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 |
50010 |
$1,537.46 |
|
|
|
|
45 |
50020 |
$1,509.01 |
|
|
|
|
45 |
50040 |
$1,438.29 |
|
|
|
|
45 |
50045 |
$1,895.82 |
|
|
|
|
45 |
50060 |
$2,364.69 |
|
|
|
|
45 |
50065 |
$2,621.47 |
|
|
|
|
45 |
50070 |
$2,506.09 |
|
|
|
|
45 |
50075 |
$3,196.79 |
|
|
|
|
45 |
50080 |
$2,042.08 |
|
|
|
|
45 |
50081 |
$2,775.87 |
|
|
|
|
45 |
50100 |
$1,999.83 |
|
|
|
|
45 |
50120 |
$2,029.90 |
|
|
|
|
45 |
50125 |
$2,075.41 |
|
|
|
|
45 |
50130 |
$2,259.06 |
|
|
|
|
45 |
50135 |
$2,744.19 |
|
|
|
|
90 |
50200 |
$357.97 |
|
|
|
|
0 |
50205 |
$1,439.94 |
|
|
|
|
45 |
50220 |
$2,290.74 |
|
|
|
|
90 |
50225 |
$2,770.19 |
|
|
|
|
90 |
50230 |
$3,041.59 |
|
|
|
|
90 |
50234 |
$2,949.78 |
|
|
|
|
90 |
50236 |
$3,208.18 |
|
|
|
|
90 |
50240 |
$2,834.37 |
|
|
|
|
90 |
50250 |
$2,287.82 |
|
|
|
|
90 |
50280 |
$1,994.14 |
|
|
|
|
90 |
50290 |
$1,773.93 |
|
|
|
|
90 |
50300 |
$1,823.49 |
|
|
|
|
0 |
50320 |
$2,970.89 |
|
|
|
|
90 |
50323 |
BR |
|
|
|
|
0 |
50325 |
BR |
|
|
|
|
0 |
50327 |
$424.25 |
|
|
|
|
0 |
50328 |
$371.43 |
|
|
|
|
0 |
50329 |
$354.83 |
|
|
|
|
0 |
50340 |
$1,843.00 |
|
|
|
|
90 |
50360 |
$4,080.10 |
|
|
|
|
90 |
50365 |
$4,964.23 |
|
|
|
|
90 |
50370 |
$1,758.48 |
|
|
|
|
90 |
50380 |
$2,104.66 |
|
|
|
|
90 |
50382 |
|
$3,047.81 |
$580.67 |
|
|
0 |
50384 |
|
$2,942.63 |
$528.66 |
|
|
0 |
50385 |
|
$2,539.05 |
$468.63 |
|
|
0 |
50386 |
|
$1,641.70 |
$354.84 |
|
|
0 |
50387 |
|
$1,473.62 |
$210.26 |
|
|
0 |
50389 |
|
$1,007.28 |
$115.55 |
|
|
0 |
50390 |
$338.00 |
|
|
|
|
0 |
50391 |
|
$274.10 |
$205.50 |
|
|
0 |
50392 |
$545.51 |
|
|
|
|
0 |
50393 |
$678.85 |
|
|
|
|
0 |
50394 |
$89.86 |
|
|
|
|
0 |
50395 |
$580.45 |
|
|
|
|
0 |
50396 |
$178.27 |
|
|
|
|
0 |
50398 |
$156.02 |
|
|
|
|
0 |
50400 |
$2,479.27 |
|
|
|
|
90 |
50405 |
$3,105.78 |
|
|
|
|
90 |
50500 |
$2,415.89 |
|
|
|
|
90 |
50520 |
$2,069.72 |
|
|
|
|
45 |
50525 |
$2,621.47 |
|
|
|
|
45 |
50526 |
$2,368.75 |
|
|
|
|
90 |
50540 |
$2,551.60 |
|
|
|
|
90 |
50541 |
$1,664.27 |
|
|
|
|
90 |
50542 |
$2,119.80 |
|
|
|
|
90 |
50543 |
$2,675.05 |
|
|
|
|
90 |
50544 |
$2,296.12 |
|
|
|
|
0 |
50545 |
$2,600.11 |
|
|
|
|
90 |
50546 |
$2,124.77 |
|
|
|
|
90 |
50547 |
$2,721.10 |
|
|
|
|
90 |
50548 |
$2,498.62 |
|
|
|
|
90 |
50549 |
BR |
|
|
|
|
90 |
50551 |
$610.28 |
|
|
|
|
0 |
50553 |
$600.51 |
|
|
|
|
0 |
50555 |
$876.80 |
|
|
|
|
15 |
50557 |
$886.56 |
|
|
|
|
0 |
50559 |
$637.90 |
|
|
|
|
15 |
50561 |
$993.00 |
|
|
|
|
0 |
50562 |
$1,124.16 |
|
|
|
|
90 |
50570 |
$863.80 |
|
|
|
|
0 |
50572 |
$1,376.55 |
|
|
|
|
0 |
50574 |
$1,413.12 |
|
|
|
|
15 |
50575 |
$1,868.19 |
|
|
|
|
0 |
50576 |
$1,534.21 |
|
|
|
|
15 |
50578 |
$1,214.04 |
|
|
|
|
15 |
50580 |
$1,210.79 |
|
|
|
|
0 |
50590 |
$1,538.26 |
|
|
|
|
90 |
50592 |
|
$11,282.46 |
$763.21 |
|
|
10 |
50593 |
|
$8,956.96 |
$906.28 |
|
|
10 |
50600 |
$1,914.50 |
|
|
|
|
45 |
50605 |
$1,606.53 |
|
|
|
|
45 |
50610 |
$2,080.27 |
|
|
|
|
45 |
50620 |
$2,004.71 |
|
|
|
|
45 |
50630 |
$2,081.09 |
|
|
|
|
45 |
50650 |
$2,222.49 |
|
|
|
|
90 |
50660 |
$2,427.26 |
|
|
|
|
90 |
50684 |
$97.52 |
|
|
|
|
0 |
50686 |
$147.89 |
|
|
|
|
0 |
50688 |
$120.26 |
|
|
|
|
0 |
50690 |
$116.20 |
|
|
|
|
0 |
50700 |
$2,083.53 |
|
|
|
|
90 |
50715 |
$2,268.00 |
|
|
|
|
45 |
50722 |
$2,019.34 |
|
|
|
|
90 |
50725 |
$2,298.05 |
|
|
|
|
90 |
50727 |
$1,010.88 |
|
|
|
|
45 |
50728 |
$1,487.07 |
|
|
|
|
45 |
50740 |
$2,375.26 |
|
|
|
|
90 |
50750 |
$2,509.33 |
|
|
|
|
90 |
50760 |
$2,393.95 |
|
|
|
|
90 |
50770 |
$2,606.85 |
|
|
|
|
90 |
50780 |
$2,416.69 |
|
|
|
|
90 |
50782 |
$2,504.47 |
|
|
|
|
90 |
50783 |
$2,578.40 |
|
|
|
|
90 |
50785 |
$2,709.23 |
|
|
|
|
90 |
50800 |
$2,167.22 |
|
|
|
|
90 |
50810 |
$2,417.51 |
|
|
|
|
90 |
50815 |
$2,981.46 |
|
|
|
|
90 |
50820 |
$3,073.29 |
|
|
|
|
90 |
50825 |
$4,432.77 |
|
|
|
|
90 |
50830 |
$3,931.41 |
|
|
|
|
90 |
50840 |
$2,459.76 |
|
|
|
|
90 |
50845 |
$2,608.48 |
|
|
|
|
45 |
50860 |
$1,948.64 |
|
|
|
|
90 |
50900 |
$1,767.42 |
|
|
|
|
45 |
50920 |
$1,778.79 |
|
|
|
|
45 |
50930 |
$2,352.50 |
|
|
|
|
45 |
50940 |
$1,825.12 |
|
|
|
|
45 |
50945 |
$1,760.56 |
|
|
|
|
90 |
50947 |
$2,801.09 |
|
|
|
|
90 |
50948 |
$2,561.05 |
|
|
|
|
90 |
50949 |
BR |
|
|
|
|
90 |
50951 |
$589.14 |
|
|
|
|
0 |
50953 |
$620.02 |
|
|
|
|
0 |
50955 |
$728.91 |
|
|
|
|
15 |
50957 |
$728.11 |
|
|
|
|
15 |
50959 |
$606.20 |
|
|
|
|
15 |
50961 |
$679.35 |
|
|
|
|
0 |
50970 |
$962.12 |
|
|
|
|
0 |
50972 |
$662.27 |
|
|
|
|
0 |
50974 |
$1,262.80 |
|
|
|
|
15 |
50976 |
$1,206.73 |
|
|
|
|
15 |
50978 |
$717.54 |
|
|
|
|
15 |
50980 |
$780.93 |
|
|
|
|
0 |
51020 |
$1,006.00 |
|
|
|
|
45 |
51030 |
$825.61 |
|
|
|
|
45 |
51040 |
$767.91 |
|
|
|
|
45 |
51045 |
$859.74 |
|
|
|
|
45 |
51050 |
$1,025.51 |
|
|
|
|
45 |
51060 |
$1,435.88 |
|
|
|
|
45 |
51065 |
$1,181.53 |
|
|
|
|
45 |
51080 |
$828.04 |
|
|
|
|
45 |
51100 |
|
$123.25 |
$76.18 |
|
|
0 |
51101 |
|
$250.10 |
$100.20 |
|
|
0 |
51102 |
|
$652.88 |
$480.52 |
|
|
0 |
51500 |
$1,299.37 |
|
|
|
|
45 |
51520 |
$1,344.05 |
|
|
|
|
45 |
51525 |
$1,831.63 |
|
|
|
|
45 |
51530 |
$1,609.79 |
|
|
|
|
45 |
51535 |
$1,513.07 |
|
|
|
|
45 |
51550 |
$1,960.83 |
|
|
|
|
45 |
51555 |
$2,494.70 |
|
|
|
|
45 |
51565 |
$2,803.50 |
|
|
|
|
45 |
51570 |
$2,957.89 |
|
|
|
|
45 |
51575 |
$3,967.15 |
|
|
|
|
90 |
51580 |
$3,765.62 |
|
|
|
|
90 |
51585 |
$4,477.47 |
|
|
|
|
90 |
51590 |
$4,279.20 |
|
|
|
|
90 |
51595 |
$5,309.59 |
|
|
|
|
90 |
51596 |
$5,552.54 |
|
|
|
|
90 |
51597 |
$5,187.70 |
|
|
|
|
90 |
51600 |
$91.01 |
|
|
|
|
0 |
51605 |
$112.15 |
|
|
|
|
0 |
51610 |
$146.26 |
|
|
|
|
0 |
51700 |
$86.13 |
|
|
|
|
0 |
51701 |
|
$112.89 |
$52.22 |
|
|
0 |
51702 |
|
$177.10 |
$57.14 |
|
|
0 |
51703 |
|
$246.85 |
$153.74 |
|
|
0 |
51705 |
$107.26 |
|
|
|
|
0 |
51710 |
$159.28 |
|
|
|
|
0 |
51715 |
$499.76 |
|
|
|
|
0 |
51720 |
$189.33 |
|
|
|
|
0 |
51725 |
$197.47 |
|
|
$29.62 |
$167.85 |
0 |
51726 |
$234.84 |
|
|
$35.23 |
$199.61 |
0 |
51727 |
$532.32 |
|
|
$331.48 |
$200.84 |
0 |
51728 |
$532.08 |
|
|
$333.44 |
$198.65 |
0 |
51729 |
$573.32 |
|
|
$337.37 |
$235.94 |
0 |
51736 |
$97.52 |
|
|
$14.63 |
$82.89 |
0 |
51741 |
$167.40 |
|
|
$25.11 |
$142.29 |
0 |
51784 |
$201.53 |
|
|
$30.23 |
$171.30 |
0 |
51785 |
$201.53 |
|
|
$30.23 |
$171.30 |
0 |
51792 |
$235.66 |
|
|
$35.35 |
$200.31 |
0 |
51797 |
$200.71 |
|
|
$30.11 |
$170.60 |
0 |
51798 |
$37.02 |
|
|
|
|
0 |
51800 |
$2,223.30 |
|
|
|
|
90 |
51820 |
$1,903.93 |
|
|
|
|
90 |
51840 |
$1,494.39 |
|
|
|
|
45 |
51841 |
$1,816.98 |
|
|
|
|
45 |
51845 |
$1,542.32 |
|
|
|
|
45 |
51860 |
$1,474.07 |
|
|
|
|
45 |
51865 |
$1,955.13 |
|
|
|
|
45 |
51880 |
$952.38 |
|
|
|
|
45 |
51900 |
$1,827.55 |
|
|
|
|
45 |
51920 |
$1,412.32 |
|
|
|
|
45 |
51925 |
$1,933.19 |
|
|
|
|
45 |
51940 |
$3,445.45 |
|
|
|
|
45 |
51960 |
$3,324.39 |
|
|
|
|
90 |
51980 |
$1,398.49 |
|
|
|
|
45 |
51990 |
$1,361.10 |
|
|
|
|
90 |
51992 |
$1,485.84 |
|
|
|
|
90 |
51999 |
BR |
|
|
|
|
0 |
52000 |
$261.66 |
|
|
|
|
0 |
52001 |
$253.67 |
|
|
|
|
15 |
52005 |
$356.73 |
|
|
|
|
0 |
52007 |
$455.88 |
|
|
|
|
15 |
52010 |
$385.18 |
|
|
|
|
0 |
52204 |
$370.55 |
|
|
|
|
15 |
52214 |
$508.70 |
|
|
|
|
0 |
52224 |
$471.31 |
|
|
|
|
0 |
52234 |
$728.11 |
|
|
|
|
15 |
52235 |
$971.89 |
|
|
|
|
15 |
52240 |
$1,587.83 |
|
|
|
|
15 |
52250 |
$576.14 |
|
|
|
|
15 |
52260 |
$472.13 |
|
|
|
|
15 |
52265 |
$336.42 |
|
|
|
|
0 |
52270 |
$570.46 |
|
|
|
|
0 |
52275 |
$634.64 |
|
|
|
|
0 |
52276 |
$663.09 |
|
|
|
|
0 |
52277 |
$858.11 |
|
|
|
|
0 |
52281 |
$398.98 |
|
|
|
|
0 |
52282 |
$765.31 |
|
|
|
|
0 |
52283 |
$411.18 |
|
|
|
|
0 |
52285 |
$511.95 |
|
|
|
|
0 |
52287 |
$601.60 |
$328.06 |
|
|
0 |
|
52290 |
$542.83 |
|
|
|
|
0 |
52300 |
$689.91 |
|
|
|
|
0 |
52301 |
$695.97 |
|
|
|
|
0 |
52305 |
$689.09 |
|
|
|
|
0 |
52310 |
$452.62 |
|
|
|
|
0 |
52315 |
$724.85 |
|
|
|
|
0 |
52317 |
$1,006.83 |
|
|
|
|
15 |
52318 |
$1,332.68 |
|
|
|
|
15 |
52320 |
$745.16 |
|
|
|
|
0 |
52325 |
$1,026.33 |
|
|
|
|
0 |
52327 |
$693.97 |
|
|
|
|
0 |
52330 |
$665.52 |
|
|
|
|
0 |
52332 |
$471.31 |
|
|
|
|
0 |
52334 |
$637.90 |
|
|
|
|
0 |
52341 |
$648.65 |
|
|
|
|
45 |
52342 |
$702.36 |
|
|
|
|
45 |
52343 |
$778.04 |
|
|
|
|
45 |
52344 |
$831.75 |
|
|
|
|
45 |
52345 |
$886.29 |
|
|
|
|
45 |
52346 |
$997.14 |
|
|
|
|
45 |
52347 |
$545.14 |
|
|
|
|
15 |
52351 |
$661.94 |
|
|
|
|
45 |
52352 |
$818.48 |
|
|
|
|
45 |
52353 |
$948.22 |
|
|
|
|
45 |
52354 |
$830.08 |
|
|
|
|
45 |
52355 |
$974.87 |
|
|
|
|
45 |
52356 |
|
$842.17 |
$842.17 |
|
|
0 |
52400 |
$1,158.79 |
|
|
|
|
45 |
52402 |
$554.18 |
|
|
|
|
0 |
52441 |
|
$2,407.60 |
$464.98 |
|
|
0 |
52442 |
|
$1,832.74 |
$124.38 |
|
|
0 |
52450 |
$941.01 |
|
|
|
|
45 |
52500 |
$1,190.47 |
|
|
|
|
90 |
52601 |
$1,823.49 |
|
|
|
|
90 |
52630 |
$1,219.73 |
|
|
|
|
90 |
52640 |
$971.89 |
|
|
|
|
90 |
52647 |
$1,500.90 |
|
|
|
|
45 |
52648 |
$1,597.59 |
|
|
|
|
45 |
52649 |
|
|
$1,915.49 |
|
|
90 |
52700 |
$752.48 |
|
|
|
|
45 |
53000 |
$294.17 |
|
|
|
|
15 |
53010 |
$510.32 |
|
|
|
|
45 |
53020 |
$203.16 |
|
|
|
|
0 |
53025 |
$151.14 |
|
|
|
|
15 |
53040 |
$616.76 |
|
|
|
|
45 |
53060 |
$243.78 |
|
|
|
|
15 |
53080 |
$771.99 |
|
|
|
|
0 |
53085 |
$1,284.74 |
|
|
|
|
15 |
53200 |
$289.29 |
|
|
|
|
15 |
53210 |
$1,435.88 |
|
|
|
|
45 |
53215 |
$1,921.01 |
|
|
|
|
45 |
53220 |
$887.37 |
|
|
|
|
45 |
53230 |
$1,325.36 |
|
|
|
|
45 |
53235 |
$1,004.02 |
|
|
|
|
45 |
53240 |
$810.18 |
|
|
|
|
15 |
53250 |
$761.42 |
|
|
|
|
15 |
53260 |
$319.36 |
|
|
|
|
15 |
53265 |
$388.43 |
|
|
|
|
15 |
53270 |
$299.03 |
|
|
|
|
15 |
53275 |
$528.20 |
|
|
|
|
15 |
53400 |
$1,506.58 |
|
|
|
|
45 |
53405 |
$1,887.68 |
|
|
|
|
45 |
53410 |
$1,889.31 |
|
|
|
|
45 |
53415 |
$2,373.64 |
|
|
|
|
45 |
53420 |
$1,886.05 |
|
|
|
|
45 |
53425 |
$1,909.62 |
|
|
|
|
90 |
53430 |
$1,779.61 |
|
|
|
|
90 |
53431 |
$2,045.39 |
|
|
|
|
90 |
53440 |
$1,923.44 |
|
|
|
|
90 |
53442 |
$1,058.82 |
|
|
|
|
45 |
53444 |
$1,466.68 |
|
|
|
|
45 |
53445 |
$2,347.62 |
|
|
|
|
90 |
53446 |
$1,354.37 |
|
|
|
|
90 |
53447 |
$1,682.09 |
|
|
|
|
45 |
53448 |
$2,443.59 |
|
|
|
|
90 |
53449 |
$1,370.87 |
|
|
|
|
45 |
53450 |
$662.27 |
|
|
|
|
45 |
53460 |
$716.72 |
|
|
|
|
45 |
53500 |
$1,423.15 |
|
|
|
|
90 |
53502 |
$954.01 |
|
|
|
|
45 |
53505 |
$967.81 |
|
|
|
|
45 |
53510 |
$1,292.05 |
|
|
|
|
45 |
53515 |
$1,698.35 |
|
|
|
|
45 |
53520 |
$1,101.09 |
|
|
|
|
45 |
53600 |
$121.09 |
|
|
|
|
0 |
53601 |
$99.95 |
|
|
|
|
0 |
53605 |
$136.52 |
|
|
|
|
0 |
53620 |
$164.14 |
|
|
|
|
0 |
53621 |
$135.71 |
|
|
|
|
0 |
53660 |
$78.01 |
|
|
|
|
0 |
53661 |
$76.38 |
|
|
|
|
0 |
53665 |
$87.76 |
|
|
|
|
0 |
53850 |
$1,126.22 |
|
|
|
|
45 |
53852 |
$1,177.08 |
|
|
|
|
45 |
53855 |
|
$1,245.15 |
$160.80 |
|
|
0 |
53860 |
|
$2,884.25 |
$459.30 |
|
|
90 |
53899 |
BR |
|
|
|
|
0 |
54000 |
$166.59 |
|
|
|
|
0 |
54001 |
$234.04 |
|
|
|
|
0 |
54015 |
$471.31 |
|
|
|
|
15 |
54050 |
$122.69 |
|
|
|
|
0 |
54055 |
$140.57 |
|
|
|
|
0 |
54056 |
$134.09 |
|
|
|
|
0 |
54057 |
$219.41 |
|
|
|
|
0 |
54060 |
$238.90 |
|
|
|
|
15 |
54065 |
$377.87 |
|
|
|
|
15 |
54100 |
$199.90 |
|
|
|
|
15 |
54105 |
$350.24 |
|
|
|
|
15 |
54110 |
$1,227.84 |
|
|
|
|
45 |
54111 |
$1,738.17 |
|
|
|
|
45 |
54112 |
$2,032.33 |
|
|
|
|
45 |
54115 |
$771.16 |
|
|
|
|
45 |
54120 |
$1,227.04 |
|
|
|
|
45 |
54125 |
$1,902.31 |
|
|
|
|
90 |
54130 |
$2,619.04 |
|
|
|
|
90 |
54135 |
$3,341.44 |
|
|
|
|
90 |
54150 |
$182.02 |
|
|
|
|
15 |
54160 |
$320.99 |
|
|
|
|
15 |
54161 |
$421.74 |
|
|
|
|
15 |
54162 |
$427.02 |
|
|
|
|
15 |
54163 |
$401.33 |
|
|
|
|
15 |
54164 |
$352.03 |
|
|
|
|
15 |
54200 |
$104.01 |
|
|
|
|
0 |
54205 |
$962.12 |
|
|
|
|
15 |
54220 |
$312.85 |
|
|
|
|
0 |
54230 |
$208.84 |
|
|
|
|
0 |
54231 |
$272.23 |
|
|
|
|
0 |
54235 |
$126.77 |
|
|
|
|
0 |
54240 |
$180.39 |
|
|
$27.06 |
$153.33 |
15 |
54250 |
$236.47 |
|
|
$35.47 |
$201.00 |
0 |
54300 |
$1,329.42 |
|
|
|
|
45 |
54304 |
$1,626.02 |
|
|
|
|
45 |
54308 |
$1,369.24 |
|
|
|
|
45 |
54312 |
$1,760.11 |
|
|
|
|
45 |
54316 |
$2,134.72 |
|
|
|
|
45 |
54318 |
$1,418.80 |
|
|
|
|
45 |
54322 |
$1,560.20 |
|
|
|
|
45 |
54324 |
$2,066.47 |
|
|
|
|
45 |
54326 |
$1,978.69 |
|
|
|
|
45 |
54328 |
$1,999.83 |
|
|
|
|
90 |
54332 |
$2,237.92 |
|
|
|
|
90 |
54336 |
$2,929.44 |
|
|
|
|
90 |
54340 |
$1,142.52 |
|
|
|
|
45 |
54344 |
$2,464.65 |
|
|
|
|
90 |
54348 |
$2,187.53 |
|
|
|
|
90 |
54352 |
$3,124.48 |
|
|
|
|
90 |
54360 |
$1,440.76 |
|
|
|
|
45 |
54380 |
$1,713.80 |
|
|
|
|
45 |
54385 |
$1,965.69 |
|
|
|
|
45 |
54390 |
$2,708.43 |
|
|
|
|
45 |
54400 |
$1,530.95 |
|
|
|
|
45 |
54401 |
$1,836.49 |
|
|
|
|
45 |
54405 |
$2,328.93 |
|
|
|
|
45 |
54406 |
$1,333.52 |
|
|
|
|
45 |
54408 |
$1,406.24 |
|
|
|
|
45 |
54410 |
$1,667.63 |
|
|
|
|
45 |
54411 |
$1,816.26 |
|
|
|
|
45 |
54415 |
$988.96 |
|
|
|
|
45 |
54416 |
$1,292.49 |
|
|
|
|
45 |
54417 |
$1,598.58 |
|
|
|
|
45 |
54420 |
$1,448.08 |
|
|
|
|
45 |
54430 |
$1,292.05 |
|
|
|
|
45 |
54435 |
$763.85 |
|
|
|
|
45 |
54440 |
$1,114.09 |
|
|
|
|
45 |
54450 |
$140.57 |
|
|
|
|
15 |
54500 |
$137.34 |
|
|
|
|
0 |
54505 |
$413.63 |
|
|
|
|
15 |
54512 |
$1,032.93 |
|
|
|
|
15 |
54520 |
$789.79 |
|
|
|
|
15 |
54522 |
$1,173.79 |
|
|
|
|
15 |
54530 |
$1,200.22 |
|
|
|
|
45 |
54535 |
$1,565.89 |
|
|
|
|
45 |
54550 |
$988.14 |
|
|
|
|
45 |
54560 |
$1,385.49 |
|
|
|
|
45 |
54600 |
$876.80 |
|
|
|
|
45 |
54620 |
$625.70 |
|
|
|
|
45 |
54640 |
$1,124.66 |
|
|
|
|
45 |
54650 |
$1,470.02 |
|
|
|
|
45 |
54660 |
$641.15 |
|
|
|
|
45 |
54670 |
$810.18 |
|
|
|
|
45 |
54680 |
$1,540.72 |
|
|
|
|
45 |
54690 |
$1,323.22 |
|
|
|
|
90 |
54692 |
$1,362.42 |
|
|
|
|
90 |
54699 |
BR |
|
|
|
|
90 |
54700 |
$336.42 |
|
|
|
|
15 |
54800 |
$335.62 |
|
|
|
|
0 |
54830 |
$672.03 |
|
|
|
|
15 |
54840 |
$768.73 |
|
|
|
|
45 |
54860 |
$872.74 |
|
|
|
|
45 |
54861 |
$1,236.78 |
|
|
|
|
45 |
54865 | $654.63 |
90 |
||||
55875 | $1,437.49 |
90 |
||||
55876 | $282.41 | $209.69 | 10 | |||
54900 |
$1,684.54 |
|
|
|
|
90 |
54901 |
$2,311.88 |
|
|
|
|
90 |
55000 |
$143.83 |
|
|
|
|
0 |
55040 |
$784.98 |
|
|
|
|
45 |
55041 |
$1,161.22 |
|
|
|
|
45 |
55060 |
$732.97 |
|
|
|
|
45 |
55100 |
$208.84 |
|
|
|
|
0 |
55110 |
$685.84 |
|
|
|
|
15 |
55120 |
$516.01 |
|
|
|
|
15 |
55150 |
$943.44 |
|
|
|
|
15 |
55175 |
$736.22 |
|
|
|
|
15 |
55180 |
$1,326.19 |
|
|