CPT Codes and Fees, |
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 |
Effective January 1, 2015ABBREVIATIONS: 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 |
|