CPT Codes and Fees

TABLE OF CONTENTS

CPT Codes and Fees,
Effective January 1, 2015

Surgery, Part 1 (10000-29999)

Surgery, Part 2 (30000-49999)

Surgery, Part 3 (50000-69999)

Assistant Surgery Guide

Radiology

Pathology and Laboratory

Evaluation & Management, Medicine, Physical Therapy

Commission Assigned Codes

N.C. Industrial Commission Assigned Codes

Surgery, Part 1

Effective January 1, 2015

ABBREVIATIONS: BR = by report (i.e., report is needed to establish fee), CPT = Current Procedural Terminology, FAC = services were performed in a facility setting, FUD = follow-up days (i.e., number of days in global period), NA = no allowance, OFF = services were performed in physician office setting, PC (26) = professional component, PER AGM = per agreement, SC = special consideration (see Guides or contact Industrial Commission), TBA = to be assigned, TC (27) = technical component, Total = total fee, and Units = requires time or number of units.

CPT Code	Total	OFF	FAC	TC (27)	PC (26)	FUD
10021	$167.11			$33.95	$133.16	0
10022	$172.48			$45.07	$127.41	0
10030		$1,524.81	$316.87			0
10040	$130.03					0
10060	$121.89					0
10061	$244.60					15
10080	$146.18					0
10081	$276.29					15
10120	$129.20					0
10121	$286.03					15
10140	$153.57					0
10160	$120.26					0
10180	$256.78					15
11000	$102.38					0
11001	$55.25					0
11004	$1,120.00					0
11005	$1,522.91					0
11006	$1,398.63					0
11008	$566.68					0
11010	$642.39					0
11011	$765.76					0
11012	$1,064.30					0
11042	$138.95					0
11043	$289.29					15
11044	$404.69					15
11045		$60.63	$35.08
11046		$105.64	$74.74
11047		$173.49	$129.82
11055	$25.13					0
11056	$35.99					0
11057	$41.65					0
11100	$103.21					15
11101	$54.45					15
11200	$87.76					0
11201	$34.13					0
11300	$81.27					0
11301	$118.64					0
11302	$151.14					0
11303	$203.96					0
11305	$92.64					0
11306	$132.46					0
11307	$162.51					0
11308	$220.21					0
11310	$110.52					0
11311	$147.89					0
11312	$181.22					0
11313	$242.98					0
11400	$108.89					15
11401	$151.97					15
11402	$191.77					15
11403	$238.09					15
11404	$277.09					15
11406	$363.24					15
11420	$119.46					15
11421	$171.45					15
11422	$207.22					15
11423	$268.97					15
11424	$310.42					15
11426	$438.80					15
11440	$139.77					15
11441	$188.53					15
11442	$229.98					15
11443	$304.74					15
11444	$378.67					15
11446	$487.56					15
11450	$416.06					15
11451	$529.01					15
11462	$376.24					15
11463	$458.31					15
11470	$464.82					15
11471	$533.89					15
11600	$194.22					15
11601	$255.15					15
11602	$300.66					15
11603	$354.30					15
11604	$399.80					15
11606	$512.75					15
11620	$204.78					15
11621	$286.03					15
11622	$349.42					15
11623	$425.80					15
11624	$514.38					15
11626	$599.71					15
11640	$243.78					15
11641	$348.61					15
11642	$425.00					15
11643	$503.81					15
11644	$624.90					15
11646	$800.41					15
11719	$11.93					0
11720	$49.93					0
11721	$84.23					0
11730	$123.52					0
11732	$48.76					0
11740	$59.33					0
11750	$292.54					10
11752	$407.12					15
11755	$180.39					15
11760	$192.59					15
11762	$421.74					15
11765	$90.21					15
11770	$413.63					15
11771	$770.36					45
11772	$891.42					45
11900	$60.13					0
11901	$94.27					0
11920	$221.84					0
11921	$264.92					0
11922	$67.44					0
11950	$157.65					0
11951	$185.28					0
11952	$225.10					0
11954	$237.29					0
11960	$1,096.21					90
11970	$1,206.73					90
11971	$376.24					15
11976	$214.63					15
11980	$215.54					0
11981		$222.95	$154.23			15
11982		$254.33	$185.59			15
11983		$412.82	$344.10			15
12001	$152.60					0
12002	$178.27					0
12004	$228.19					0
12005	$293.80					15
12006	$371.52					15
12007	$459.94					15
12011	$168.28					0
12013	$203.24					0
12014	$246.73					15
12015	$326.59					15
12016	$420.71					15
12017	$549.07					15
12018	$828.86					15
12020	$296.60					15
12021	$190.96					15
12031	$221.04					0
12032	$271.41					0
12034	$339.67					15
12035	$416.06					15
12036	$498.93					15
12037	$608.65					15
12041	$217.49					0
12042	$265.27					15
12044	$323.75					15
12045	$392.90					15
12046	$551.77					15
12047	$595.42					15
12051	$268.97					0
12052	$327.48					15
12053	$377.87					15
12054	$469.68					15
12055	$597.28					15
12056	$776.85					15
12057	$893.88					15
13100	$330.73					15
13101	$465.62					15
13102	$143.19					0
13120	$361.61					15
13121	$544.44					15
13122	$166.57					0
13131	$448.57					15
13132	$684.21					15
13133	$246.95					0
13151	$539.58					15
13152	$897.11					15
13153	$271.03					0
13160	$1,016.57					45
14000	$692.35					45
14001	$989.75					45
14020	$858.11					45
14021	$1,228.67					45
14040	$1,088.09					45
14041	$1,462.70					45
14060	$1,241.67					45
14061	$1,717.85					45
14301		$1,971.17	$1,670.00			90
14302		$433.73	$433.73
14350	$1,196.96					45
15002		$576.72	$398.94			0
15003		$127.84	$81.78			0
15004		$695.48	$493.95			0
15005		$215.37	$163.54			0
15040		$496.36	$249.28			0
15050	$449.37					15
15100	$999.51					45
15101	$264.09					0
15110		$1,575.61	$1,311.31			90
15111		$250.06	$214.16			0
15115		$1,487.67	$1,352.66			90
15116		$325.15	$292.11			0
15120	$1,198.59					45
15121	$442.88					0
15130		$1,305.28	$1,051.75			90
15131		$204.46	$173.56			0
15135		$1,592.24	$1,466.53			90
15136		$191.02	$175.22			0
15150		$1,310.10	$1,165.01			90
15151		$264.22	$231.17			0
15152		$324.70	$288.79			0
15155		$1,318.17	$1,256.41			90
15156		$344.72	$321.73			0
15157		$381.53	$350.65			0
15200	$915.81					45
15201	$273.03					0
15220	$971.06					45
15221	$257.60					0
15240	$1,139.28					45
15241	$360.79					0
15260	$1,337.56					45
15261	$442.88					0
15570	$901.19					45
15271		$279.21	$171.31			0
15272		$53.05	$34.20			0
15273		$573.98	$407.57			0
15274		$135.71	$86.97			0
15275		$300.06	$198.67			0
15276		$65.94	$49.03			0
15277		$580.26	$423.62			0
15278		$159.65	$107.66			0
15572	$875.17					45
15574	$871.94					45
15576	$586.71					45
15600	$407.92					45
15610	$436.37					45
15620	$533.07					45
15630	$582.63					45
15650	$656.58					45
15731		$1,927.54	$1,742.55			90
15732	$2,235.49					45
15734	$2,814.87					45
15736	$2,501.21					45
15738	$1,908.01					45
15740	$1,566.71					45
15750	$1,787.73					45
15756	$5,022.98					45
15757	$5,022.98					45
15758	$5,022.98					45
15760	$1,228.67					45
15770	$1,123.03					45
15775	$543.63					15
15776	$760.59					15
15777		$415.01	$415.01			0
15780	$647.64					15
15781	$659.84					45
15782	$422.55					45
15783	$471.31					45
15786	$203.96					0
15787	$43.88					0
15788	$268.17					45
15789	$482.70					45
15792	$174.71					45
15793	$315.28					45
15819	$1,320.48					45
15820	$853.23					45
15821	$954.01					45
15822	$778.47					45
15823	$1,114.09					45
15824	$1,418.00					45
15825	$1,621.16					45
15826	$1,418.00					45
15828	$3,748.56					45
15829	$4,153.25					45
15830	$2,061.34					90
15832	$1,521.21					45
15833	$1,286.37					45
15834	$1,371.69					45
15835	$1,423.69					45
15836	$1,161.22					45
15837	$1,106.78					45
15838	$993.00					45
15839	$898.74					45
15840	$2,190.79					45
15841	$3,035.90					45
15842	$5,069.04					45
15845	$2,130.66					45
15847	BR					0
15850	$89.38					0
15851	$79.87					0
15852	$89.86					0
15860	$261.66					0
15876	BR					45
15877	BR					45
15878	BR					45
15879	BR					45
15920	$819.92					45
15922	$1,204.28					45
15931	$875.99					15
15933	$1,318.85					45
15934	$1,500.07					45
15935	$1,934.81					45
15936	$1,718.66					45
15937	$2,107.09					45
15940	$932.07					15
15941	$1,367.61					45
15944	$1,547.20					45
15945	$1,785.30					45
15946	$2,896.96					45
15950	$776.85					15
15951	$1,372.50					45
15952	$1,374.93					45
15953	$1,630.90					45
15956	$2,479.27					45
15958	$2,532.89					45
15999	BR					0
16000	$84.85					0
16020	$78.44					0
16025	$180.39					0
16030	$204.78					0
16035	$507.07					15
16036	$169.17					15
17000	$82.89					0
17003	$14.98					0
17004	$273.09					0
17106	$506.25					15
17107	$1,000.32					15
17108	$1,744.68					15
17110	$73.95					0
17111	$84.54					0
17250	$65.82					0
17260	$154.40					0
17261	$195.02					15
17262	$260.84					15
17263	$310.42					15
17264	$349.42					15
17266	$426.63					15
17270	$203.16					0
17271	$247.84					15
17272	$304.74					15
17273	$356.73					15
17274	$447.74					15
17276	$517.64					15
17280	$215.33					0
17281	$291.72					15
17282	$354.30					15
17283	$436.37					15
17284	$519.26					15
17286	$685.03					15
17311		$1,224.05	$674.88			0
17312		$736.35	$359.18			0
17313		$1,117.36	$604.86			0
17314		$681.98	$332.15			0
17315		$145.15	$94.04			0
17340	$78.82					0
17360	$130.83					0
17380	$60.96					0
17999	BR					0
19000	$96.70					0
19001	$52.82					0
19020	$378.67					15
19030	$139.05					0
19081		$1,311.93	$365.18			0
19082		$1,059.54	$175.86			0
19083		$1,303.03	$342.58			0
19084		$1,044.91	$165.34			0
19085		$1,970.23	$400.30			0
19086		$1,572.42	$183.48			0
19100	$151.97					0
19101	$434.74					15
19105		$3,579.97	$345.92
19110	$525.75					15
19112	$462.37					15
19120	$615.96					15
19125	$695.60					15
19126	$348.61					0
19260	$1,504.13					90
19271	$2,468.70					90
19272	$2,550.77					90
19281		$478.00	$208.58			0
19282		$331.12	$100.78			0
19283		$541.76	$210.64			0
19284		$396.26	$101.48			0
19285		$910.15	$178.66			0
19286		$761.56	$86.97			0
19287		$1,679.50	$285.06			0
19288		$1,338.84	$130.21			0
19296		$9,356.25	$411.85			0
19297	$188.98					0
19298		$3,534.42	$663.93			0
19300		$927.62	$651.23			90
19301	$711.75					90
19302	$1,515.58					90
19303	$1555.36					90
19304	$944.70					90
19305	$1881.54					90
19306	$1954.90					90
19307	$1965.10					90
19316	$1,823.49					45
19318	$2,028.28					45
19324	$702.91					45
19325	$1,105.95					45
19328	$721.60					15
19330	$877.62					45
19340	$1,203.47					0
19342	$1,704.86					45
19350	$1,216.47					15
19355	$970.26					15
19357	$2,294.80					90
19361	$3,021.28					90
19364	$3,526.72					90
19366	$2,881.51					0
19367	$3,565.72					90
19368	$4,071.98					90
19369	$3,876.96					90
19370	$1,093.78					15
19371	$1,332.68					45
19380	$1,331.87					90
19396	$297.42					0
19499	BR					0
20005	$382.75					15
20100	$1,201.15					10
20101	$379.48					10
20102	$464.91					10
20103	$625.73					10
20150	$2,011.71					15
20200	$203.96					15
20205	$334.79					15
20206	$153.57					0
20220	$175.43					15
20225	$292.38					15
20240	$386.81					15
20245	$569.63					15
20250	$764.67					45
20251	$868.68					45
20500	$106.25					0
20501	$72.74					0
20520	$196.65					0
20525	$430.68					15
20526		$119.03	$91.94			0
20527		$147.62	$116.43			0
20550	$85.57					0
20551		$119.03	$91.94			0
20552		$119.03	$91.94			0
20553		$119.03	$91.94			0
20555			$593.47			0
20600	$88.58					0
20604		$143.81	$93.81			0
20605	$88.58					0
20606		$159.22	$107.16			0
20610	$85.57					0
20611		$183.11	$125.58			0
20612		$108.48	$73.91			0
20615	$187.54					15
20650	$247.84					0
20660	$320.17					0
20661	$640.33					90
20662	$952.38					90
20663	$752.48					90
20664	$831.17					90
20665	$138.95					0
20670	$191.77					0
20680	$519.26					15
20690	$567.20					0
20692	$941.81					0
20693	$624.90					15
20694	$506.25					15
20696			$1,968.60			90
20697		$2,273.89				90
20802	$6,110.80					90
20805	$7,479.24					90
20808	$9,298.68					90
20816	$4,583.93					90
20822	$3,789.18					90
20824	$4,583.93					90
20827	$3,896.45					90
20838	$6,110.80					90
20900	$618.39					45
20902	$923.93					90
20910	$457.51					90
20912	$838.61					45
20920	$690.72					45
20922	$823.98					45
20924	$906.87					45
20926	$600.51					45
20930	$450.00					0
20931	$291.43					0
20936	$449.00					0
20937	$449.00					0
20938	$485.84					0
20950	$185.28					0
20955	$5,806.09					45
20956	$5,056.56					45
20957	$5,238.60					45
20962	$3,545.40					45
20969	$6,500.87					45
20970	$6,368.41					45
20972	$6,417.17					45
20973	$6,844.60					45
20974	$319.36					0
20975	$469.68					0
20979	$30.24					90
20982		$8,135.87	$806.08			0
20983		$13,467.70	$807.75			0
20985	$268.11
20999	BR					0
21010	$1,501.70					90
21011		$587.29	$460.08			90
21012			$629.33			90
21013		$912.64	$741.44			90
21014			$972.07			90
21015	$893.88					90
21016			$1,948.20			90
21025	$715.09					90
21026	$598.88					90
21029	$1,276.60					90
21030	$812.61					90
21031	$441.25					90
21032	$634.64					90
21034	$1,736.54					90
21040	$370.55					90
21044	$1,616.28					90
21045	$2,265.55					90
21046	$1,736.23					90
21047	$2,143.53					90
21048	$1,787.79					90
21049	$2,042.39					90
21050	$1,741.42					90
21060	$1,644.72					90
21070	$1,134.40					90
21073	$649.50					90
21076	$1,719.65					10
21077	$5,952.19					90
21079	$648.47					90
21080	$1,170.16					90
21081	$1,160.40					90
21082	$750.05					90
21083	$962.12					90
21084	$1,179.91					90
21085	$440.43					90
21086	$1,205.90					90
21087	$1,200.22					90
21088	$1,245.72					90
21089	BR					0
21100	$400.61					0
21110	$820.72					45
21116	$119.46					0
21120	$653.33					90
21121	$1,027.94					90
21122	$1,131.97					90
21123	$1,479.76					90
21125	$857.31					90
21127	$1,437.51					90
21137	$1,294.48					90
21138	$1,613.02					90
21139	$1,936.44					90
21141	$2,548.62					90
21142	$2,643.23					90
21143	$2,747.76					90
21145	$2,606.85					90
21146	$2,697.86					90
21147	$2,798.61					90
21150	$3,360.95					90
21151	$3,764.01					90
21154	$4,031.36					90
21155	$4,570.11					90
21159	$5,644.38					90
21160	$6,181.50					90
21172	$3,694.94					90
21175	$4,435.22					90
21179	$2,956.26					90
21180	$3,360.95					90
21181	$1,294.48					90
21182	$4,300.33					90
21183	$4,705.00					90
21184	$5,107.23					90
21188	$2,956.26					90
21193	$2,237.12					90
21194	$2,592.22					90
21195	$2,242.80					90
21196	$2,472.76					90
21198	$2,206.24					90
21199	$2,035.49					90
21206	$1,842.18					90
21208	$1,621.16					90
21209	$859.74					90
21210	$1,701.60					90
21215	$1,793.44					90
21230	$1,616.28					90
21235	$1,125.46					90
21240	$2,458.14					90
21242	$2,433.77					90
21243	$2,616.59					90
21244	$2,053.47					90
21245	$1,764.99					90
21246	$1,605.71					90
21247	$3,744.50					90
21248	$2,135.54					90
21249	$3,607.99					90
21255	$2,766.13					90
21256	$2,678.35					90
21260	$2,732.80					90
21261	$3,689.23					90
21263	$4,701.74					90
21267	$2,542.66					90
21268	$3,041.59					90
21270	$1,710.54					90
21275	$1,530.95					90
21280	$996.26					90
21282	$711.85					90
21295	$187.71					90
21296	$587.51					90
21299	BR					0
21310	$91.98					90
21315	$251.92					0
21320	$326.67					45
21325	$597.28					45
21330	$901.99					45
21335	$1,462.70					45
21336	$741.11					45
21337	$419.31					45
21338	$868.68					90
21339	$1,143.34					90
21340	$1,487.07					90
21343	$1,667.47					90
21344	$2,166.42					90
21345	$1,212.41					90
21346	$1,511.44					90
21347	$1,745.48					90
21348	$2,141.23					90
21355	$398.18					0
21356	$747.59					45
21360	$1,043.39					90
21365	$2,068.10					90
21366	$2,280.17					90
21385	$1,421.26					90
21386	$1,386.32					90
21387	$1,297.74					90
21390	$1,670.72					90
21395	$1,691.03					90
21400	$203.94					45
21401	$442.06					90
21406	$926.38					90
21407	$1,184.79					90
21408	$1,572.40					90
21421	$853.23					90
21422	$1,377.38					90
21423	$1,530.15					90
21431	$988.14					90
21432	$1,162.03					90
21433	$3,265.06					90
21435	$2,312.68					90
21436	$3,217.93					90
21440	$434.74					45
21445	$867.05					45
21450	$438.00					90
21451	$830.49					90
21452	$254.35					90
21453	$917.44					90
21454	$1,287.17					90
21461	$1,387.12					90
21462	$1,631.73					90
21465	$1,534.21					90
21470	$2,442.71					90
21480	$112.15					45
21485	$462.37					90
21490	$1,357.05					90
21495	$792.30					90
21497	$590.77					90
21499	BR					0
21501	$420.94					15
21502	$844.29					45
21510	$695.60					45
21550	$225.10					15
21552			$837.72			90
21554			$1,376.55			90
21555	$448.57					15
21556	$718.34					15
21557	$1,349.73					45
21558			$2,584.25			90
21600	$855.68					90
21610	$1,080.78					90
21615	$1,525.27					45
21616	$1,461.88					45
21620	$1,023.08					45
21627	$879.25					90
21630	$2,275.31					90
21632	$2,236.29					90
21685	$1,793.13					90
21700	$784.16					45
21705	$1,101.89					45
21720	$729.71					90
21725	$898.74					90
21740	$1,934.01					90
21742	BR					90
21743	BR					90
21750	$1,383.06					90
21805	$312.05					90
21811		$1,225.86	$1,225.86			0
21812		$1,469.91	$1,469.91			0
21813		$2,000.40	$2,000.40			0
21820	$200.71					45
21825	$1,084.84					90
21899	BR					0
21920	$220.21					15
21925	$488.38					15
21930	$733.79					15
21931			$876.12			90
21932			$1,257.16			90
21933			$1,385.99			90
21935	$1,879.56					45
21936			$2,686.45			90
22010	$751.53					90
22015	$1,575.16					90
22100	$1,144.14					90
22101	$1,170.97					90
22102	$1,036.08					90
22103	$376.55					0
22110	$1,686.17					90
22112	$1,699.17					90
22114	$1,487.88					90
22116	$373.01					0
22206			$4,149.09			90
22207			$4,097.94			90
22208	$1,040.44
22210	$2,877.45					90
22212	$2,801.87					90
22214	$2,635.30					90
22216	$916.62					0
22220	$2,905.88					90
22222	$2,646.67					90
22224	$2,761.24					90
22226	$916.62					0
22305	$334.79					45
22310	$405.49					90
22315	$1,094.58					90
22318	$2,729.34					90
22319	$3,083.82					90
22325	$2,014.45					90
22326	$2,721.42					90
22327	$2,640.98					90
22328	$742.02					0
22505	$212.51					15
22510		$3,461.97	$928.19			10
22511		$3,428.11	$871.05			10
22512		$1,922.29	$432.44			0
22513		$14,314.07	$1,097.90			10
22514		$14,236.99	$1,022.87			10
22515		$8,634.37	$463.13			0
22526		$3,831.06	$633.02			90
22527		$3,112.91	$292.05			0
22532	$3,120.86					90
22533	$2,923.78					90
22534	$734.49					0
22548	$3,705.49					90
22551			$3,349.35			90
22552			$782.24
22554	$3,010.71					90
22556	$3,547.86					90
22558	$3,346.33					90
22585	$866.25					0
22586		$2,973.90	$2,973.90			90
22590	$3,203.30					90
22595	$3,304.88					90
22600	$2,963.58					90
22610	$2,602.79					90
22612	$3,277.25					90
22614	$995.11					0
22630	$3,117.17					90
22632	$841.78					0
22633			$3,583.76			90
22634			$965.85			0
22800	$3,053.79					90
22802	$4,713.94					90
22804	$5,209.81					90
22808	$3,575.75					90
22810	$3,750.99					90
22812	$4,201.18					90
22818	$4,279.11					90
22819	$4,589.33					90
22830	$1,637.99					90
22840	$1,294.61					90
22841	BR					90
22842	$1,363.49					90
22843	$1,550.19					90
22844	$1,893.90					90
22845	$1,234.33					90
22846	$1,431.10					90
22847	$1,589.81					90
22848	$835.00					90
22849	$2,133.54					90
22850	$1,435.06					90
22851	$1,079.75					90
22852	$1,438.31					90
22855	$1,309.93					90
22856			$2,977.15			90
22857	$2,699.34
22858		$1,008.08	$1,008.08			0
22861			$3,656.54			90
22862	$3,265.72					90
22864			$3,344.64			90
22865	$3,180.80					90
22899	BR					0
22900	$760.59					45
22901			$1,238.00			90
22902		$783.67	$627.58			90
22903			$820.58			90
22904			$1,937.31			90
22905			$2,512.31			90
22999	BR					0
23000	$580.20					45
23020	$1,223.78					45
23030	$420.12					15
23031	$250.29					15
23035	$1,109.21					45
23040	$1,395.24					90
23044	$1,054.76					90
23065	$228.35					15
23066	$406.31					15
23071			$778.33			90
23073			$1,289.60			90
23075	$318.54					15
23076	$844.29					15
23077	$1,746.30					45
23078			$2,614.22			90
23100	$1,017.39					90
23101	$944.24					90
23105	$1,400.12					90
23106	$815.86					90
23107	$1,402.57					90
23120	$889.80					90
23125	$1,370.87					90
23130	$1,118.97					90
23140	$838.61					45
23145	$1,318.05					90
23146	$998.69					90
23150	$1,139.28					45
23155	$1,451.31					90
23156	$1,236.78					90
23170	$875.99					90
23172	$897.11					45
23174	$1,358.67					90
23180	$956.44					90
23182	$1,109.21					90
23184	$1,380.61					90
23190	$1,015.77					45
23195	$1,416.37					90
23200	$1,590.28					90
23210	$1,610.59					90
23220	$2,007.14					90
23330	$184.45					15
23333		$907.06	$907.06			90
23334		$2,144.40	$2,144.40			90
23335		$2,558.44	$2,558.44			90
23350	$104.11					0
23395	$1,862.51					90
23397	$2,311.05					90
23400	$1,804.81					90
23405	$1,214.84					90
23406	$1,561.83					90
23410	$1,804.81					90
23412	$2,059.96					90
23415	$1,160.40					90
23420	$2,155.85					90
23430	$1,335.93					90
23440	$1,363.56					90
23450	$2,023.39					90
23455	$2,322.44					90
23460	$2,269.61					90
23462	$2,353.32					90
23465	$2,314.31					90
23466	$2,386.63					90
23470	$2,597.10					90
23472	$3,154.54					90
23473		$3,184.72	$3,184.72			90
23474		$3,440.30	$3,440.30			90
23480	$1,352.99					90
23485	$1,900.70					90
23490	$1,656.10					90
23491	$2,082.72					90
23500	$282.80					45
23505	$481.88					90
23515	$1,101.89					90
23520	$268.17					45
23525	$423.37					90
23530	$1,070.21					90
23532	$1,171.79					90
23540	$286.03					45
23545	$398.18					90
23550	$1,201.85					90
23552	$1,194.53					90
23570	$299.85					45
23575	$523.32					90
23585	$1,274.98					90
23600	$445.31					45
23605	$736.22					90
23615	$1,512.27					90
23616	$3,334.13					90
23620	$405.49					45
23625	$589.14					90
23630	$1,241.67					90
23650	$418.49					45
23655	$567.20					45
23660	$1,275.80					90
23665	$592.39					90
23670	$1,351.36					90
23675	$752.48					90
23680	$1,708.11					90
23700	$360.79					0
23800	$2,345.99					90
23802	$2,270.43					90
23900	$2,458.96					90
23920	$2,180.22					90
23921	$737.03					45
23929	BR					0
23930	$346.16					15
23931	$187.71					15
23935	$810.98					45
24000	$992.20					90
24006	$1,252.23					90
24065	$221.84					15
24066	$603.77					15
24071			$755.30			90
24073			$1,296.91			90
24075	$456.68					15
24076	$767.91					15
24077	$1,666.66					45
24079			$2,410.41			90
24100	$703.72					90
24101	$1,058.82					90
24102	$1,372.50					90
24105	$569.63					90
24110	$1,166.91					45
24115	$1,311.54					90
24116	$1,644.72					90
24120	$979.20					45
24125	$1,031.19					90
24126	$1,198.59					90
24130	$1,001.94					90
24134	$1,391.18					90
24136	$1,257.12					90
24138	$1,087.27					90
24140	$1,370.87					90
24145	$1,066.96					90
24147	$1,075.90					90
24149	$2,050.54					90
24150	$2,094.90					90
24152	$1,290.43					90
24155	$1,727.60					90
24160	$970.26					90
24164	$894.68					90
24200	$156.17					15
24201	$581.02					15
24220	$125.50					0
24300	$673.37					45
24301	$1,395.24					90
24305	$802.04					90
24310	$685.03					90
24320	$1,512.27					90
24330	$1,417.20					90
24331	$1,559.40					90
24332	$936.15					90
24340	$1,152.28					90
24341	$1,133.99					90
24342	$1,624.41					90
24343	$1,228.52					90
24344	$1,853.84					90
24345	$1,228.52					90
24346	$1,853.84					90
24357			$783.27			90
24358			$919.93			90
24359			$1,130.90			90
24360	$2,121.72					90
24361	$2,101.41					90
24362	$2,133.91					90
24363	$3,200.05					90
24365	$1,220.53					90
24366	$1,560.20					90
24370		$3,013.24	$3,013.24			90
24371		$3,472.48	$3,472.48			90
24400	$1,500.07					90
24410	$2,231.41					90
24420	$1,992.51					90
24430	$2,127.40					90
24435	$2,208.67					90
24470	$1,284.74					90
24495	$1,059.64					45
24498	$1,711.35					90
24500	$437.17					45
24505	$737.03					90
24515	$1,625.22					90
24516	$1,625.22					90
24530	$476.19					90
24535	$897.11					90
24538	$1,329.42					90
24545	$1,550.46					90
24546	$1,945.38					90
24560	$376.24					45
24565	$684.21					90
24566	$1,045.02					90
24575	$1,398.49					90
24576	$380.30					45
24577	$745.16					90
24579	$1,518.76					90
24582	$1,141.71					90
24586	$2,298.88					90
24587	$2,210.30					90
24600	$474.56					45
24605	$581.83					45
24615	$1,426.12					90
24620	$819.92					90
24635	$1,855.19					90
24640	$147.62					0
24650	$335.62					45
24655	$566.40					90
24665	$1,170.97					90
24666	$1,511.44					90
24670	$341.30					45
24675	$633.84					90
24685	$1,322.93					90
24800	$1,681.29					90
24802	$1,974.63					90
24900	$1,304.23					90
24920	$1,225.41					90
24925	$1,009.26					45
24930	$1,383.06					90
24931	$1,809.67					90
24935	$2,220.04					90
24940	$1,519.58					90
24999	BR					0
25000	$563.95					45
25001	$562.98					45
25020	$784.16					45
25023	$1,363.56					45
25024	$1,307.61					45
25025	$2,117.70					45
25028	$548.52					15
25031	$359.18					15
25035	$1,037.70					45
25040	$971.89					90
25065	$247.04					15
25066	$425.80					15
25071			$791.58			90
25073			$986.72			90
25075	$458.31					15
25076	$676.90					15
25077	$1,411.49					45
25078			$2,103.96			90
25085	$769.53					45
25100	$661.47					90
25101	$796.35					90
25105	$1,003.57					90
25107	$884.11					90
25109	$907.92					90
25110	$520.89					45
25111	$511.95					45
25112	$641.96					45
25115	$1,062.07					90
25116	$1,157.16					90
25118	$746.79					90
25119	$1,022.25					90
25120	$969.44					45
25125	$1,096.21					90
25126	$1,101.89					90
25130	$733.79					45
25135	$954.81					90
25136	$826.43					90
25145	$935.30					90
25150	$1,047.45					90
25151	$999.51					90
25170	$1,597.59					90
25210	$824.80					45
25215	$1,271.74					90
25230	$823.18					90
25240	$806.92					90
25246	$134.06					0
25248	$564.77					45
25250	$943.44					45
25251	$1,371.69					45
25259	$665.75					45
25260	$944.24					90
25263	$1,041.76					90
25265	$1,384.69					90
25270	$716.72					90
25272	$804.49					90
25274	$1,192.10					90
25275	$1,186.85					90
25280	$872.74					90
25290	$592.39					45
25295	$736.22					45
25300	$1,250.61					90
25301	$1,177.48					90
25310	$1,171.79					90
25312	$1,322.93					90
25315	$1,385.49					90
25316	$1,747.11					90
25320	$1,463.51					90
25332	$1,644.72					90
25335	$1,849.49					90
25337	$1,400.94					90
25350	$1,253.04					90
25355	$1,476.51					90
25360	$1,127.89					90
25365	$1,730.85					90
25370	$1,905.56					90
25375	$1,985.20					90
25390	$1,478.13					90
25391	$1,900.70					90
25392	$2,016.08					90
25393	$2,302.11					90
25394	$1,388.54					90
25400	$1,666.66					90
25405	$2,047.76					90
25415	$1,903.93					90
25420	$2,371.18					90
25425	$1,930.76					90
25426	$2,112.78					90
25430	$1,236.82					90
25431	$1,225.72					90
25440	$1,503.33					90
25441	$1,869.00					90
25442	$1,377.38					90
25443	$1,522.83					90
25444	$1,643.10					90
25445	$1,553.71					90
25446	$2,806.75					90
25447	$1,542.32					90
25449	$1,704.03					90
25450	$1,184.79					90
25455	$1,412.32					90
25490	$1,408.26					90
25491	$1,474.07					90
25492	$1,815.38					90
25500	$363.24					45
25505	$672.03					90
25515	$1,284.74					90
25520	$928.81					45
25525	$1,806.43					90
25526	$1,920.19					90
25530	$344.56					45
25535	$668.78					90
25545	$1,257.92					90
25560	$357.55					45
25565	$784.98					90
25574	$1,151.46					90
25575	$1,595.14					90
25600	$419.31					45
25605	$734.60					90
25606			$1236.43			90
25607			$1246.01			90
25608			$1420.43			90
25609			$1811.77			90
25622	$371.36					45
25624	$627.33					90
25628	$1,180.71					90
25630	$386.81					45
25635	$593.20					90
25645	$1,065.33					90
25650	$434.74					45
25651	$724.87					45
25652	$1,071.80					90
25660	$500.56					90
25670	$1,153.09					90
25671	$885.22					45
25675	$529.81					45
25676	$1,173.40					90
25680	$636.27					90
25685	$1,425.31					90
25690	$792.30					90
25695	$1,184.79					90
25800	$1,594.34					90
25805	$1,851.94					90
25810	$1,765.79					90
25820	$1,270.11					90
25825	$1,558.58					90
25830	$1,400.94					90
25900	$1,209.16					90
25905	$1,226.24					90
25907	$1,030.39					45
25909	$1,105.15					90
25915	$2,565.40					90
25920	$1,194.53					90
25922	$993.00					45
25924	$1,214.84					90
25927	$1,157.16					90
25929	$944.24					45
25931	$945.07					90
25999	BR					0
26010	$135.49					0
26011	$290.11					0
26020	$611.90					15
26025	$698.83					15
26030	$878.43					15
26034	$776.85					45
26035	$1,071.01					90
26037	$1,032.02					45
26040	$471.31					45
26045	$799.61					45
26055	$463.19					45
26060	$303.11					15
26070	$481.07					90
26075	$571.26					45
26080	$546.89					45
26100	$515.19					90
26105	$612.71					45
26110	$501.38					45
26111			$768.61			90
26113			$1,011.60			90
26115	$450.19					15
26116	$703.72					15
26117	$1,054.76					45
26118			$1,980.57			90
26121	$1,326.99					45
26123	$1,404.18					45
26125	$572.08					0
26130	$802.86					90
26135	$912.56					90
26140	$813.41					90
26145	$850.00					90
26160	$420.94					15
26170	$588.34					45
26180	$714.28					45
26185	$719.13					45
26200	$768.73					45
26205	$1,077.52					90
26210	$701.29					45
26215	$978.38					90
26230	$807.73					45
26235	$790.67					45
26236	$697.23					45
26250	$1,051.51					90
26260	$987.32					90
26262	$802.86					90
26320	$575.32					45
26340	$509.52					45
26341		$190.88	$144.74			10
26350	$910.93					90
26352	$1,096.21					90
26356	$1,129.52					90
26357	$1,169.34					90
26358	$1,274.17					90
26370	$1,062.07					90
26372	$1,162.03					90
26373	$1,147.40					90
26390	$1,316.42					90
26392	$1,448.08					90
26410	$604.59					90
26412	$942.64					90
26415	$1,163.65					90
26416	$1,399.32					90
26418	$601.33					90
26420	$954.01					90
26426	$963.75					90
26428	$983.26					90
26432	$555.01					45
26433	$660.64					45
26434	$850.80					90
26437	$758.16					90
26440	$659.04					90
26442	$749.22					90
26445	$585.88					90
26449	$947.50					90
26450	$459.13					45
26455	$427.43					45
26460	$399.80					45
26471	$766.30					90
26474	$771.16					90
26476	$616.76					90
26477	$711.03					90
26478	$784.98					90
26479	$858.11					90
26480	$1,031.19					90
26483	$1,295.31					90
26485	$1,090.52					90
26489	$977.57					90
26490	$1,248.98					90
26492	$1,409.88					90
26494	$1,213.22					90
26496	$1,418.80					90
26497	$1,359.50					90
26498	$2,006.34					90
26499	$1,288.80					90
26500	$724.85					90
26502	$952.38					90
26508	$772.79					90
26510	$725.66					90
26516	$862.17					90
26517	$1,220.53					90
26518	$1,193.73					90
26520	$749.22					90
26525	$686.66					90
26530	$912.56					90
26531	$1,125.46					90
26535	$767.10					90
26536	$1,049.90					90
26540	$1,003.57					90
26541	$1,356.24					90
26542	$954.01					90
26545	$932.87					90
26546	$1,315.62					90
26548	$1,061.27					90
26550	$3,208.99					90
26551	$6,855.70					90
26553	$6,808.11					90
26554	$8,122.95					90
26555	$2,496.33					90
26556	$6,923.87					90
26560	$777.67					45
26561	$1,536.64					45
26562	$1,565.89					90
26565	$967.01					90
26567	$853.23					45
26568	$1,342.42					90
26580	$2,442.71					90
26587	BR					90
26590	$2,693.80					90
26591	$411.18					90
26593	$713.46					90
26596	$1,335.11					90
26600	$264.09					45
26605	$391.67					90
26607	$685.03					90
26608	$685.03					45
26615	$794.73					90
26641	$381.12					45
26645	$507.07					45
26650	$750.05					45
26665	$1,071.01					90
26670	$353.48					45
26675	$690.72					45
26676	$798.79					45
26685	$971.06					90
26686	$1,090.52					90
26700	$347.79					45
26705	$455.05					45
26706	$758.97					45
26715	$758.97					90
26720	$209.65					45
26725	$372.18					45
26727	$581.83					45
26735	$746.79					90
26740	$234.04					45
26742	$448.57					90
26746	$815.04					90
26750	$190.96					45
26755	$318.54					45
26756	$481.88					45
26765	$529.81					45
26770	$286.86					45
26775	$365.67					45
26776	$528.20					45
26785	$557.46					45
26820	$1,144.14					90
26841	$1,024.71					90
26842	$1,290.43					90
26843	$1,075.90					90
26844	$1,231.92					90
26850	$884.93					90
26852	$1,084.01					90
26860	$693.97					90
26861	$316.11					0
26862	$966.18					90
26863	$575.32					0
26910	$978.38					90
26951	$576.14					90
26952	$793.10					90
26989	BR					0
26990	$779.30					45
26991	$620.02					45
26992	$1,607.34					45
27000	$559.89					45
27001	$792.30					45
27003	$1,050.70					45
27005	$976.75					45
27006	$1,117.34					45
27025	$1,287.17					45
27027			$1,567.70			90
27030	$1,858.43					90
27033	$1,888.51					90
27035	$2,189.16					90
27036	$1,856.35					0
27040	$275.26					15
27041	$949.95					15
27043			$874.74			90
27045			$1,390.25			90
27047	$715.09					15
27048	$796.35					15
27049	$1,798.30					90
27050	$676.90					90
27052	$1,057.21					90
27054	$1,467.56					90
27057			$1,759.30			90
27059			$3,411.50			90
27060	$685.84					90
27062	$709.40					90
27065	$835.37					90
27066	$1,349.73					90
27067	$1,920.19					90
27070	$1,343.24					90
27071	$1,483.01					90
27075	$2,327.31					90
27076	$2,710.05					90
27077	$3,188.67					90
27078	$1,669.92					90
27080	$825.61					90
27086	$188.53					0
27087	$919.07					15
27090	$1,665.84					90
27091	$3,183.79					90
27093	$166.59					0
27095	$167.58					0
27096		$777.98	$108.93			0
27097	$1,248.98					90
27098	$1,248.98					90
27100	$1,448.08					90
27105	$1,367.61					90
27110	$1,830.80					90
27111	$1,816.18					90
27120	$2,731.17					90
27122	$2,449.20					90
27125	$2,390.69					90
27130	$3,391.83					90
27132	$3,886.71					90
27134	$4,453.91					90
27137	$3,428.40					90
27138	$3,434.89					90
27140	$1,774.73					90
27146	$1,930.76					90
27147	$2,731.99					90
27151	$2,870.14					90
27156	$3,045.65					90
27158	$2,580.03					90
27161	$2,332.19					90
27165	$2,602.79					90
27170	$2,475.21					90
27175	$663.90					90
27176	$1,682.92					90
27177	$2,068.10					90
27178	$1,673.15					90
27179	$1,806.43					90
27181	$2,130.66					90
27185	$887.37					90
27187	$2,272.06					90
27193	$556.63					90
27194	$993.00					90
27200	$254.35					45
27202	$997.88					90
27215	$1,705.66					90
27216	$1,458.62					90
27217	$2,192.42					90
27218	$2,636.92					90
27220	$750.85					90
27222	$1,368.44					90
27226	$2,348.44					90
27227	$2,775.07					90
27228	$2,992.03					90
27230	$647.64					90
27232	$1,446.45					90
27235	$1,997.40					90
27236	$2,454.08					90
27238	$784.98					90
27240	$1,623.59					90
27244	$2,423.20					90
27245	$2,767.73					90
27246	$649.27					90
27248	$1,757.67					90
27250	$748.42					45
27252	$1,089.70					45
27253	$1,985.20					90
27254	$2,433.77					90
27256	$442.88					0
27257	$745.97					0
27258	$2,224.92					90
27259	$2,786.44					90
27265	$713.46					45
27266	$962.12					45
27267			$734.66			90
27268			$904.36			90
27269			$2,156.86			90
27275	$306.36					0
27279		$1,132.36	$1,132.36			90
27280	$1,733.28					90
27282	$1,555.34					90
27284	$2,382.58					90
27286	$2,432.14					90
27290	$3,742.05					90
27295	$2,685.66					90
27299	BR					0
27301	$664.72					15
27303	$1,071.01					45
27305	$730.54					45
27306	$494.07					45
27307	$655.78					45
27310	$1,410.69					90
27323	$281.97					15
27324	$566.40					15
27325	$917.34					90
27326	$867.22					90
27327	$523.32					15
27328	$743.54					15
27329	$1,860.06					45
27330	$875.99					90
27331	$1,034.45					90
27332	$1,418.80					90
27333	$1,450.51					90
27334	$1,437.51					90
27335	$1,661.78					90
27337			$779.94			90
27339			$1,404.69			90
27340	$614.33					90
27345	$891.42					45
27347	$588.75					45
27350	$1,337.56					45
27355	$1,157.97					45
27356	$1,328.62					90
27357	$1,457.00					90
27358	$733.79					0
27360	$1,406.63					90
27364			$2,935.13			90
27365	$2,202.16					90
27370	$106.96					0
27372	$650.09					15
27380	$1,152.28					90
27381	$1,654.47					90
27385	$1,266.03					90
27386	$1,752.79					90
27390	$731.34					45
27391	$956.44					45
27392	$1,280.66					45
27393	$919.07					90
27394	$1,083.21					90
27395	$1,693.48					90
27396	$1,136.83					90
27397	$1,439.94					90
27400	$1,292.05					90
27403	$1,312.36					90
27405	$1,435.06					90
27407	$1,447.25					90
27409	$2,128.23					90
27412	$3,098.65					90
27415	$2,566.12					90
27416			$1,690.02			90
27418	$1,739.79					90
27420	$1,591.08					90
27422	$1,624.41					90
27424	$1,645.53					90
27425	$910.93					90
27427	$1,600.85					90
27428	$1,942.13					90
27429	$1,828.37					90
27430	$1,444.82					90
27435	$1,245.72					90
27437	$1,394.43					90
27438	$1,852.74					90
27440	$1,691.86					90
27441	$1,499.27					90
27442	$2,086.78					90
27443	$2,042.08					90
27445	$3,083.04					90
27446	$2,775.87					90
27447	$3,586.85					90
27448	$1,828.37					90
27450	$2,206.24					90
27454	$2,220.04					90
27455	$1,899.07					90
27457	$2,046.96					90
27465	$1,983.57					90
27466	$2,256.61					90
27468	$2,727.11					90
27470	$2,486.58					90
27472	$2,866.08					90
27475	$1,253.86					90
27477	$1,771.48					90
27479	$1,882.82					90
27485	$1,283.11					90
27486	$3,058.67					90
27487	$4,088.23					90
27488	$2,421.57					90
27495	$2,520.72					90
27496	$733.79					45
27497	$898.74					90
27498	$1,023.88					45
27499	$1,179.91					90
27500	$844.29					90
27501	$844.29					90
27502	$1,357.05					90
27503	$1,357.05					90
27506	$2,524.78					90
27507	$2,281.80					90
27508	$744.34					90
27509	$867.05					90
27510	$1,185.59					90
27511	$2,252.55					90
27513	$2,591.40					90
27514	$2,508.52					90
27516	$767.91					90
27517	$1,266.86					90
27519	$2,094.90					90
27520	$451.00					45
27524	$1,558.58					90
27530	$522.50					90
27532	$986.51					90
27535	$1,743.05					90
27536	$2,070.53					90
27538	$631.39					90
27540	$1,843.00					90
27550	$637.90					45
27552	$853.23					45
27556	$2,048.59					90
27557	$2,405.32					90
27558	$2,480.08					90
27560	$398.18					45
27562	$840.23					45
27566	$1,742.22					45
27570	$269.78					0
27580	$2,211.93					90
27590	$1,539.89					90
27591	$1,813.75					90
27592	$1,342.42					90
27594	$789.04					90
27596	$1,350.56					90
27598	$1,554.52					90
27599	BR					0
27600	$667.15					45
27601	$664.72					45
27602	$847.55					15
27603	$537.12					15
27604	$413.63					15
27605	$314.48					0
27606	$473.76					15
27607	$1,032.82					45
27610	$1,159.59					90
27612	$1,123.03					90
27613	$220.21					15
27614	$596.45					15
27615	$1,584.59					45
27616			$2,395.99			90
27618	$555.01					15
27619	$956.44					15
27620	$926.38					90
27625	$1,307.48					90
27626	$1,513.89					90
27630	$611.08					45
27632			$771.12			90
27634			$1,259.55			90
27635	$1,210.79					45
27637	$1,392.81					90
27638	$1,506.58					90
27640	$1,582.14					90
27641	$1,225.41					90
27645	$1,961.64					90
27646	$1,773.10					90
27647	$1,664.21					90
27648	$101.25					0
27650	$1,425.31					90
27652	$1,579.71					90
27654	$1,599.22					90
27656	$592.39					45
27658	$680.15					90
27659	$957.26					90
27664	$610.28					90
27665	$793.92					90
27675	$1,038.51					90
27676	$1,217.30					90
27680	$748.42					90
27681	$971.06					90
27685	$776.04					90
27686	$1,061.27					90
27687	$888.19					90
27690	$1,165.28					90
27691	$1,352.99					90
27692	$307.17					0
27695	$1,099.46					90
27696	$1,168.54					90
27698	$1,600.02					90
27700	$1,554.52					90
27702	$2,501.21					90
27703	$2,238.73					90
27704	$1,032.02					45
27705	$1,611.39					90
27707	$669.58					90
27709	$1,656.10					90
27712	$1,797.49					90
27715	$2,016.88					90
27720	$1,970.58					90
27722	$1,691.03					90
27724	$2,195.67					90
27725	$1,691.86					90
27726			$1,607.81			90
27727	$1,770.67					90
27730	$835.37					90
27732	$782.53					90
27734	$1,219.73					90
27740	$1,352.99					90
27742	$1,503.33					90
27745	$1,449.68					45
27750	$500.56					45
27752	$810.18					90
27756	$1,123.83					90
27758	$1,896.62					90
27759	$2,082.72					90
27760	$424.17					45
27762	$643.59					90
27766	$1,222.98					90
27767		$449.64	$451.82			90
27768			$695.79			90
27769			$1,203.43			90
27780	$348.61					45
27781	$590.77					90
27784	$950.75					90
27786	$408.75					45
27788	$593.20					90
27792	$1,139.28					90
27808	$426.63					45
27810	$780.10					90
27814	$1,569.97					90
27816	$488.38					45
27818	$916.62					90
27822	$1,517.15					90
27823	$1,872.25					90
27824	$488.38					90
27825	$916.62					90
27826	$1,355.44					90
27827	$1,708.11					90
27828	$1,985.20					90
27829	$927.19					90
27830	$531.44					45
27831	$650.09					45
27832	$920.68					90
27840	$481.88					45
27842	$626.53					45
27846	$1,392.81					90
27848	$1,485.45					90
27860	$290.91					0
27870	$1,881.19					90
27871	$1,289.60					90
27880	$1,513.89					90
27881	$1,720.29					90
27882	$1,205.90					90
27884	$852.43					45
27886	$1,232.72					90
27888	$1,441.57					90
27889	$1,370.06					90
27892	$746.79					90
27893	$744.34					90
27894	$927.19					90
27899	BR					0
28001	$251.09					0
28002	$473.76					0
28003	$868.68					45
28005	$924.75					45
28008	$537.95					45
28010	$512.75					45
28011	$451.82					45
28020	$718.34					90
28022	$560.69					45
28024	$509.50					45
28035	$867.05					45
28039		$893.36	$642.39			90
28041			$844.74			90
28043	$403.06					15
28045	$661.47					15
28046	$1,163.65					45
28047			$1,791.03			90
28050	$615.96					90
28052	$588.34					45
28054	$428.25					45
28055	$732.58					90
28060	$727.28					45
28062	$1,041.76					90
28070	$719.97					90
28072	$591.57					45
28080	$566.40					45
28086	$602.14					45
28088	$566.40					45
28090	$568.83					45
28092	$433.12					45
28100	$780.10					45
28102	$1,110.03					90
28103	$918.25					90
28104	$719.17					45
28106	$1,032.02					90
28107	$781.73					90
28108	$639.53					45
28110	$571.26					45
28111	$759.79					45
28112	$641.15					45
28113	$666.35					45
28114	$1,289.60					45
28116	$910.13					45
28118	$882.48					45
28119	$823.18					45
28120	$773.61					45
28122	$871.11					45
28124	$662.27					45
28126	$573.71					45
28130	$1,126.28					90
28140	$893.05					45
28150	$557.46					45
28153	$575.32					45
28160	$600.51					45
28171	$1,327.79					90
28173	$1,093.78					90
28175	$857.31					90
28190	$190.96					0
28192	$506.25					15
28193	$614.33					15
28200	$741.11					90
28202	$958.87					90
28208	$541.20					90
28210	$902.82					90
28220	$637.08					45
28222	$916.62					45
28225	$453.43					45
28226	$599.71					45
28230	$502.19					45
28232	$380.30					45
28234	$368.93					45
28238	$1,136.03					90
28240	$490.01					90
28250	$792.30					90
28260	$934.50					90
28261	$1,159.59					90
28262	$1,889.31					90
28264	$1,517.95					90
28270	$563.14					90
28272	$446.11					90
28280	$562.32					45
28285	$683.41					45
28286	$624.90					45
28288	$585.88					45
28289	$687.30					90
28290	$840.23					90
28292	$1,037.70					90
28293	$1,388.75					90
28294	$1,347.30					90
28296	$1,368.44					90
28297	$1,386.32					90
28298	$1,276.60					90
28299	$1,452.14					90
28300	$1,227.04					90
28302	$1,413.94					90
28304	$1,182.34					90
28305	$1,549.64					90
28306	$803.67					90
28307	$935.30					90
28308	$840.23					90
28309	$1,236.78					45
28310	$720.77					90
28312	$689.91					90
28313	$574.51					90
28315	$689.91					90
28320	$1,366.81					90
28322	$995.45					90
28340	$1,017.39					90
28341	$1,217.30					90
28344	$599.71					90
28345	$854.06					90
28360	$1,929.95					90
28400	$361.61					45
28405	$645.21					90
28406	$939.38					45
28415	$1,759.30					90
28420	$2,104.66					90
28430	$346.99					45
28435	$520.89					90
28436	$679.35					45
28445	$1,388.75					90
28446			$2,080.79			90
28450	$286.03					45
28455	$430.68					90
28456	$368.93					45
28465	$952.38					90
28470	$279.54					45
28475	$398.98					90
28476	$511.95					90
28485	$784.16					90
28490	$149.51					45
28495	$203.96					45
28496	$334.79					45
28505	$515.19					45
28510	$148.71					45
28515	$193.39					45
28525	$404.69					45
28530	$156.83					45
28531	$310.42					45
28540	$195.02					45
28545	$273.86					45
28546	$445.31					45
28555	$897.11					45
28570	$246.21					45
28575	$447.74					45
28576	$514.38					45
28585	$972.69					45
28600	$191.77					45
28605	$368.93					45
28606	$628.96					45
28615	$796.35					45
28630	$209.65					0
28635	$260.03					0
28636	$413.63					45
28645	$563.95					45
28660	$141.40					0
28665	$223.47					0
28666	$395.75					45
28675	$446.94					45
28705	$2,316.74					90
28715	$1,934.01					90
28725	$1,601.65					90
28730	$1,490.33					90
28735	$1,561.03					90
28737	$1,393.63					90
28740	$892.25					90
28750	$796.35					90
28755	$641.15					90
28760	$851.60					90
28800	$1,111.64					90
28805	$1,102.72					90
28810	$750.05					90
28820	$486.76					45
28825	$438.00					45
28890		$326.17	$202.53			90
28899	BR					0
29000	$320.99					0
29010	$346.16					0
29015	$372.98					0
29035	$294.17					0
29040	$333.99					0
29044	$333.16					0
29046	$366.49					0
29049	$103.21					0
29055	$234.84					0
29058	$154.40					0
29065	$131.63					0
29075	$108.89					0
29085	$108.07					0
29086		$104.19	$82.67			0
29105	$108.07					0
29125	$75.58					0
29126	$92.64					0
29130	$52.82					0
29131	$73.95					0
29200	$63.47					0
29240	$77.19					0
29260	$60.96					0
29280	$56.07					0
29305	$309.60					0
29325	$335.62					0
29345	$190.96					0
29355	$207.22					0
29358	$260.03					0
29365	$160.91					0
29405	$130.03					0
29425	$156.02					0
29435	$186.08					0
29440	$62.56					0
29445	$275.48					0
29450	$110.52					0
29505	$99.15					0
29515	$94.27					0
29520	$69.88					0
29530	$72.33					0
29540	$63.39					0
29550	$58.50					0
29580	$104.83					0
29581		$165.83	$61.99			0
29582		$134.87	$30.88			0
29583		$83.66	$22.56			0
29584		$134.87	$30.88			0
29700	$95.07					0
29705	$116.20					0
29710	$141.40					0
29720	$72.33					0
29730	$79.64					0
29740	$118.64					0
29750	$138.95					0
29799	BR					0
29800	$728.11					15
29804	$1,547.20					90
29805	$687.11					15
29806	$1,915.20					90
29807	$1,862.45					90
29819	$1,328.62					45
29820	$1,238.41					45
29821	$1,422.06					90
29822	$1,296.11					45
29823	$1,517.15					90
29824	$1,167.53					90
29825	$1,384.69					45
29826	$1,608.16					90
29827	$2,027.74					90
29828			$1,598.33			90
29830	$864.62					15
29834	$946.69					45
29835	$977.57					45
29836	$1,138.46					90
29837	$1,037.70					45
29838	$1,144.14					90
29840	$685.84					15
29843	$906.05					45
29844	$935.30					45
29845	$1,134.40					90
29846	$1,291.23					90
29847	$1,079.96					90
29848	$623.27					90
29850	$1,438.31					90
29851	$1,843.00					90
29855	$1,673.98					90
29856	$1,973.01					90
29860	$905.37					90
29861	$1,329.57					90
29862	$1,448.84					90
29863	$1,334.10					90
29866	$2,022.13					90
29867	$2,419.73					90
29868	$3,270.45					90
29870	$707.77					15
29871	$1,027.94					45
29873	$936.74					90
29874	$1,227.84					45
29875	$1,137.66					45
29876	$1,379.81					90
29877	$1,290.43					90
29879	$1,453.76					90
29880	$1,520.38					90
29881	$1,353.81					90
29882	$1,491.96					90
29883	$1,768.24					90
29884	$1,252.23					45
29885	$1,333.50					90
29886	$1,101.89					90
29887	$1,510.64					90
29888	$2,408.57					90
29889	$1,662.61					90
29891	$1,244.30					90
29892	$1,284.68					90
29893	$729.43					90
29894	$1,254.66					90
29895	$1,216.47					90
29897	$1,261.98					90
29898	$1,456.19					90
29899	$1,856.78					90
29900	$830.88					90
29901	$915.34					90
29902	$982.33					90
29904			$1,076.19			90
29905			$1,159.80			90
29906			$1,221.52			90
29907			$1,493.46			90
29914			$2,018.04			90
29915			$2,056.44			90
29916			$2,056.44			90
29999	BR					0

N.C. Industrial Commission · Medical Fees Section
4337 Mail Service Center · Raleigh, NC 27699-4337
Telephone: (919) 807-2503 · Fax: (919) 715-0280
NCIC Home Page: http://www.ic.nc.gov//