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Health Care Services Review
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Fee Schedule
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Fee Schedule 80438-84630
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2024 Workers' Compensation Part B Fee Schedule
80438-84630
View the PDF
CPT/HCPC Code
Modifier
Medicare Location
Global Surgery Indicator
Multiple Surgery Indicator
Prevailing Charge Amount
Fee Schedule Amount
Site of Service Amount
80438
XXX
9
X
56.96
X
80439
XXX
9
X
75.95
X
80503
002
XXX
0
X
31.23
26.53
80503
003
XXX
0
X
31.23
26.53
80503
004
XXX
0
X
31.23
26.53
80503
001
XXX
0
X
33.80
28.38
80504
004
XXX
0
X
62.56
56.68
80504
003
XXX
0
X
62.56
56.68
80504
002
XXX
0
X
62.56
56.68
80504
001
XXX
0
X
67.54
60.76
80505
004
XXX
0
X
113.47
106.82
80505
003
XXX
0
X
113.47
106.82
80505
002
XXX
0
X
113.47
106.82
80505
001
XXX
0
X
122.23
114.56
80506
004
ZZZ
0
X
50.94
X
80506
003
ZZZ
0
X
50.94
X
80506
002
ZZZ
0
X
50.94
X
80506
001
ZZZ
0
X
54.65
X
81000
XXX
9
X
4.54
X
81001
XXX
9
X
3.58
X
81002
XXX
9
X
3.93
X
81003
XXX
9
X
2.54
X
81005
XXX
9
X
2.45
X
81007
XXX
9
X
33.88
X
81015
XXX
9
X
3.45
X
81020
XXX
9
X
5.31
X
81025
XXX
9
X
9.73
X
81050
XXX
9
X
4.11
X
81099
XXX
9
X
#
X
81105
XXX
9
X
138.11
X
81106
XXX
9
X
138.11
X
81107
XXX
9
X
138.11
X
81108
XXX
9
X
138.11
X
81109
XXX
9
X
138.11
X
81110
XXX
9
X
138.11
X
81111
XXX
9
X
138.11
X
81112
XXX
9
X
138.11
X
81120
XXX
9
X
218.37
X
81121
XXX
9
X
334.24
X
81162
XXX
9
X
2,062.11
X
81163
XXX
9
X
528.84
X
81164
XXX
9
X
660.18
X
81165
XXX
9
X
319.65
X
81166
XXX
9
X
340.53
X
81167
XXX
9
X
319.65
X
81168
XXX
9
X
234.26
X
81170
XXX
9
X
339.00
X
81171
XXX
9
X
154.81
X
81172
XXX
9
X
310.56
X
81173
XXX
9
X
340.53
X
81174
XXX
9
X
209.28
X
81175
XXX
9
X
764.45
X
81176
XXX
9
X
273.35
X
81177
XXX
9
X
154.81
X
81178
XXX
9
X
154.81
X
81179
XXX
9
X
154.81
X
81180
XXX
9
X
154.81
X
81181
XXX
9
X
154.81
X
81182
XXX
9
X
154.81
X
81183
XXX
9
X
154.81
X
81184
XXX
9
X
154.81
X
81185
XXX
9
X
956.29
X
81186
XXX
9
X
209.28
X
81187
XXX
9
X
154.81
X
81188
XXX
9
X
154.81
X
81189
XXX
9
X
310.56
X
81190
XXX
9
X
209.28
X
81191
XXX
9
X
234.26
X
81192
XXX
9
X
234.26
X
81193
XXX
9
X
234.26
X
81194
XXX
9
X
585.66
X
81200
XXX
9
X
53.39
X
81201
XXX
9
X
881.40
X
81202
XXX
9
X
316.40
X
81203
XXX
9
X
226.00
X
81204
XXX
9
X
154.81
X
81205
XXX
9
X
107.34
X
81206
XXX
9
X
185.27
X
81207
XXX
9
X
163.67
X
81208
XXX
9
X
242.52
X
81209
XXX
9
X
44.42
X
81210
XXX
9
X
198.20
X
81212
XXX
9
X
497.20
X
81215
XXX
9
X
424.03
X
81216
XXX
9
X
209.19
X
81217
XXX
9
X
424.03
X
81218
XXX
9
X
273.35
X
81219
XXX
9
X
137.44
X
81220
XXX
9
X
628.96
X
81221
XXX
9
X
109.86
X
81222
XXX
9
X
491.63
X
81223
XXX
9
X
563.87
X
81224
XXX
9
X
190.69
X
81225
XXX
9
X
329.24
X
81226
XXX
9
X
509.53
X
81227
XXX
9
X
197.54
X
81228
XXX
9
X
1,017.00
X
81229
XXX
9
X
1,310.80
X
81230
XXX
9
X
197.54
X
81231
XXX
9
X
197.54
X
81232
XXX
9
X
197.54
X
81233
XXX
9
X
198.20
X
81234
XXX
9
X
154.81
X
81235
XXX
9
X
366.78
X
81236
XXX
9
X
319.65
X
81237
XXX
9
X
198.20
X
81238
XXX
9
X
678.00
X
81239
XXX
9
X
310.56
X
81240
XXX
9
X
74.23
X
81241
XXX
9
X
82.91
X
81242
XXX
9
X
41.38
X
81243
XXX
9
X
64.46
X
81244
XXX
9
X
50.73
X
81245
XXX
9
X
187.03
X
81246
XXX
9
X
93.79
X
81247
XXX
9
X
197.54
X
81248
XXX
9
X
424.03
X
81249
XXX
9
X
678.00
X
81250
XXX
9
X
66.09
X
81251
XXX
9
X
53.39
X
81252
XXX
9
X
114.27
X
81253
XXX
9
X
69.52
X
81254
XXX
9
X
39.55
X
81255
XXX
9
X
58.14
X
81256
XXX
9
X
73.86
X
81257
XXX
9
X
115.55
X
81258
XXX
9
X
424.03
X
81259
XXX
9
X
678.00
X
81260
XXX
9
X
44.42
X
81261
XXX
9
X
223.73
X
81262
XXX
9
X
77.46
X
81263
XXX
9
X
332.81
X
81264
XXX
9
X
195.18
X
81265
XXX
9
X
263.37
X
81266
XXX
9
X
344.44
X
81267
XXX
9
X
234.43
X
81268
XXX
9
X
294.69
X
81269
XXX
9
X
228.71
X
81270
XXX
9
X
103.58
X
81271
XXX
9
X
154.81
X
81272
XXX
9
X
372.35
X
81273
XXX
9
X
141.10
X
81274
XXX
9
X
310.56
X
81275
XXX
9
X
218.37
X
81276
XXX
9
X
218.37
X
81277
XXX
9
X
1,310.80
X
81278
XXX
9
X
234.26
X
81279
XXX
9
X
209.28
X
81283
XXX
9
X
82.91
X
81284
XXX
9
X
154.81
X
81285
XXX
9
X
310.56
X
81286
XXX
9
X
310.56
X
81287
XXX
9
X
140.84
X
81288
XXX
9
X
217.32
X
81289
XXX
9
X
209.28
X
81290
XXX
9
X
44.42
X
81291
XXX
9
X
73.83
X
81292
XXX
9
X
763.20
X
81293
XXX
9
X
374.03
X
81294
XXX
9
X
228.71
X
81295
XXX
9
X
431.32
X
81296
XXX
9
X
381.63
X
81297
XXX
9
X
241.03
X
81298
XXX
9
X
725.29
X
81299
XXX
9
X
348.04
X
81300
XXX
9
X
268.94
X
81301
XXX
9
X
393.87
X
81302
XXX
9
X
596.49
X
81303
XXX
9
X
135.60
X
81304
XXX
9
X
169.50
X
81305
XXX
9
X
198.20
X
81306
XXX
9
X
329.24
X
81307
XXX
9
X
764.45
X
81308
XXX
9
X
340.53
X
81309
XXX
9
X
310.56
X
81310
XXX
9
X
278.57
X
81311
XXX
9
X
334.24
X
81312
XXX
9
X
154.81
X
81313
XXX
9
X
288.21
X
81314
XXX
9
X
372.35
X
81315
XXX
9
X
234.26
X
81316
XXX
9
X
234.26
X
81317
XXX
9
X
764.45
X
81318
XXX
9
X
374.03
X
81319
XXX
9
X
229.96
X
81320
XXX
9
X
329.24
X
81321
XXX
9
X
678.00
X
81322
XXX
9
X
52.66
X
81323
XXX
9
X
339.00
X
81324
XXX
9
X
856.95
X
81325
XXX
9
X
869.63
X
81326
XXX
9
X
52.66
X
81327
XXX
9
X
216.96
X
81328
XXX
9
X
197.54
X
81329
XXX
9
X
154.81
X
81330
XXX
9
X
53.11
X
81331
XXX
9
X
57.71
X
81332
XXX
9
X
49.32
X
81333
XXX
9
X
154.81
X
81334
XXX
9
X
372.35
X
81335
XXX
9
X
197.54
X
81336
XXX
9
X
340.53
X
81337
XXX
9
X
209.28
X
81338
XXX
9
X
169.87
X
81339
XXX
9
X
209.28
X
81340
XXX
9
X
236.08
X
81341
XXX
9
X
56.04
X
81342
XXX
9
X
227.69
X
81343
XXX
9
X
154.81
X
81344
XXX
9
X
154.81
X
81345
XXX
9
X
209.28
X
81346
XXX
9
X
197.54
X
81347
XXX
9
X
218.37
X
81348
XXX
9
X
198.20
X
81349
XXX
9
X
1,310.80
X
81350
XXX
9
X
264.42
X
81351
XXX
9
X
725.29
X
81352
XXX
9
X
372.35
X
81353
XXX
9
X
348.04
X
81355
XXX
9
X
99.67
X
81357
XXX
9
X
218.37
X
81360
XXX
9
X
218.37
X
81361
XXX
9
X
197.54
X
81362
XXX
9
X
424.03
X
81363
XXX
9
X
228.71
X
81364
XXX
9
X
366.78
X
81370
XXX
9
X
454.40
X
81371
XXX
9
X
457.11
X
81372
XXX
9
X
456.06
X
81373
XXX
9
X
144.00
X
81374
XXX
9
X
83.99
X
81375
XXX
9
X
249.44
X
81376
XXX
9
X
138.11
X
81377
XXX
9
X
107.06
X
81378
XXX
9
X
390.49
X
81379
XXX
9
X
378.98
X
81380
XXX
9
X
200.29
X
81381
XXX
9
X
191.99
X
81382
XXX
9
X
139.76
X
81383
XXX
9
X
123.32
X
81400
XXX
9
X
72.27
X
81401
XXX
9
X
154.81
X
81402
XXX
9
X
169.87
X
81403
XXX
9
X
209.28
X
81404
XXX
9
X
310.56
X
81405
XXX
9
X
340.53
X
81406
XXX
9
X
319.65
X
81407
XXX
9
X
956.29
X
81408
XXX
9
X
2,260.00
X
81410
XXX
9
X
569.52
X
81411
XXX
9
X
1,525.71
X
81412
XXX
9
X
2,766.87
X
81413
XXX
9
X
660.94
X
81414
XXX
9
X
660.94
X
81415
XXX
9
X
5,401.40
X
81416
XXX
9
X
13,560.00
X
81417
XXX
9
X
361.60
X
81418
XXX
9
X
1,036.30
X
81419
XXX
9
X
2,766.87
X
81420
XXX
9
X
857.73
X
81422
XXX
9
X
857.73
X
81425
XXX
9
X
5,685.26
X
81426
XXX
9
X
3,062.24
X
81427
XXX
9
X
2,641.54
X
81430
XXX
9
X
1,836.25
X
81431
XXX
9
X
767.91
X
81432
XXX
9
X
767.33
X
81433
XXX
9
X
495.99
X
81434
XXX
9
X
675.64
X
81435
XXX
9
X
660.94
X
81436
XXX
9
X
660.94
X
81437
XXX
9
X
495.99
X
81438
XXX
9
X
495.99
X
81439
XXX
9
X
660.94
X
81440
XXX
9
X
3,756.12
X
81441
XXX
9
X
2,766.87
X
81442
XXX
9
X
2,422.27
X
81443
XXX
9
X
2,766.87
X
81445
XXX
9
X
675.64
X
81448
XXX
9
X
660.94
X
81449
XXX
9
X
675.64
X
81450
XXX
9
X
858.27
X
81451
XXX
9
X
858.27
X
81455
XXX
9
X
3,299.15
X
81456
XXX
9
X
3,299.15
X
81457
XXX
9
X
#
X
81458
XXX
9
X
#
X
81459
XXX
9
X
#
X
81460
XXX
9
X
1,454.31
X
81462
XXX
9
X
#
X
81463
XXX
9
X
#
X
81464
XXX
9
X
#
X
81465
XXX
9
X
1,057.68
X
81470
XXX
9
X
1,032.82
X
81471
XXX
9
X
1,032.82
X
81479
XXX
9
X
#
X
81490
XXX
9
X
949.93
X
81493
XXX
9
X
1,186.50
X
81500
XXX
9
X
294.36
X
81503
XXX
9
X
1,013.61
X
81504
XXX
9
X
587.60
X
81506
XXX
9
X
77.88
X
81507
XXX
9
X
898.35
X
81508
XXX
9
X
61.36
X
81509
XXX
9
X
1,680.73
X
81510
XXX
9
X
62.76
X
81511
XXX
9
X
173.46
X
81512
XXX
9
X
78.56
X
81513
XXX
9
X
161.17
X
81514
XXX
9
X
297.18
X
81517
XXX
9
X
568.84
X
81518
XXX
9
X
4,376.49
X
81519
XXX
9
X
4,376.49
X
81520
XXX
9
X
2,836.54
X
81521
XXX
9
X
4,376.49
X
81522
XXX
9
X
4,376.49
X
81523
XXX
9
X
4,376.49
X
81525
XXX
9
X
3,521.08
X
81528
XXX
9
X
575.02
X
81529
XXX
9
X
8,128.09
X
81535
XXX
9
X
654.79
X
81536
XXX
9
X
200.64
X
81538
XXX
9
X
3,244.23
X
81539
XXX
9
X
858.80
X
81540
XXX
9
X
4,237.50
X
81541
XXX
9
X
4,376.49
X
81542
XXX
9
X
4,376.49
X
81546
XXX
9
X
4,068.00
X
81551
XXX
9
X
2,293.90
X
81552
XXX
9
X
8,786.88
X
81554
XXX
9
X
6,215.00
X
81560
XXX
9
X
724.02
X
81595
XXX
9
X
3,661.20
X
81596
XXX
9
X
81.57
X
81599
XXX
9
X
#
X
82009
XXX
9
X
5.11
X
82010
XXX
9
X
9.23
X
82013
XXX
9
X
13.89
X
82016
XXX
9
X
18.63
X
82017
XXX
9
X
19.06
X
82024
XXX
9
X
43.64
X
82030
XXX
9
X
29.15
X
82040
XXX
9
X
5.59
X
82042
XXX
9
X
8.79
X
82043
XXX
9
X
6.53
X
82044
XXX
9
X
7.04
X
82045
XXX
9
X
38.35
X
82075
XXX
9
X
33.90
X
82077
XXX
9
X
19.52
X
82085
XXX
9
X
10.97
X
82088
XXX
9
X
46.05
X
82103
XXX
9
X
15.19
X
82104
XXX
9
X
16.34
X
82105
XXX
9
X
18.95
X
82106
XXX
9
X
19.21
X
82107
XXX
9
X
72.78
X
82108
XXX
9
X
28.79
X
82120
XXX
9
X
6.77
X
82127
XXX
9
X
16.02
X
82128
XXX
9
X
15.67
X
82131
XXX
9
X
25.97
X
82135
XXX
9
X
18.59
X
82136
XXX
9
X
22.16
X
82139
XXX
9
X
19.06
X
82140
XXX
9
X
16.46
X
82143
XXX
9
X
10.57
X
82150
XXX
9
X
7.32
X
82154
XXX
9
X
32.58
X
82157
XXX
9
X
33.09
X
82160
XXX
9
X
28.87
X
82163
XXX
9
X
23.19
X
82164
XXX
9
X
16.50
X
82166
XXX
9
X
43.64
X
82172
XXX
9
X
23.83
X
82175
XXX
9
X
21.44
X
82180
XXX
9
X
11.18
X
82190
XXX
9
X
17.97
X
82232
XXX
9
X
18.28
X
82239
XXX
9
X
19.35
X
82240
XXX
9
X
30.04
X
82247
XXX
9
X
5.67
X
82248
XXX
9
X
5.67
X
82252
XXX
9
X
5.15
X
82261
XXX
9
X
19.06
X
82270
XXX
9
X
4.95
X
82271
XXX
9
X
6.01
X
82272
XXX
9
X
4.78
X
82274
XXX
9
X
17.99
X
82286
XXX
9
X
5.83
X
82300
XXX
9
X
26.71
X
82306
XXX
9
X
33.45
X
82308
XXX
9
X
30.27
X
82310
XXX
9
X
5.83
X
82330
XXX
9
X
15.46
X
82331
XXX
9
X
15.07
X
82340
XXX
9
X
6.81
X
82355
XXX
9
X
13.09
X
82360
XXX
9
X
14.54
X
82365
XXX
9
X
14.58
X
82370
XXX
9
X
14.15
X
82373
XXX
9
X
20.41
X
82374
XXX
9
X
5.51
X
82375
XXX
9
X
13.92
X
82376
XXX
9
X
15.90
X
82378
XXX
9
X
21.42
X
82379
XXX
9
X
19.06
X
82380
XXX
9
X
10.42
X
82382
XXX
9
X
30.85
X
82383
XXX
9
X
32.86
X
82384
XXX
9
X
28.53
X
82387
XXX
9
X
20.41
X
82390
XXX
9
X
12.14
X
82397
XXX
9
X
15.96
X
82415
XXX
9
X
14.32
X
82435
XXX
9
X
5.20
X
82436
XXX
9
X
6.50
X
82438
XXX
9
X
5.65
X
82441
XXX
9
X
6.79
X
82465
XXX
9
X
4.92
X
82480
XXX
9
X
8.89
X
82482
XXX
9
X
11.09
X
82485
XXX
9
X
23.33
X
82495
XXX
9
X
22.92
X
82507
XXX
9
X
31.41
X
82523
XXX
9
X
21.11
X
82525
XXX
9
X
14.02
X
82528
XXX
9
X
25.45
X
82530
XXX
9
X
18.88
X
82533
XXX
9
X
18.42
X
82540
XXX
9
X
5.24
X
82542
XXX
9
X
27.22
X
82550
XXX
9
X
7.36
X
82552
XXX
9
X
15.13
X
82553
XXX
9
X
13.05
X
82554
XXX
9
X
13.41
X
82565
XXX
9
X
5.79
X
82570
XXX
9
X
5.85
X
82575
XXX
9
X
10.69
X
82585
XXX
9
X
15.98
X
82595
XXX
9
X
7.31
X
82600
XXX
9
X
21.92
X
82607
XXX
9
X
17.04
X
82608
XXX
9
X
16.18
X
82610
XXX
9
X
20.93
X
82615
XXX
9
X
10.79
X
82626
XXX
9
X
28.56
X
82627
XXX
9
X
25.12
X
82633
XXX
9
X
35.01
X
82634
XXX
9
X
33.09
X
82638
XXX
9
X
13.84
X
82642
XXX
9
X
33.09
X
82652
XXX
9
X
43.51
X
82653
XXX
9
X
25.96
X
82656
XXX
9
X
13.03
X
82657
XXX
9
X
25.05
X
82658
XXX
9
X
49.75
X
82664
XXX
9
X
69.49
X
82668
XXX
9
X
21.23
X
82670
XXX
9
X
31.57
X
82671
XXX
9
X
36.50
X
82672
XXX
9
X
24.52
X
82677
XXX
9
X
27.32
X
82679
XXX
9
X
28.19
X
82681
XXX
9
X
31.57
X
82693
XXX
9
X
16.84
X
82696
XXX
9
X
29.65
X
82705
XXX
9
X
5.76
X
82710
XXX
9
X
18.98
X
82715
XXX
9
X
25.96
X
82725
XXX
9
X
21.21
X
82726
XXX
9
X
22.32
X
82728
XXX
9
X
15.40
X
82731
XXX
9
X
72.78
X
82735
XXX
9
X
20.95
X
82746
XXX
9
X
16.61
X
82747
XXX
9
X
19.94
X
82757
XXX
9
X
19.59
X
82759
XXX
9
X
24.27
X
82760
XXX
9
X
12.66
X
82775
XXX
9
X
23.81
X
82776
XXX
9
X
13.27
X
82777
XXX
9
X
50.00
X
82784
XXX
9
X
10.51
X
82785
XXX
9
X
18.60
X
82787
XXX
9
X
9.06
X
82800
XXX
9
X
12.43
X
82803
XXX
9
X
29.46
X
82805
XXX
9
X
89.01
X
82810
XXX
9
X
11.04
X
82820
XXX
9
X
15.07
X
82930
XXX
9
X
7.58
X
82938
XXX
9
X
19.99
X
82941
XXX
9
X
19.92
X
82943
XXX
9
X
16.15
X
82945
XXX
9
X
4.44
X
82946
XXX
9
X
20.08
X
82947
XXX
9
X
4.44
X
82948
XXX
9
X
5.70
X
82950
XXX
9
X
5.37
X
82951
XXX
9
X
14.54
X
82952
XXX
9
X
4.43
X
82955
XXX
9
X
10.96
X
82960
XXX
9
X
6.84
X
82962
XXX
9
X
3.71
X
82963
XXX
9
X
24.27
X
82965
XXX
9
X
14.86
X
82977
XXX
9
X
8.14
X
82978
XXX
9
X
17.46
X
82979
XXX
9
X
10.67
X
82985
XXX
9
X
18.94
X
83001
XXX
9
X
21.00
X
83002
XXX
9
X
20.93
X
83003
XXX
9
X
18.84
X
83006
XXX
9
X
85.43
X
83009
XXX
9
X
76.12
X
83010
XXX
9
X
14.22
X
83012
XXX
9
X
30.39
X
83013
XXX
9
X
76.12
X
83014
XXX
9
X
8.88
X
83015
XXX
9
X
23.66
X
83018
XXX
9
X
24.81
X
83020
XXX
9
X
14.54
X
83020
26
003
XXX
9
X
56.18
X
83020
26
004
XXX
9
X
55.61
X
83020
26
002
XXX
9
X
58.66
X
83020
26
001
XXX
9
X
59.23
X
83021
XXX
9
X
20.41
X
83026
XXX
9
X
4.53
X
83030
XXX
9
X
12.14
X
83033
XXX
9
X
9.04
X
83036
XXX
9
X
10.97
X
83037
XXX
9
X
10.97
X
83045
XXX
9
X
7.33
X
83050
XXX
9
X
9.27
X
83051
XXX
9
X
8.26
X
83060
XXX
9
X
9.94
X
83065
XXX
9
X
10.17
X
83068
XXX
9
X
10.70
X
83069
XXX
9
X
4.46
X
83070
XXX
9
X
5.37
X
83080
XXX
9
X
19.06
X
83088
XXX
9
X
33.37
X
83090
XXX
9
X
20.25
X
83150
XXX
9
X
25.32
X
83491
XXX
9
X
20.23
X
83497
XXX
9
X
14.58
X
83498
XXX
9
X
30.70
X
83500
XXX
9
X
25.59
X
83505
XXX
9
X
27.46
X
83516
XXX
9
X
13.03
X
83518
XXX
9
X
10.89
X
83519
XXX
9
X
20.79
X
83520
XXX
9
X
19.52
X
83521
XXX
9
X
19.52
X
83525
XXX
9
X
12.92
X
83527
XXX
9
X
14.63
X
83528
XXX
9
X
22.40
X
83529
XXX
9
X
19.52
X
83540
XXX
9
X
7.31
X
83550
XXX
9
X
9.88
X
83570
XXX
9
X
10.00
X
83582
XXX
9
X
17.48
X
83586
XXX
9
X
14.46
X
83593
XXX
9
X
32.21
X
83605
XXX
9
X
13.07
X
83615
XXX
9
X
6.83
X
83625
XXX
9
X
14.45
X
83630
XXX
9
X
22.26
X
83631
XXX
9
X
22.18
X
83632
XXX
9
X
22.85
X
83633
XXX
9
X
12.71
X
83655
XXX
9
X
13.68
X
83661
XXX
9
X
24.85
X
83662
XXX
9
X
21.37
X
83663
XXX
9
X
21.37
X
83664
XXX
9
X
21.83
X
83670
XXX
9
X
11.09
X
83690
XXX
9
X
7.79
X
83695
XXX
9
X
16.18
X
83698
XXX
9
X
52.33
X
83700
XXX
9
X
12.72
X
83701
XXX
9
X
38.26
X
83704
XXX
9
X
38.63
X
83718
XXX
9
X
9.25
X
83719
XXX
9
X
14.41
X
83721
XXX
9
X
11.86
X
83722
XXX
9
X
38.63
X
83727
XXX
9
X
19.42
X
83735
XXX
9
X
7.57
X
83775
XXX
9
X
8.33
X
83785
XXX
9
X
30.11
X
83789
XXX
9
X
27.24
X
83825
XXX
9
X
18.37
X
83835
XXX
9
X
19.14
X
83857
XXX
9
X
12.14
X
83861
XXX
9
X
25.40
X
83864
XXX
9
X
32.21
X
83872
XXX
9
X
6.62
X
83873
XXX
9
X
19.44
X
83874
XXX
9
X
14.60
X
83876
XXX
9
X
57.47
X
83880
XXX
9
X
44.36
X
83883
XXX
9
X
15.37
X
83885
XXX
9
X
27.70
X
83915
XXX
9
X
12.60
X
83916
XXX
9
X
30.95
X
83918
XXX
9
X
26.67
X
83919
XXX
9
X
18.59
X
83921
XXX
9
X
23.97
X
83930
XXX
9
X
7.47
X
83935
XXX
9
X
7.71
X
83937
XXX
9
X
33.73
X
83945
XXX
9
X
16.33
X
83950
XXX
9
X
72.78
X
83951
XXX
9
X
72.78
X
83970
XXX
9
X
46.65
X
83986
XXX
9
X
4.05
X
83987
XXX
9
X
4.05
X
83992
XXX
9
X
66.26
68.45
83993
XXX
9
X
22.18
X
84030
XXX
9
X
6.22
X
84035
XXX
9
X
4.50
X
84060
XXX
9
X
8.63
X
84066
XXX
9
X
10.92
X
84075
XXX
9
X
5.85
X
84078
XXX
9
X
9.33
X
84080
XXX
9
X
16.70
X
84081
XXX
9
X
18.67
X
84085
XXX
9
X
10.67
X
84087
XXX
9
X
12.12
X
84100
XXX
9
X
5.36
X
84105
XXX
9
X
6.53
X
84106
XXX
9
X
6.58
X
84110
XXX
9
X
9.54
X
84112
XXX
9
X
110.86
X
84119
XXX
9
X
15.10
X
84120
XXX
9
X
16.62
X
84126
XXX
9
X
44.19
X
84132
XXX
9
X
5.38
X
84133
XXX
9
X
5.34
X
84134
XXX
9
X
16.49
X
84135
XXX
9
X
24.04
X
84138
XXX
9
X
23.79
X
84140
XXX
9
X
23.36
X
84143
XXX
9
X
25.78
X
84144
XXX
9
X
23.57
X
84145
XXX
9
X
30.76
X
84146
XXX
9
X
21.90
X
84150
XXX
9
X
47.20
X
84152
XXX
9
X
20.78
X
84153
XXX
9
X
20.78
X
84154
XXX
9
X
20.78
X
84155
XXX
9
X
4.15
X
84156
XXX
9
X
4.15
X
84157
XXX
9
X
4.52
X
84160
XXX
9
X
6.34
X
84163
XXX
9
X
17.01
X
84165
XXX
9
X
12.14
X
84165
26
001
XXX
9
X
59.23
X
84165
26
002
XXX
9
X
58.66
X
84165
26
003
XXX
9
X
56.18
X
84165
26
004
XXX
9
X
55.61
X
84166
XXX
9
X
20.15
X
84166
26
004
XXX
9
X
40.09
X
84166
26
003
XXX
9
X
40.09
X
84166
26
002
XXX
9
X
40.09
X
84166
26
001
XXX
9
X
43.18
X
84181
XXX
9
X
19.24
X
84182
XXX
9
X
33.01
X
84202
XXX
9
X
16.22
X
84203
XXX
9
X
11.01
X
84206
XXX
9
X
30.16
X
84207
XXX
9
X
31.75
X
84210
XXX
9
X
16.36
X
84220
XXX
9
X
10.67
X
84228
XXX
9
X
13.14
X
84233
XXX
9
X
99.30
X
84234
XXX
9
X
73.31
X
84235
XXX
9
X
80.49
X
84238
XXX
9
X
41.32
X
84244
XXX
9
X
24.85
X
84252
XXX
9
X
22.87
X
84255
XXX
9
X
28.85
X
84260
XXX
9
X
35.01
X
84270
XXX
9
X
24.55
X
84275
XXX
9
X
15.19
X
84285
XXX
9
X
28.49
X
84295
XXX
9
X
5.44
X
84300
XXX
9
X
5.72
X
84302
XXX
9
X
5.49
X
84305
XXX
9
X
24.02
X
84307
XXX
9
X
20.66
X
84311
XXX
9
X
9.15
X
84315
XXX
9
X
3.71
X
84375
XXX
9
X
44.07
X
84376
XXX
9
X
6.22
X
84377
XXX
9
X
6.22
X
84378
XXX
9
X
13.03
X
84379
XXX
9
X
13.03
X
84392
XXX
9
X
6.20
X
84402
XXX
9
X
28.78
X
84403
XXX
9
X
29.17
X
84410
XXX
9
X
57.95
X
84425
XXX
9
X
23.99
X
84430
XXX
9
X
13.14
X
84431
XXX
9
X
39.67
X
84432
XXX
9
X
18.15
X
84433
XXX
9
X
25.05
X
84436
XXX
9
X
7.76
X
84437
XXX
9
X
7.31
X
84439
XXX
9
X
10.19
X
84442
XXX
9
X
16.70
X
84443
XXX
9
X
18.98
X
84445
XXX
9
X
57.47
X
84446
XXX
9
X
16.02
X
84449
XXX
9
X
20.34
X
84450
XXX
9
X
5.85
X
84460
XXX
9
X
5.99
X
84466
XXX
9
X
14.42
X
84478
XXX
9
X
6.49
X
84479
XXX
9
X
7.31
X
84480
XXX
9
X
16.02
X
84481
XXX
9
X
19.14
X
84482
XXX
9
X
17.81
X
84484
XXX
9
X
14.09
X
84485
XXX
9
X
8.14
X
84488
XXX
9
X
8.25
X
84490
XXX
9
X
11.22
X
84510
XXX
9
X
12.01
X
84512
XXX
9
X
11.40
X
84520
XXX
9
X
4.46
X
84525
XXX
9
X
5.80
X
84540
XXX
9
X
6.28
X
84545
XXX
9
X
8.14
X
84550
XXX
9
X
5.11
X
84560
XXX
9
X
5.74
X
84577
XXX
9
X
18.98
X
84578
XXX
9
X
5.05
X
84580
XXX
9
X
10.79
X
84583
XXX
9
X
6.84
X
84585
XXX
9
X
17.51
X
84586
XXX
9
X
39.92
X
84588
XXX
9
X
38.35
X
84590
XXX
9
X
13.12
X
84591
XXX
9
X
19.28
X
84597
XXX
9
X
15.50
X
84600
XXX
9
X
19.33
X
84620
XXX
9
X
14.59
X
84630
XXX
9
X
12.87
X
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