |
- |
- |
$81.96 |
$44.80 |
$37.16 | |
93285 |
- |
- |
$47.35 |
$18.76 |
$28.59 | |
93286 |
- |
- |
$36.14 |
$10.76 |
$25.38 | |
93287 |
- |
- |
$41.68 |
$16.31 |
$25.38 | |
93288 |
- |
- |
$44.14 |
$15.01 |
$29.13 | |
93289 |
- |
- |
$56.33 |
$26.93 |
$29.39 | |
93290 |
- |
- |
$41.93 |
$15.48 |
$26.45 | |
93291 |
- |
- |
$38.92 |
$13.28 |
$25.64 | |
93292 |
- |
- |
$39.79 |
$15.21 |
$24.57 | |
93293 |
- |
- |
$35.58 |
$10.47 |
$25.11 | |
93294 |
- |
- |
$21.92 |
- |
- | |
93295 |
- |
- |
$26.95 |
- |
- | |
93296 |
- |
- |
$17.88 |
- |
- | |
93297 |
- |
- |
$18.89 |
- |
- | |
93298 |
- |
- |
$19.16 |
- |
- | |
93303 |
- |
- |
$172.97 |
$44.95 |
$128.02 | |
93304 |
- |
- |
$122.41 |
$26.40 |
$96.02 | |
93306 |
- |
- |
$153.05 |
$50.21 |
$102.85 | |
93307 |
- |
- |
$107.02 |
$31.90 |
$75.13 | |
93308 |
- |
- |
$77.25 |
$18.20 |
$59.06 | |
93312 |
- |
- |
$183.13 |
$77.74 |
$105.39 | |
93313 |
- |
- |
$8.11 |
- |
- | |
93314 |
- |
- |
$176.79 |
$64.97 |
$111.82 | |
93315 |
- |
- |
- |
$92.24 |
$397.67 | |
93316 |
- |
- |
$18.44 |
- |
- | |
93317 |
- |
- |
- |
$64.19 |
- | |
93318 |
- |
- |
- |
$74.33 |
$397.67 | |
93319 |
$42.77 |
$17.60 |
- |
- |
- | |
93320 |
- |
- |
$39.43 |
$12.99 |
$26.45 | |
93321 |
- |
- |
$19.68 |
$5.21 |
$14.46 | |
93325 |
- |
- |
$18.59 |
$2.25 |
$16.34 | |
93350 |
- |
- |
$144.62 |
$50.21 |
$94.41 | |
93351 |
- |
- |
$180.91 |
$60.39 |
$120.52 | |
93352 |
- |
- |
$26.48 |
- |
- | |
93355 |
- |
- |
$163.15 |
- |
- | |
93356 |
$29.04 |
$8.42 |
- |
- |
- | |
93451 |
- |
- |
$687.51 |
$93.45 |
$594.06 | |
93452 |
- |
- |
$707.11 |
$167.96 |
$539.16 | |
93453 |
- |
- |
$898.18 |
$224.56 |
$673.61 | |
93454 |
- |
- |
$709.76 |
$169.54 |
$540.23 | |
93455 |
- |
- |
$789.85 |
$197.66 |
$592.19 | |
93456 |
- |
- |
$882.25 |
$220.96 |
$661.29 | |
93457 |
- |
- |
$960.55 |
$248.10 |
$712.45 | |
93458 |
- |
- |
$814.18 |
$209.13 |
$605.05 | |
93459 |
- |
- |
$874.71 |
$237.26 |
$637.45 | |
93460 |
- |
- |
$971.40 |
$265.65 |
$705.75 | |
93461 |
- |
- |
$1,071.17 |
$293.51 |
$777.67 | |
93462 |
- |
- |
$149.50 |
- |
- | |
93463 |
- |
- |
$71.12 |
- |
- | |
93464 |
- |
- |
$170.21 |
$64.22 |
$106.00 | |
93503 |
- |
- |
$63.28 |
- |
- | |
93505 |
- |
- |
$503.03 |
$162.21 |
$340.82 | |
93563 |
- |
- |
$37.26 |
- |
- | |
93564 |
- |
- |
$39.19 |
- |
- | |
93565 |
- |
- |
$19.19 |
- |
- | |
93566 |
- |
- |
$19.06 |
- |
- | |
93567 |
- |
- |
$26.97 |
- |
- | |
93568 |
- |
- |
$33.65 |
- |
- | |
93569 |
- |
- |
$27.53 |
- |
- | |
93571 |
- |
- |
- |
$51.64 |
- | |
93572 |
- |
- |
- |
$37.39 |
- | |
93573 |
- |
- |
$45.88 |
- |
- | |
93574 |
- |
- |
$50.65 |
- |
- | |
93575 |
- |
- |
$67.76 |
- |
- | |
93580 |
- |
- |
$692.85 |
- |
- | |
93581 |
- |
- |
$939.34 |
- |
- | |
93582 |
- |
- |
$469.27 |
- |
- | |
93583 |
- |
- |
$526.06 |
- |
- | |
93584 |
- |
- |
$42.77 |
- |
- | |
93585 |
- |
- |
$40.26 |
- |
- | |
93586 |
- |
- |
$50.92 |
- |
- | |
93587 |
- |
- |
$75.13 |
- |
- | |
93588 |
- |
- |
$75.89 |
- |
- | |
93590 |
- |
- |
$775.77 |
- |
- | |
93591 |
- |
- |
$639.81 |
- |
- | |
93592 |
- |
- |
$282.00 |
- |
- | |
93593 |
- |
- |
- |
$137.73 |
- | |
93594 |
- |
- |
- |
$215.10 |
- | |
93595 |
- |
- |
- |
$193.85 |
- | |
93596 |
- |
- |
- |
$236.03 |
- | |
93597 |
- |
- |
- |
$312.83 |
- | |
93598 |
- |
- |
- |
$51.06 |
- | |
93600 |
- |
- |
- |
$84.54 |
- | |
93602 |
- |
- |
- |
$82.34 |
- | |
93603 |
- |
- |
- |
$82.34 |
- | |
93609 |
- |
- |
- |
$197.42 |
- | |
93610 |
- |
- |
- |
$116.34 |
- | |
93612 |
- |
- |
- |
$114.41 |
- | |
93613 |
- |
- |
$210.50 |
- |
- | |
93615 |
- |
- |
- |
$27.09 |
- | |
93616 |
- |
- |
- |
$42.68 |
- | |
93618 |
- |
- |
- |
$156.53 |
- | |
93619 |
- |
- |
- |
$277.46 |
- | |
93620 |
- |
- |
- |
$446.44 |
- | |
93621 |
- |
- |
- |
$59.27 |
- | |
93622 |
- |
- |
- |
$122.32 |
- | |
93623 |
- |
- |
- |
$61.81 |
- | |
93624 |
- |
- |
- |
$177.95 |
- | |
93631 |
- |
- |
- |
$282.12 |
- | |
93640 |
- |
- |
- |
$126.70 |
- | |
93641 |
- |
- |
- |
$222.16 |
- | |
93642 |
- |
- |
$247.13 |
$181.25 |
$65.88 | |
93644 |
- |
- |
$144.40 |
$104.02 |
$40.38 | |
93650 |
- |
- |
$421.65 |
- |
- | |
93653 |
- |
- |
$604.45 |
- |
- | |
93654 |
- |
- |
$728.43 |
- |
- | |
93655 |
- |
- |
$221.80 |
- |
- | |
93656 |
- |
- |
$685.45 |
- |
- | |
93657 |
- |
- |
$221.80 |
- |
- | |
93660 |
- |
- |
$123.00 |
$67.03 |
$55.97 | |
93662 |
- |
- |
- |
$54.27 |
- | |
93668 |
- |
- |
$11.45 |
- |
- | |
93701 |
- |
- |
$21.09 |
- |
- | |
93702 |
- |
- |
$102.71 |
- |
- | |
93724 |
- |
- |
$212.01 |
$174.85 |
$37.16 | |
93740 |
- |
- |
$5.72 |
- |
- | |
93745 |
- |
- |
I.C. |
- |
- | |
93750 |
$37.64 |
$29.07 |
- |
- |
- | |
93770 |
- |
- |
$5.72 |
- |
- | |
93784 |
- |
- |
$35.35 |
- |
- | |
93786 |
- |
- |
$17.88 |
- |
- | |
93788 |
- |
- |
$4.22 |
- |
- | |
93790 |
- |
- |
$13.25 |
- |
- | |
93792 |
- |
- |
$55.97 |
- |
- | |
93793 |
- |
- |
$8.62 |
- |
- | |
93797 |
$12.91 |
$6.48 |
- |
- |
- | |
93798 |
$19.58 |
$9.93 |
- |
- |
- | |
93799 |
- |
- |
I.C. |
- |
- | |
93880 |
- |
- |
$150.89 |
$27.95 |
$122.93 | |
93882 |
- |
- |
$97.88 |
$17.39 |
$80.48 | |
93886 |
- |
- |
$214.05 |
$33.53 |
$180.52 | |
93888 |
- |
- |
$102.90 |
$18.40 |
$84.50 | |
93890 |
- |
- |
$220.00 |
$37.07 |
$182.93 | |
93892 |
- |
- |
$127.79 |
$43.29 |
$84.50 | |
93893 |
- |
- |
$128.25 |
$43.95 |
$84.30 | |
93895 |
- |
- |
I.C. |
- |
- | |
93922 |
- |
- |
$64.91 |
$8.80 |
$56.11 | |
93923 |
- |
- |
$101.27 |
$15.70 |
$85.57 | |
93924 |
- |
- |
$124.59 |
$17.46 |
$107.13 | |
93925 |
- |
- |
$190.33 |
$27.22 |
$163.11 | |
93926 |
- |
- |
$101.03 |
$16.52 |
$84.50 | |
93930 |
- |
- |
$154.57 |
$27.62 |
$126.95 | |
93931 |
- |
- |
$97.54 |
$16.79 |
$80.75 | |
93970 |
- |
- |
$149.04 |
$24.23 |
$124.81 | |
93971 |
- |
- |
$94.44 |
$15.57 |
$78.88 | |
93975 |
- |
- |
$210.12 |
$40.58 |
$169.54 | |
93976 |
- |
- |
$112.39 |
$27.89 |
$84.50 | |
93978 |
- |
- |
$142.11 |
$27.48 |
$114.63 | |
93979 |
- |
- |
$92.45 |
$16.79 |
$75.66 | |
93980 |
- |
- |
$89.46 |
$43.46 |
$46.00 | |
93981 |
- |
- |
$54.90 |
$15.59 |
$39.30 | |
93985 |
- |
- |
$196.35 |
$27.34 |
$169.00 | |
93986 |
- |
- |
$101.63 |
$17.12 |
$84.50 | |
93990 |
- |
- |
$101.29 |
$16.79 |
$84.50 | |
93998 |
- |
- |
I.C. |
- |
- | |
94002 |
- |
- |
$66.59 |
- |
- | |
94003 |
- |
- |
$46.73 |
- |
- | |
94004 |
- |
- |
$34.66 |
- |
- | |
94005 |
- |
- |
$67.39 |
- |
- | |
94010 |
- |
- |
$20.90 |
$5.97 |
$14.93 | |
94011 |
- |
- |
$62.39 |
- |
- | |
94012 |
- |
- |
$101.17 |
- |
- | |
94013 |
- |
- |
$13.78 |
- |
- | |
94014 |
- |
- |
$42.53 |
- |
- | |
94015 |
- |
- |
$24.57 |
- |
- | |
94016 |
- |
- |
$17.95 |
- |
- | |
94060 |
- |
- |
$30.16 |
$7.46 |
$22.70 | |
94070 |
- |
- |
$47.16 |
$20.18 |
$26.98 | |
94150 |
- |
- |
$19.52 |
$2.72 |
$16.81 | |
94200 |
- |
- |
$11.53 |
$1.96 |
$9.57 | |
94375 |
- |
- |
$29.69 |
$10.47 |
$19.22 | |
94450 |
- |
- |
$64.43 |
$14.48 |
$49.95 | |
94452 |
- |
- |
$37.99 |
$10.20 |
$27.79 | |
94453 |
- |
- |
$51.84 |
$13.41 |
$38.43 | |
94610 |
- |
- |
$41.25 |
- |
- | |
94617 |
- |
- |
$67.83 |
$23.23 |
$44.59 | |
94618 |
- |
- |
$25.48 |
$16.17 |
$9.31 | |
94619 |
- |
- |
$59.67 |
$16.42 |
$43.25 | |
94621 |
- |
- |
$118.06 |
$49.49 |
$68.56 | |
94625 |
$45.24 |
$12.29 |
- |
- |
- | |
94626 |
$60.04 |
$19.87 |
- |
- |
- | |
94640 |
- |
- |
$7.16 |
- |
- | |
94642 |
- |
- |
I.C. |
- |
- | |
94644 |
- |
- |
$47.61 |
- |
- | |
94645 |
- |
- |
$12.52 |
- |
- | |
94660 |
$48.20 |
$27.04 |
- |
- |
- | |
94662 |
- |
- |
$25.43 |
- |
- | |
94664 |
- |
- |
$13.59 |
- |
- | |
94667 |
- |
- |
$18.61 |
- |
- | |
94668 |
- |
- |
$29.06 |
- |
- | |
94669 |
- |
- |
$15.40 |
- |
- | |
94680 |
- |
- |
$41.18 |
$9.18 |
$32.00 | |
94681 |
- |
- |
$36.83 |
$6.97 |
$29.86 | |
94690 |
- |
- |
$37.74 |
$2.72 |
$35.02 | |
94726 |
- |
- |
$42.59 |
$8.71 |
$33.88 | |
94727 |
- |
- |
$34.09 |
$8.71 |
$25.38 | |
94728 |
- |
- |
$30.87 |
$8.98 |
$21.89 | |
94729 |
- |
- |
$44.69 |
$6.46 |
$38.23 | |
94760 |
- |
- |
$1.81 |
- |
- | |
94761 |
- |
- |
$2.88 |
- |
- | |
94762 |
- |
- |
$20.29 |
- |
- | |
94772 |
- |
- |
I.C. |
- |
- | |
94774 |
- |
- |
I.C. |
- |
- | |
94775 |
- |
- |
I.C. |
- |
- | |
94776 |
- |
- |
I.C. |
- |
- | |
94777 |
- |
- |
I.C. |
- |
- | |
94780 |
$39.87 |
$17.37 |
- |
- |
- | |
94781 |
$15.88 |
$5.97 |
- |
- |
- | |
94799 |
- |
- |
I.C. |
- |
- | |
95004 |
- |
- |
$3.12 |
- |
- | |
95012 |
- |
- |
$14.93 |
- |
- | |
95017 |
$6.73 |
$2.72 |
- |
- |
- | |
95018 |
$15.68 |
$5.23 |
- |
- |
- | |
95024 |
$6.34 |
$0.71 |
- |
- |
- | |
95027 |
- |
- |
$3.93 |
- |
- | |
95028 |
- |
- |
$10.11 |
- |
- | |
95044 |
- |
- |
$3.95 |
- |
- | |
95052 |
- |
- |
$5.02 |
- |
- | |
95056 |
- |
- |
$40.58 |
- |
- | |
95060 |
- |
- |
$29.93 |
- |
- | |
95065 |
- |
- |
$22.16 |
- |
- | |
95070 |
- |
- |
$27.45 |
- |
- | |
95076 |
$92.57 |
$54.27 |
- |
- |
- | |
95079 |
$63.65 |
$49.99 |
- |
- |
- | |
95115 |
- |
- |
$7.97 |
- |
- | |
95117 |
- |
- |
$9.31 |
- |
- | |
95120 |
- |
- |
I.C. |
- |
- | |
95125 |
- |
- |
I.C. |
- |
- | |
95130 |
- |
- |
I.C. |
- |
- | |
95131 |
- |
- |
I.C. |
- |
- | |
95132 |
- |
- |
I.C. |
- |
- | |
95133 |
- |
- |
I.C. |
- |
- | |
95134 |
- |
- |
I.C. |
- |
- | |
95144 |
$13.19 |
$2.47 |
- |
- |
- | |
95145 |
$26.31 |
$2.20 |
- |
- |
- | |
95146 |
$48.54 |
$2.20 |
- |
- |
- | |
95147 |
$46.93 |
$2.20 |
- |
- |
- | |
95148 |
$69.43 |
$2.20 |
- |
- |
- | |
95149 |
$91.93 |
$2.20 |
- |
- |
- | |
95165 |
$11.85 |
$2.47 |
- |
- |
- | |
95170 |
$8.90 |
$2.20 |
- |
- |
- | |
95180 |
$103.85 |
$75.46 |
- |
- |
- | |
95199 |
- |
- |
I.C. |
- |
- | |
95249 |
- |
- |
$48.47 |
- |
- | |
95250 |
- |
- |
$115.97 |
- |
- | |
95251 |
- |
- |
$25.44 |
- |
- | |
95700 |
- |
- |
I.C. |
- |
- | |
95705 |
- |
- |
I.C. |
- |
- | |
95706 |
- |
- |
I.C. |
- |
- | |
95707 |
- |
- |
I.C. |
- |
- | |
95708 |
- |
- |
I.C. |
- |
- | |
95709 |
- |
- |
I.C. |
- |
- | |
95710 |
- |
- |
I.C. |
- |
- | |
95711 |
- |
- |
I.C. |
- |
- | |
95712 |
- |
- |
I.C. |
- |
- | |
95713 |
- |
- |
I.C. |
- |
- | |
95714 |
- |
- |
I.C. |
- |
- | |
95715 |
- |
- |
I.C. |
- |
- | |
95716 |
- |
- |
I.C. |
- |
- | |
95717 |
$74.94 |
$74.14 |
- |
- |
- | |
95718 |
$99.30 |
$97.42 |
- |
- |
- | |
95719 |
$116.42 |
$114.82 |
- |
- |
- | |
95720 |
$153.54 |
$150.60 |
- |
- |
- | |
95721 |
$153.08 |
$149.86 |
- |
- |
- | |
95722 |
$186.22 |
$182.47 |
- |
- |
- | |
95723 |
$187.05 |
$183.30 |
- |
- |
- | |
95724 |
$235.52 |
$231.24 |
- |
- |
- | |
95725 |
$214.07 |
$209.25 |
- |
- |
- | |
95726 |
$299.51 |
$293.62 |
- |
- |
- | |
95782 |
- |
- |
$752.45 |
$90.44 |
$662.01 | |
95783 |
- |
- |
$796.98 |
$98.61 |
$698.37 | |
95800 |
- |
- |
$116.83 |
$29.65 |
$87.18 | |
95801 |
- |
- |
$71.83 |
$29.65 |
$42.18 | |
95803 |
- |
- |
$108.88 |
$31.28 |
$77.61 | |
95805 |
- |
- |
$330.75 |
$41.70 |
$289.05 | |
95806 |
- |
- |
$70.84 |
$32.14 |
$38.70 | |
95807 |
- |
- |
$305.46 |
$43.12 |
$262.34 | |
95808 |
- |
- |
$434.30 |
$60.68 |
$373.62 | |
95810 |
- |
- |
$478.75 |
$86.52 |
$392.24 | |
95811 |
- |
- |
$500.82 |
$89.77 |
$411.05 | |
95812 |
- |
- |
$273.38 |
$41.44 |
$231.95 | |
95813 |
- |
- |
$338.88 |
$62.74 |
$276.14 | |
95816 |
- |
- |
$303.38 |
$41.44 |
$261.94 | |
95819 |
- |
- |
$352.40 |
$41.44 |
$310.96 | |
95822 |
- |
- |
$329.90 |
$41.71 |
$288.19 | |
95824 |
- |
- |
- |
$28.56 |
- | |
95829 |
- |
- |
$1,400.03 |
$242.03 |
$1,157.99 | |
95830 |
$550.37 |
$67.19 |
- |
- |
- | |
95836 |
- |
- |
$77.79 |
- |
- | |
95851 |
$16.44 |
$5.72 |
- |
- |
- | |
95852 |
$13.61 |
$3.96 |
- |
- |
- | |
95857 |
$48.33 |
$21.01 |
- |
- |
- | |
95860 |
- |
- |
$87.18 |
$37.16 |
$50.02 | |
95861 |
- |
- |
$124.21 |
$59.46 |
$64.75 | |
95863 |
- |
- |
$161.69 |
$72.56 |
$89.12 | |
95864 |
- |
- |
$181.36 |
$77.24 |
$104.12 | |
95865 |
- |
- |
$115.37 |
$60.27 |
$55.11 | |
95866 |
- |
- |
$98.03 |
$46.94 |
$51.09 | |
95867 |
- |
- |
$83.55 |
$30.59 |
$52.96 | |
95868 |
- |
- |
$108.37 |
$45.50 |
$62.87 | |
95869 |
- |
- |
$75.82 |
$14.55 |
$61.27 | |
95870 |
- |
- |
$65.64 |
$14.28 |
$51.36 | |
95872 |
- |
- |
$149.65 |
$109.81 |
$39.84 | |
95873 |
- |
- |
$56.67 |
$14.35 |
$42.32 | |
95874 |
- |
- |
$60.95 |
$14.35 |
$46.60 | |
95875 |
- |
- |
$106.41 |
$42.46 |
$63.95 | |
95885 |
- |
- |
$48.68 |
$13.32 |
$35.35 | |
95886 |
- |
- |
$75.69 |
$33.37 |
$42.32 | |
95887 |
- |
- |
$65.06 |
$27.29 |
$37.77 | |
95905 |
- |
- |
$27.34 |
$1.96 |
$25.38 | |
95907 |
- |
- |
$68.88 |
$38.68 |
$30.20 | |
95908 |
- |
- |
$85.71 |
$48.28 |
$37.43 | |
95909 |
- |
- |
$102.94 |
$58.02 |
$44.93 | |
95910 |
- |
- |
$134.60 |
$77.09 |
$57.52 | |
95911 |
- |
- |
$162.25 |
$96.16 |
$66.09 | |
95912 |
- |
- |
$189.55 |
$115.23 |
$74.32 | |
95913 |
- |
- |
$218.66 |
$136.57 |
$82.09 | |
95919 |
- |
- |
$11.77 |
$7.29 |
$4.49 | |
95921 |
- |
- |
$67.50 |
$32.75 |
$34.75 | |
95922 |
- |
- |
$74.79 |
$33.68 |
$41.11 | |
95923 |
- |
- |
$96.16 |
$32.75 |
$63.41 | |
95924 |
- |
- |
$116.54 |
$63.91 |
$52.63 | |
95925 |
- |
- |
$140.71 |
$20.72 |
$119.99 | |
95926 |
- |
- |
$122.63 |
$20.05 |
$102.58 | |
95927 |
- |
- |
$131.20 |
$19.78 |
$111.42 | |
95928 |
- |
- |
$184.50 |
$57.95 |
$126.55 | |
95929 |
- |
- |
$187.51 |
$57.75 |
$129.77 | |
95930 |
- |
- |
$52.09 |
$13.59 |
$38.50 | |
95933 |
- |
- |
$64.19 |
$23.01 |
$41.18 | |
95937 |
- |
- |
$82.54 |
$25.29 |
$57.25 | |
95938 |
- |
- |
$288.89 |
$33.11 |
$255.78 | |
95939 |
- |
- |
$430.72 |
$86.55 |
$344.17 | |
95940 |
- |
- |
$23.79 |
- |
- | |
95941 |
- |
- |
I.C. |
- |
- | |
95954 |
- |
- |
$316.16 |
$78.79 |
$237.37 | |
95955 |
- |
- |
$151.35 |
$38.92 |
$112.42 | |
95957 |
- |
- |
$214.80 |
$74.45 |
$140.34 | |
95958 |
- |
- |
$524.64 |
$164.40 |
$360.24 | |
95961 |
- |
- |
$240.69 |
$117.09 |
$123.61 | |
95962 |
- |
- |
$207.07 |
$125.78 |
$81.29 | |
95965 |
- |
- |
- |
$302.54 |
- | |
95966 |
- |
- |
- |
$154.60 |
- | |
95967 |
- |
- |
- |
$135.46 |
- | |
95970 |
$13.92 |
$13.65 |
- |
- |
- | |
95971 |
$35.76 |
$28.53 |
- |
- |
- | |
95972 |
$42.48 |
$29.62 |
- |
- |
- | |
95976 |
$29.45 |
$28.65 |
- |
- |
- | |
95977 |
$38.87 |
$38.34 |
- |
- |
- | |
95980 |
- |
- |
$33.03 |
- |
- | |
95981 |
$29.70 |
$13.10 |
- |
- |
- | |
95982 |
$44.56 |
$26.62 |
- |
- |
- | |
95983 |
$37.14 |
$36.33 |
- |
- |
- | |
95984 |
$32.17 |
$31.90 |
- |
- |
- | |
95990 |
- |
- |
$71.51 |
- |
- | |
95991 |
$85.94 |
$29.42 |
- |
- |
- | |
95992 |
$32.56 |
$26.66 |
- |
- |
- | |
95999 |
- |
- |
I.C. |
- |
- | |
96000 |
- |
- |
$61.34 |
- |
- | |
96001 |
- |
- |
$81.22 |
- |
- | |
96002 |
- |
- |
$15.93 |
- |
- | |
96003 |
- |
- |
$12.21 |
- |
- | |
96004 |
- |
- |
$79.90 |
- |
- | |
96020 |
- |
- |
- |
$116.25 |
- | |
96040 |
- |
- |
$38.83 |
- |
- | |
96105 |
- |
- |
$72.97 |
- |
- | |
96110 |
- |
- |
$10.27 |
- |
- | |
96112 |
$93.34 |
$92.27 |
- |
- |
- | |
96113 |
$44.33 |
$41.39 |
- |
- |
- | |
96116 |
$68.84 |
$58.66 |
- |
- |
- | |
96121 |
$55.79 |
$48.83 |
- |
- |
- | |
96125 |
- |
- |
$77.38 |
- |
- | |
96127 |
- |
- |
$10.27 |
- |
- | |
96130 |
$88.52 |
$79.41 |
- |
- |
- | |
96131 |
$63.79 |
$55.76 |
- |
- |
- | |
96132 |
$96.29 |
$77.27 |
- |
- |
- | |
96133 |
$73.43 |
$55.76 |
- |
- |
- | |
96136 |
$32.35 |
$17.08 |
- |
- |
- | |
96137 |
$29.94 |
$13.07 |
- |
- |
- | |
96138 |
- |
- |
$26.98 |
- |
- | |
96139 |
- |
- |
$27.79 |
- |
- | |
96146 |
- |
- |
$1.81 |
- |
- | |
96156 |
$70.03 |
$61.46 |
- |
- |
- | |
96158 |
$47.82 |
$41.66 |
- |
- |
- | |
96159 |
$16.46 |
$14.32 |
- |
- |
- | |
96160 |
- |
- |
$2.14 |
- |
- | |
96161 |
- |
- |
$2.14 |
- |
- | |
96164 |
$7.22 |
$6.41 |
- |
- |
- | |
96165 |
$3.25 |
$2.98 |
- |
- |
- | |
96167 |
$50.81 |
$44.11 |
- |
- |
- | |
96168 |
$17.95 |
$15.54 |
- |
- |
- | |
96170 |
$58.01 |
$54.26 |
- |
- |
- | |
96171 |
$20.99 |
$19.65 |
- |
- |
- | |
96202 |
$17.49 |
$15.88 |
- |
- |
- | |
96203 |
- |
- |
$4.48 |
- |
- | |
96360 |
- |
- |
$25.52 |
- |
- | |
96361 |
- |
- |
$9.90 |
- |
- | |
96365 |
- |
- |
$50.40 |
- |
- | |
96366 |
- |
- |
$15.86 |
- |
- | |
96367 |
- |
- |
$22.53 |
- |
- | |
96368 |
- |
- |
$15.34 |
- |
- | |
96369 |
- |
- |
$111.20 |
- |
- | |
96370 |
- |
- |
$11.84 |
- |
- | |
96371 |
- |
- |
$45.00 |
- |
- | |
96372 |
- |
- |
$10.79 |
- |
- | |
96373 |
- |
- |
$14.00 |
- |
- | |
96374 |
- |
- |
$29.18 |
- |
- | |
96375 |
- |
- |
$12.02 |
- |
- | |
96376 |
- |
- |
I.C. |
- |
- | |
96377 |
- |
- |
$14.27 |
- |
- | |
96379 |
- |
- |
I.C. |
- |
- | |
96380 |
- |
- |
$17.56 |
- |
- | |
96381 |
- |
- |
$15.31 |
- |
- | |
96401 |
- |
- |
$57.37 |
- |
- | |
96402 |
- |
- |
$26.48 |
- |
- | |
96405 |
$65.76 |
$21.57 |
- |
- |
- | |
96406 |
$102.75 |
$33.11 |
- |
- |
- | |
96409 |
- |
- |
$79.66 |
- |
- | |
96411 |
- |
- |
$43.46 |
- |
- | |
96413 |
- |
- |
$103.34 |
- |
- | |
96415 |
- |
- |
$21.93 |
- |
- | |
96416 |
- |
- |
$101.62 |
- |
- | |
96417 |
- |
- |
$50.67 |
- |
- | |
96420 |
- |
- |
$81.43 |
- |
- | |
96422 |
- |
- |
$125.35 |
- |
- | |
96423 |
- |
- |
$57.73 |
- |
- | |
96425 |
- |
- |
$134.39 |
- |
- | |
96440 |
$597.89 |
$99.70 |
- |
- |
- | |
96446 |
$150.39 |
$18.08 |
- |
- |
- | |
96450 |
$127.58 |
$56.33 |
- |
- |
- | |
96521 |
- |
- |
$100.02 |
- |
- | |
96522 |
- |
- |
$92.25 |
- |
- | |
96523 |
- |
- |
$20.20 |
- |
- | |
96542 |
$101.52 |
$31.08 |
- |
- |
- | |
96547 |
- |
- |
I.C. |
- |
- | |
96548 |
- |
- |
I.C. |
- |
- | |
96549 |
- |
- |
I.C. |
- |
- | |
96567 |
- |
- |
$112.69 |
- |
- | |
96570 |
- |
- |
$39.57 |
- |
- | |
96571 |
- |
- |
$18.28 |
- |
- | |
96573 |
- |
- |
$183.57 |
- |
- | |
96574 |
- |
- |
$223.20 |
- |
- | |
96900 |
- |
- |
$19.48 |
- |
- | |
96902 |
$16.33 |
$14.72 |
- |
- |
- | |
96904 |
- |
- |
$56.18 |
- |
- | |
96910 |
- |
- |
$94.41 |
- |
- | |
96912 |
- |
- |
$80.55 |
- |
- | |
96913 |
- |
- |
$122.00 |
- |
- | |
96920 |
$122.17 |
$47.17 |
- |
- |
- | |
96921 |
$134.01 |
$53.39 |
- |
- |
- | |
96922 |
$181.71 |
$86.36 |
- |
- |
- | |
96931 |
- |
- |
$135.22 |
- |
- | |
96932 |
- |
- |
$102.51 |
- |
- | |
96933 |
- |
- |
$32.71 |
- |
- | |
96934 |
- |
- |
$93.33 |
- |
- | |
96935 |
- |
- |
$62.41 |
- |
- | |
96936 |
- |
- |
$30.93 |
- |
- | |
96999 |
- |
- |
I.C. |
- |
- | |
97010 |
- |
- |
$4.88 |
- |
- | |
97012 |
- |
- |
$10.87 |
- |
- | |
97014 |
- |
- |
$9.43 |
- |
- | |
97016 |
- |
- |
$8.89 |
- |
- | |
97018 |
- |
- |
$4.35 |
- |
- | |
97022 |
- |
- |
$13.20 |
- |
- | |
97024 |
- |
- |
$5.69 |
- |
- | |
97026 |
- |
- |
$5.15 |
- |
- | |
97028 |
- |
- |
$6.44 |
- |
- | |
97032 |
- |
- |
$10.87 |
- |
- | |
97033 |
- |
- |
$15.14 |
- |
- | |
97034 |
- |
- |
$10.97 |
- |
- | |
97035 |
- |
- |
$10.97 |
- |
- | |
97036 |
- |
- |
$27.14 |
- |
- | |
97037 |
- |
- |
I.C. |
- |
- | |
97039 |
- |
- |
I.C. |
- |
- | |
97110 |
- |
- |
$22.47 |
- |
- | |
97112 |
- |
- |
$25.83 |
- |
- | |
97113 |
- |
- |
$28.29 |
- |
- | |
97116 |
- |
- |
$22.47 |
- |
- | |
97124 |
- |
- |
$23.23 |
- |
- | |
97129 |
$16.73 |
$16.46 |
- |
- |
- | |
97130 |
- |
- |
$15.97 |
- |
- | |
97139 |
- |
- |
I.C. |
- |
- | |
97140 |
- |
- |
$20.64 |
- |
- | |
97150 |
- |
- |
$13.46 |
- |
- | |
97151 |
- |
- |
I.C. |
- |
- | |
97152 |
- |
- |
I.C. |
- |
- | |
97153 |
- |
- |
I.C. |
- |
- | |
97154 |
- |
- |
I.C. |
- |
- | |
97155 |
- |
- |
I.C. |
- |
- | |
97156 |
- |
- |
I.C. |
- |
- | |
97157 |
- |
- |
I.C. |
- |
- | |
97158 |
- |
- |
I.C. |
- |
- | |
97161 |
- |
- |
$76.54 |
- |
- | |
97162 |
- |
- |
$76.54 |
- |
- | |
97163 |
- |
- |
$76.54 |
- |
- | |
97164 |
- |
- |
$53.23 |
- |
- | |
97165 |
- |
- |
$76.54 |
- |
- | |
97166 |
- |
- |
$76.54 |
- |
- | |
97167 |
- |
- |
$76.54 |
- |
- | |
97168 |
- |
- |
$52.96 |
- |
- | |
97169 |
- |
- |
I.C. |
- |
- | |
97170 |
- |
- |
I.C. |
- |
- | |
97171 |
- |
- |
I.C. |
- |
- | |
97172 |
- |
- |
I.C. |
- |
- | |
97530 |
- |
- |
$28.65 |
- |
- | |
97533 |
- |
- |
$49.72 |
- |
- | |
97535 |
- |
- |
$25.15 |
- |
- | |
97537 |
- |
- |
$24.27 |
- |
- | |
97542 |
- |
- |
$24.27 |
- |
- | |
97545 |
- |
- |
I.C. |
- |
- | |
97546 |
- |
- |
I.C. |
- |
- | |
97550 |
- |
- |
$39.97 |
- |
- | |
97551 |
$19.79 |
$18.19 |
- |
- |
- | |
97552 |
- |
- |
$17.31 |
- |
- | |
97597 |
$78.44 |
$25.95 |
- |
- |
- | |
97598 |
$34.33 |
$18.00 |
- |
- |
- | |
97602 |
- |
- |
I.C. |
- |
- | |
97605 |
$32.68 |
$18.22 |
- |
- |
- | |
97606 |
$39.26 |
$19.71 |
- |
- |
- | |
97607 |
$292.13 |
$15.99 |
- |
- |
- | |
97608 |
$292.89 |
$18.35 |
- |
- |
- | |
97610 |
$355.78 |
$13.21 |
- |
- |
- | |
97750 |
- |
- |
$25.95 |
- |
- | |
97755 |
- |
- |
$29.24 |
- |
- | |
97760 |
- |
- |
$37.62 |
- |
- | |
97761 |
- |
- |
$32.26 |
- |
- | |
97763 |
- |
- |
$41.42 |
- |
- | |
97799 |
- |
- |
I.C. |
- |
- | |
97802 |
$27.91 |
$24.43 |
- |
- |
- | |
97803 |
$24.34 |
$20.59 |
- |
- |
- | |
97804 |
$12.75 |
$11.68 |
- |
- |
- | |
97810 |
$28.88 |
$22.72 |
- |
- |
- | |
97811 |
$21.61 |
$19.20 |
- |
- |
- | |
97813 |
$34.39 |
$24.75 |
- |
- |
- | |
97814 |
$27.93 |
$20.96 |
- |
- |
- | |
98925 |
$23.58 |
$17.15 |
- |
- |
- | |
98926 |
$33.72 |
$25.68 |
- |
- |
- | |
98927 |
$43.59 |
$33.68 |
- |
- |
- | |
98928 |
$53.53 |
$42.81 |
- |
- |
- | |
98929 |
$62.79 |
$51.28 |
- |
- |
- | |
98940 |
$20.84 |
$16.28 |
- |
- |
- | |
98941 |
$29.91 |
$25.08 |
- |
- |
- | |
98942 |
$38.71 |
$33.88 |
- |
- |
- | |
98943 |
$19.56 |
$16.88 |
- |
- |
- | |
98960 |
- |
- |
$23.17 |
- |
- | |
98961 |
- |
- |
$11.18 |
- |
- | |
98962 |
- |
- |
$8.24 |
- |
- | |
98966 |
$9.80 |
$8.20 |
- |
- |
- | |
98967 |
$17.73 |
$16.12 |
- |
- |
- | |
98968 |
$24.66 |
$22.78 |
- |
- |
- | |
98970 |
- |
- |
$8.46 |
- |
- | |
98971 |
$14.99 |
$14.72 |
- |
- |
- | |
98972 |
$22.92 |
$22.65 |
- |
- |
- | |
98975 |
- |
- |
$15.13 |
- |
- | |
98976 |
- |
- |
$39.57 |
- |
- | |
98977 |
- |
- |
$39.57 |
- |
- | |
98978 |
- |
- |
I.C. |
- |
- | |
98980 |
$37.41 |
$22.68 |
- |
- |
- | |
98981 |
$29.66 |
$22.16 |
- |
- |
- | |
99000 |
- |
- |
I.C. |
- |
- | |
99001 |
- |
- |
I.C. |
- |
- | |
99002 |
- |
- |
I.C. |
- |
- | |
99024 |
- |
- |
I.C. |
- |
- | |
99026 |
- |
- |
I.C. |
- |
- | |
99027 |
- |
- |
I.C. |
- |
- | |
99050 |
- |
- |
I.C. |
- |
- | |
99051 |
- |
- |
I.C. |
- |
- | |
99053 |
- |
- |
I.C. |
- |
- | |
99056 |
- |
- |
I.C. |
- |
- | |
99058 |
- |
- |
I.C. |
- |
- | |
99060 |
- |
- |
I.C. |
- |
- | |
99070 |
- |
- |
I.C. |
- |
- | |
99071 |
- |
- |
I.C. |
- |
- | |
99075 |
- |
- |
I.C. |
- |
- | |
99078 |
- |
- |
I.C. |
- |
- | |
99080 |
- |
- |
I.C. |
- |
- | |
99082 |
- |
- |
I.C. |
- |
- | |
99091 |
- |
- |
$39.78 |
- |
- | |
99100 |
- |
- |
I.C. |
- |
- | |
99116 |
- |
- |
I.C. |
- |
- | |
99135 |
- |
- |
I.C. |
- |
- | |
99140 |
- |
- |
I.C. |
- |
- | |
99151 |
$46.79 |
$17.86 |
- |
- |
- | |
99152 |
$39.33 |
$9.06 |
- |
- |
- | |
99153 |
- |
- |
$8.70 |
- |
- | |
99155 |
- |
- |
$59.63 |
- |
- | |
99156 |
- |
- |
$54.98 |
- |
- | |
99157 |
- |
- |
$45.39 |
- |
- | |
99170 |
$124.80 |
$62.39 |
- |
- |
- | |
99172 |
- |
- |
I.C. |
- |
- | |
99174 |
- |
- |
$4.75 |
- |
- | |
99175 |
- |
- |
$24.04 |
- |
- | |
99177 |
- |
- |
$3.68 |
- |
- | |
99183 |
- |
- |
$77.48 |
- |
- | |
99184 |
- |
- |
$157.16 |
- |
- | |
99188 |
- |
- |
$28.00 |
- |
- | |
99190 |
- |
- |
I.C. |
- |
- | |
99191 |
- |
- |
I.C. |
- |
- | |
99192 |
- |
- |
I.C. |
- |
- | |
99195 |
- |
- |
$77.27 |
- |
- | |
99199 |
- |
- |
I.C. |
- |
- | |
99202 |
$59.34 |
$38.76 |
- |
- |
- | |
99203 |
$84.36 |
$60.79 |
- |
- |
- | |
99204 |
$128.18 |
$99.46 |
- |
- |
- | |
99205 |
$164.48 |
$133.14 |
- |
- |
- | |
99211 |
$18.35 |
$7.10 |
- |
- |
- | |
99212 |
$42.98 |
$26.11 |
- |
- |
- | |
99213 |
$68.11 |
$48.56 |
- |
- |
- | |
99214 |
$96.15 |
$71.77 |
- |
- |
- | |
99215 |
$134.43 |
$105.50 |
- |
- |
- | |
99221 |
- |
- |
$60.92 |
- |
- | |
99222 |
- |
- |
$95.65 |
- |
- | |
99223 |
- |
- |
$127.59 |
- |
- | |
99231 |
- |
- |
$36.39 |
- |
- | |
99232 |
- |
- |
$58.20 |
- |
- | |
99233 |
- |
- |
$87.54 |
- |
- | |
99234 |
- |
- |
$72.39 |
- |
- | |
99235 |
- |
- |
$117.14 |
- |
- | |
99236 |
- |
- |
$153.34 |
- |
- | |
99238 |
- |
- |
$59.82 |
- |
- | |
99239 |
- |
- |
$84.70 |
- |
- | |
99242 |
$57.31 |
$41.50 |
- |
- |
- | |
99243 |
$85.38 |
$65.29 |
- |
- |
- | |
99244 |
$121.76 |
$99.80 |
- |
- |
- | |
99245 |
$157.82 |
$133.18 |
- |
- |
- | |
99252 |
- |
- |
$52.65 |
- |
- | |
99253 |
- |
- |
$73.87 |
- |
- | |
99254 |
- |
- |
$102.94 |
- |
- | |
99255 |
- |
- |
$137.48 |
- |
- | |
99281 |
- |
- |
$8.53 |
- |
- | |
99282 |
- |
- |
$30.39 |
- |
- | |
99283 |
- |
- |
$52.15 |
- |
- | |
99284 |
- |
- |
$87.75 |
- |
- | |
99285 |
- |
- |
$127.50 |
- |
- | |
99288 |
- |
- |
I.C. |
- |
- | |
99291 |
$204.56 |
$155.81 |
- |
- |
- | |
99292 |
$88.42 |
$78.24 |
- |
- |
- | |
99304 |
- |
- |
$59.55 |
- |
- | |
99305 |
- |
- |
$98.56 |
- |
- | |
99306 |
- |
- |
$134.56 |
- |
- | |
99307 |
- |
- |
$29.46 |
- |
- | |
99308 |
- |
- |
$55.26 |
- |
- | |
99309 |
- |
- |
$79.14 |
- |
- | |
99310 |
- |
- |
$113.60 |
- |
- | |
99315 |
- |
- |
$60.42 |
- |
- | |
99316 |
- |
- |
$96.95 |
- |
- | |
99341 |
- |
- |
$36.00 |
- |
- | |
99342 |
- |
- |
$57.27 |
- |
- | |
99344 |
- |
- |
$106.01 |
- |
- | |
99345 |
- |
- |
$149.55 |
- |
- | |
99347 |
- |
- |
$33.01 |
- |
- | |
99348 |
- |
- |
$56.27 |
- |
- | |
99349 |
- |
- |
$94.21 |
- |
- | |
99350 |
- |
- |
$137.34 |
- |
- | |
99358 |
$67.76 |
$66.69 |
- |
- |
- | |
99359 |
- |
- |
$31.82 |
- |
- | |
99360 |
- |
- |
$43.10 |
- |
- | |
99366 |
$30.25 |
$29.45 |
- |
- |
- | |
99367 |
- |
- |
$39.85 |
- |
- | |
99368 |
- |
- |
$25.93 |
- |
- | |
99374 |
$50.83 |
$39.85 |
- |
- |
- | |
99375 |
$75.43 |
$62.30 |
- |
- |
- | |
99377 |
$50.83 |
$39.85 |
- |
- |
- | |
99378 |
$75.43 |
$62.30 |
- |
- |
- | |
99379 |
$50.83 |
$39.85 |
- |
- |
- | |
99380 |
$75.43 |
$62.30 |
- |
- |
- | |
99381 |
$86.71 |
$59.30 |
- |
- |
- | |
99382 |
$90.60 |
$63.35 |
- |
- |
- | |
99383 |
$94.36 |
$67.12 |
- |
- |
- | |
99384 |
$106.53 |
$79.29 |
- |
- |
- | |
99385 |
$103.30 |
$76.05 |
- |
- |
- | |
99386 |
$119.26 |
$92.30 |
- |
- |
- | |
99387 |
$129.72 |
$99.28 |
- |
- |
- | |
99391 |
$78.16 |
$54.40 |
- |
- |
- | |
99392 |
$83.15 |
$59.30 |
- |
- |
- | |
99393 |
$82.86 |
$59.30 |
- |
- |
- | |
99394 |
$90.89 |
$67.12 |
- |
- |
- | |
99395 |
$93.08 |
$69.03 |
- |
- |
- | |
99396 |
$99.00 |
$75.23 |
- |
- |
- | |
99397 |
$106.53 |
$79.29 |
- |
- |
- | |
99401 |
$29.43 |
$17.64 |
- |
- |
- | |
99402 |
$47.16 |
$35.37 |
- |
- |
- | |
99403 |
$64.53 |
$53.01 |
- |
- |
- | |
99404 |
$82.02 |
$70.50 |
- |
- |
- | |
99406 |
$11.10 |
$8.69 |
- |
- |
- | |
99407 |
$58.08 |
$54.04 |
- |
- |
- | |
99408 |
$25.82 |
$23.41 |
- |
- |
- | |
99409 |
$49.23 |
$46.82 |
- |
- |
- | |
99411 |
$15.66 |
$5.48 |
- |
- |
- | |
99412 |
$19.38 |
$9.20 |
- |
- |
- | |
99415 |
- |
- |
$14.93 |
- |
- | |
99416 |
- |
- |
$6.90 |
- |
- | |
99417 |
$22.97 |
$22.16 |
- |
- |
- | |
99418 |
- |
- |
$28.94 |
- |
- | |
99421 |
$11.07 |
$9.47 |
- |
- |
- | |
99422 |
$21.88 |
$18.67 |
- |
- |
- | |
99423 |
$34.98 |
$29.63 |
- |
- |
- | |
99424 |
$60.27 |
$54.11 |
- |
- |
- | |
99425 |
$43.29 |
$37.40 |
- |
- |
- | |
99426 |
$45.64 |
$35.99 |
- |
- |
- | |
99427 |
$35.46 |
$25.55 |
- |
- |
- | |
99429 |
- |
- |
I.C. |
- |
- | |
99437 |
$44.63 |
$37.13 |
- |
- |
- | |
99439 |
$35.62 |
$25.71 |
- |
- |
- | |
99441 |
$42.58 |
$25.71 |
- |
- |
- | |
99442 |
$68.11 |
$48.56 |
- |
- |
- | |
99443 |
$95.75 |
$71.37 |
- |
- |
- | |
99446 |
- |
- |
$13.12 |
- |
- | |
99447 |
- |
- |
$26.11 |
- |
- | |
99448 |
- |
- |
$39.76 |
- |
- | |
99449 |
- |
- |
$52.82 |
- |
- | |
99450 |
- |
- |
I.C. |
- |
- | |
99451 |
- |
- |
$26.24 |
- |
- | |
99452 |
- |
- |
$24.37 |
- |
- | |
99453 |
- |
- |
$15.13 |
- |
- | |
99454 |
- |
- |
$39.57 |
- |
- | |
99455 |
- |
- |
I.C. |
- |
- | |
99456 |
- |
- |
I.C. |
- |
- | |
99457 |
$36.90 |
$22.16 |
- |
- |
- | |
99458 |
$29.66 |
$22.16 |
- |
- |
- | |
99459 |
- |
- |
$18.19 |
- |
- | |
99460 |
- |
- |
$100.99 |
- |
- | |
99461 |
$69.28 |
$45.17 |
- |
- |
- | |
99462 |
- |
- |
$43.82 |
- |
- | |
99463 |
- |
- |
$125.76 |
- |
- | |
99464 |
- |
- |
$53.46 |
- |
- | |
99465 |
- |
- |
$160.43 |
- |
- | |
99466 |
- |
- |
$170.09 |
- |
- | |
99467 |
- |
- |
$85.93 |
- |
- | |
99468 |
- |
- |
$656.51 |
- |
- | |
99469 |
- |
- |
$284.11 |
- |
- | |
99471 |
- |
- |
$568.08 |
- |
- | |
99472 |
- |
- |
$287.98 |
- |
- | |
99473 |
- |
- |
$10.11 |
- |
- | |
99474 |
$11.57 |
$6.48 |
- |
- |
- | |
99475 |
- |
- |
$409.16 |
- |
- | |
99476 |
- |
- |
$246.71 |
- |
- | |
99477 |
- |
- |
$248.89 |
- |
- | |
99478 |
- |
- |
$97.92 |
- |
- | |
99479 |
- |
- |
$89.19 |
- |
- | |
99480 |
- |
- |
$85.93 |
- |
- | |
99483 |
$205.02 |
$142.88 |
- |
- |
- | |
99484 |
$32.34 |
$21.63 |
- |
- |
- | |
99485 |
- |
- |
$54.26 |
- |
- | |
99486 |
- |
- |
$46.82 |
- |
- | |
99487 |
$100.29 |
$66.81 |
- |
- |
- | |
99489 |
$52.94 |
$36.87 |
- |
- |
- | |
99490 |
$46.78 |
$37.13 |
- |
- |
- | |
99491 |
$63.10 |
$55.60 |
- |
- |
- | |
99492 |
$114.05 |
$68.25 |
- |
- |
- | |
99493 |
$107.23 |
$74.56 |
- |
- |
- | |
99494 |
$43.51 |
$29.85 |
- |
- |
- | |
99495 |
$154.70 |
$103.01 |
- |
- |
- | |
99496 |
$209.49 |
$140.38 |
- |
- |
- | |
99497 |
$61.49 |
$55.60 |
- |
- |
- | |
99498 |
$52.88 |
$52.62 |
- |
- |
- | |
99499 |
- |
- |
I.C. |
- |
- | |
99500 |
- |
- |
I.C. |
- |
- | |
99501 |
- |
- |
I.C. |
- |
- | |
99502 |
- |
- |
I.C. |
- |
- | |
99503 |
- |
- |
I.C. |
- |
- | |
99504 |
- |
- |
I.C. |
- |
- | |
99505 |
- |
- |
I.C. |
- |
- | |
99506 |
- |
- |
I.C. |
- |
- | |
99507 |
- |
- |
I.C. |
- |
- | |
99509 |
- |
- |
I.C. |
- |
- | |
99510 |
- |
- |
I.C. |
- |
- | |
99511 |
- |
- |
I.C. |
- |
- | |
99512 |
- |
- |
I.C. |
- |
- | |
99600 |
- |
- |
I.C. |
- |
- | |
99601 |
- |
- |
I.C. |
- |
- | |
99602 |
- |
- |
I.C. |
- |
- | |
99605 |
- |
- |
I.C. |
- |
- | |
99606 |
- |
- |
I.C. |
- |
- | |
99607 |
- |
- |
I.C. |
- |
- | |
A9593 |
- |
- |
I.C. |
- |
- | |
A9594 |
- |
- |
I.C. |
- |
- | |
A9595 |
- |
- |
I.C. |
- |
- | |
A9596 |
- |
- |
I.C. |
- |
- | |
A9800 |
- |
- |
I.C. |
- |
- | |
G0108 |
- |
- |
$41.05 |
- |
- | |
G0109 |
- |
- |
$11.68 |
- |
- | |
G0270 |
$24.34 |
$20.59 |
- |
- |
- | |
G0271 |
$12.75 |
$11.68 |
- |
- |
- | |
G0310 |
$29.43 |
$17.64 |
- |
- |
- | |
G0311 |
$47.16 |
$35.37 |
- |
- |
- | |
G0312 |
$29.43 |
$17.64 |
- |
- |
- | |
G0313 |
$47.16 |
$35.37 |
- |
- |
- | |
G0314 |
$47.16 |
$35.37 |
- |
- |
- | |
G0315 |
$29.43 |
$17.64 |
- |
- |
- | |
G0399 |
- |
- |
I.C. |
- |
- | |
S0302 |
- |
- |
I.C. |
- |
- | |
S3005-U1 |
- |
- |
$10.27 |
- |
- | |
S3005-U2 |
- |
- |
$10.27 |
- |
- | |
T1023 |
- |
- |
I.C. |
- |
- | |
T2023 |
- |
- |
$241.88 |
- |
- | |
J0131 |
- |
- |
I.C. |
- |
- | |
J0134 |
- |
- |
I.C. |
- |
- | |
J0135 |
- |
- |
I.C. |
- |
- | |
J0136 |
- |
- |
I.C. |
- |
- | |
J0172 |
- |
- |
I.C. |
- |
- | |
J0173 |
- |
- |
I.C. |
- |
- | |
J0179 |
- |
- |
I.C. |
- |
- | |
J0184 |
- |
- |
I.C. |
- |
- | |
J0215 |
- |
- |
I.C. |
- |
- | |
J0217 |
- |
- |
I.C. |
- |
- | |
J0219 |
- |
- |
I.C. |
- |
- | |
J0222 |
- |
- |
I.C. |
- |
- | |
J0223 |
- |
- |
I.C. |
- |
- | |
J0224 |
- |
- |
I.C. |
- |
- | |
J0225 |
- |
- |
I.C. |
- |
- | |
J0282 |
- |
- |
I.C. |
- |
- | |
J0283 |
- |
- |
I.C. |
- |
- | |
J0291 |
- |
- |
I.C. |
- |
- | |
J0364 |
- |
- |
I.C. |
- |
- | |
J0391 |
- |
- |
I.C. |
- |
- | |
J0400 |
- |
- |
I.C. |
- |
- | |
J0402 |
- |
- |
I.C. |
- |
- | |
J0491 |
- |
- |
I.C. |
- |
- | |
J0565 |
- |
- |
I.C. |
- |
- | |
J0567 |
- |
- |
I.C. |
- |
- | |
J0570 |
- |
- |
I.C. |
- |
- | |
J0571 |
- |
- |
I.C. |
- |
- | |
J0572 |
- |
- |
I.C. |
- |
- | |
J0573 |
- |
- |
I.C. |
- |
- | |
J0574 |
- |
- |
I.C. |
- |
- | |
J0575 |
- |
- |
I.C. |
- |
- | |
J0576 |
- |
- |
I.C. |
- |
- | |
J0584 |
- |
- |
I.C. |
- |
- | |
J0593 |
- |
- |
I.C. |
- |
- | |
J0599 |
- |
- |
I.C. |
- |
- | |
J0604 |
- |
- |
I.C. |
- |
- | |
J0611 |
- |
- |
I.C. |
- |
- | |
J0688 |
- |
- |
I.C. |
- |
- | |
J0689 |
- |
- |
I.C. |
- |
- | |
J0691 |
- |
- |
I.C. |
- |
- | |
J0692 |
- |
- |
I.C. |
- |
- | |
J0695 |
- |
- |
I.C. |
- |
- | |
J0699 |
- |
- |
I.C. |
- |
- | |
J0701 |
- |
- |
I.C. |
- |
- | |
J0703 |
- |
- |
I.C. |
- |
- | |
J0714 |
- |
- |
I.C. |
- |
- | |
J0715 |
- |
- |
I.C. |
- |
- | |
J0716 |
- |
- |
I.C. |
- |
- | |
J0739 |
- |
- |
I.C. |
- |
- | |
J0741 |
- |
- |
I.C. |
- |
- | |
J0742 |
- |
- |
I.C. |
- |
- | |
J0750 |
- |
- |
I.C. |
- |
- | |
J0751 |
- |
- |
I.C. |
- |
- | |
J0799 |
- |
- |
I.C. |
- |
- | |
J0841 |
- |
- |
I.C. |
- |
- | |
J0873 |
- |
- |
I.C. |
- |
- | |
J0877 |
- |
- |
I.C. |
- |
- | |
J0878 |
- |
- |
I.C. |
- |
- | |
J0879 |
- |
- |
I.C. |
- |
- | |
J0883 |
- |
- |
I.C. |
- |
- | |
J0884 |
- |
- |
I.C. |
- |
- | |
J0890 |
- |
- |
I.C. |
- |
- | |
J0891 |
- |
- |
I.C. |
- |
- | |
J0892 |
- |
- |
I.C. |
- |
- | |
J0893 |
- |
- |
I.C. |
- |
- | |
J0898 |
- |
- |
I.C. |
- |
- | |
J0899 |
- |
- |
I.C. |
- |
- | |
J1094 |
- |
- |
I.C. |
- |
- | |
J1096 |
- |
- |
I.C. |
- |
- | |
J1097 |
- |
- |
I.C. |
- |
- | |
J1105 |
- |
- |
I.C. |
- |
- | |
J1130 |
- |
- |
I.C. |
- |
- | |
J1201 |
- |
- |
I.C. |
- |
- | |
J1246 |
- |
- |
I.C. |
- |
- | |
J1260 |
- |
- |
I.C. |
- |
- | |
J1290 |
- |
- |
I.C. |
- |
- | |
J1301 |
- |
- |
I.C. |
- |
- | |
J1302 |
- |
- |
I.C. |
- |
- | |
J1304 |
- |
- |
I.C. |
- |
- | |
J1305 |
- |
- |
I.C. |
- |
- | |
J1306 |
- |
- |
I.C. |
- |
- | |
J1320 |
- |
- |
I.C. |
- |
- | |
J1322 |
- |
- |
I.C. |
- |
- | |
J1324 |
- |
- |
I.C. |
- |
- | |
J1412 |
- |
- |
I.C. |
- |
- | |
J1413 |
- |
- |
I.C. |
- |
- | |
J1426 |
- |
- |
I.C. |
- |
- | |
J1427 |
- |
- |
I.C. |
- |
- | |
J1428 |
- |
- |
I.C. |
- |
- | |
J1429 |
- |
- |
I.C. |
- |
- | |
J1437 |
- |
- |
I.C. |
- |
- | |
J1438 |
- |
- |
I.C. |
- |
- | |
J1444 |
- |
- |
I.C. |
- |
- | |
J1445 |
- |
- |
I.C. |
- |
- | |
J1448 |
- |
- |
I.C. |
- |
- | |
J1455 |
- |
- |
I.C. |
- |
- | |
J1456 |
- |
- |
I.C. |
- |
- | |
J1554 |
- |
- |
I.C. |
- |
- | |
J1562 |
- |
- |
I.C. |
- |
- | |
J1573 |
- |
- |
I.C. |
- |
- | |
J1574 |
- |
- |
I.C. |
- |
- | |
J1595 |
- |
- |
I.C. |
- |
- | |
J1596 |
- |
- |
I.C. |
- |
- | |
J1599 |
- |
- |
I.C. |
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J1840 |
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J1850 |
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J1890 |
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J1939 |
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I.C. |
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J1951 |
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J1952 |
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J1956 |
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J1990 |
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- |
- |
I.C. |
- |
- | |
Q4220 |
- |
- |
I.C. |
- |
- | |
Q4221 |
- |
- |
I.C. |
- |
- | |
Q4222 |
- |
- |
I.C. |
- |
- | |
Q4226 |
- |
- |
I.C. |
- |
- | |
Q4251 |
- |
- |
I.C. |
- |
- | |
Q4252 |
- |
- |
I.C. |
- |
- | |
Q4253 |
- |
- |
I.C. |
- |
- | |
Q4262 |
- |
- |
I.C. |
- |
- | |
Q4263 |
- |
- |
I.C. |
- |
- | |
Q4264 |
- |
- |
I.C. |
- |
- | |
Q4279 |
- |
- |
I.C. |
- |
- | |
Q4287 |
- |
- |
I.C. |
- |
- | |
Q4288 |
- |
- |
I.C. |
- |
- | |
Q4289 |
- |
- |
I.C. |
- |
- | |
Q4290 |
- |
- |
I.C. |
- |
- | |
Q4291 |
- |
- |
I.C. |
- |
- | |
Q4292 |
- |
- |
I.C. |
- |
- | |
Q4293 |
- |
- |
I.C. |
- |
- | |
Q4294 |
- |
- |
I.C. |
- |
- | |
Q4295 |
- |
- |
I.C. |
- |
- | |
Q4296 |
- |
- |
I.C. |
- |
- | |
Q4297 |
- |
- |
I.C. |
- |
- | |
Q4298 |
- |
- |
I.C. |
- |
- | |
Q4299 |
- |
- |
I.C. |
- |
- | |
Q4300 |
- |
- |
I.C. |
- |
- | |
Q4301 |
- |
- |
I.C. |
- |
- | |
Q4302 |
- |
- |
I.C. |
- |
- | |
Q4303 |
- |
- |
I.C. |
- |
- | |
Q4304 |
- |
- |
I.C. |
- |
- | |
Q5101 |
- |
- |
I.C. |
- |
- | |
Q5107 |
- |
- |
I.C. |
- |
- | |
Q5109 |
- |
- |
I.C. |
- |
- | |
Q5112 |
- |
- |
I.C. |
- |
- | |
Q5113 |
- |
- |
I.C. |
- |
- | |
Q5114 |
- |
- |
I.C. |
- |
- | |
Q5115 |
- |
- |
I.C. |
- |
- | |
Q5116 |
- |
- |
I.C. |
- |
- | |
Q5117 |
- |
- |
I.C. |
- |
- | |
Q5118 |
- |
- |
I.C. |
- |
- | |
Q5119 |
- |
- |
I.C. |
- |
- | |
Q5122 |
- |
- |
I.C. |
- |
- | |
Q5123 |
- |
- |
I.C. |
- |
- | |
Q5125 |
- |
- |
I.C. |
- |
- | |
Q5126 |
- |
- |
I.C. |
- |
- | |
Q5132 |
- |
- |
I.C. |
- |
- | |
Q9950 |
- |
- |
I.C. |
- |
- | |
Q9980 |
- |
- |
I.C. |
- |
- |
Tobacco Cessation Codes
Code |
NFAC |
FAC |
Description (see
medicine services code spreadsheet at
|
99407 |
$58.08 |
$54.04 | |
99407 SA |
$58.08 |
$54.04 | |
99407 TD |
$49.37 |
$45.93 | |
99407 U1 |
$49.37 |
$45.93 | |
99407 TF |
$87.12 |
$81.06 | |
99407 U2 |
$74.05 |
$68.90 | |
99407 HQ |
$37.03 |
$34.45 | |
99407 U3 |
$31.47 |
$29.28 |
Behavioral Health and Developmental Screening Services
Code |
NFAC |
FAC |
Global |
PC |
TC |
Description
(see medicine services code spreadsheet at
|
96110 U1 |
- |
- |
$10.27 |
- |
- | |
96110U2 |
- |
- |
$10.27 |
- |
- | |
96127 U1 |
- |
- |
$10.27 |
- |
- | |
96127 U2 |
- |
- |
$10.27 |
- |
- |