Arizona Administrative Code › Title 20 - COMMERCE, FINANCIAL INSTITUTIONS, AND INSURANCE › Chapter 05 - INDUSTRIAL COMMISSION OF ARIZONA › Article 6 - OCCUPATIONAL SAFETY AND HEALTH STANDARDS › Appendix A - Arizona Physicians' and Pharmaceutical Fee Schedule 2024/2025

Current through Register Vol. 30, No. 28, July 12, 2024
Arizona Physicians' and Pharmaceutical Fee Schedule
				  2024/2025
Adopted by The Industrial Commission of Arizona
				  Medical
Resource Office
Phone (602) 542-4308 / Fax (602) 542-4797
mro@azica.gov
Effective May 1, 2024
INTRODUCTION
Since 1925, when the Arizona Legislature passed the state's
				  first Workers' Compensation Act ("Act"), the Industrial Commission of Arizona
				  ("Commission") has administered the workers' compensation laws of that Act. The
				  Act includes the authority of the Commission to set a schedule of fees to be
				  charged by healthcare providers attending injured employees (also referred to
				  in this document as "injured worker" or "claimant." A.R.S. §
									23-908(B). In
				  2004, the Act was amended to include the setting of fees for prescription
				  medicines required to treat an injured employee. A.R.S. §
									23-908(C). This
				  fee schedule is referred to as the Arizona Physicians' and Pharmaceutical Fee
				  Schedule (Fee Schedule).
Any reference to "healthcare providers" in the Fee Schedule
				  is intended to include all licensed professionals whose scope of practice
				  allows them to legally provide services to injured workers. Any reference to
				  "physician" in relation to workers' compensation cases includes the following:
				  doctors of medicine, doctors of osteopathy, doctors of podiatric medicine,
				  doctors of chiropractic, doctors of naturopathic medicine, certified registered
				  nurse anesthesiologists, physician assistants and nurse practitioners.
				  Healthcare providers treating employees under industrial coverage are entitled
				  by law to charge according to the schedule of fees adopted by the Commission.
				  Accurate calculation of fees based upon this schedule, the filing of reports
				  and bills for payment, and the use of forms prescribed are essential to timely
				  and correct payment for a provider's services and can be vital in the award of
				  benefits to the injured worker and their dependents.
This Fee Schedule has been updated to incorporate by
				  reference the following:
1. The 2024 Edition of the American Medical Association's
Current Procedural Terminology
(CPT®) publication, including the general
				  guidelines, identifiers, modifiers, and terminology associated with the
				  incorporated codes.
2. The 2024 Healthcare Common Procedure Coding System (HCPCS)
				  codes that include procedures, supplies, products, and services published by
				  the Centers for Medicare & Medicaid Services (CMS).
3. The unit values and guidance for consultative, diagnostic,
				  and therapeutic services published in the most recent edition of
Relative Value Guide,
American Society of Anesthesiologists
				  (ASA)
https://www.asahq.org
.
4. The
2024 Clinical Diagnostic Laboratory Fee
				  Schedule,
CMS Clinical Laboratory Fee Schedule
https://www.cms.gov
.
5. The
National Correct Coding Initiative
				  Edits,
CMS;
				  https://www.cms.gov/ncci-medicare/medicare-ncci-policy-manual
The codes listed herein are CPT only copyright 2023 American
				  Medical Association. All rights reserved.
6. Physicians as Assistants at Surgery: 2023 Update
https://www.facs.org/for-medical-professionals/practice-management/coding-and-billing/physicians-as-assistants-at-surgery-report/
7. Surgical global periods published by CMS, 2024
				  Update
8. FAIR Health data, copyright 2024, FAIR Health, Inc.
Codes that are unique to Arizona are preceded by an AZ
				  identifier and numbered in the following format: AZxxx. To the extent that a
				  conflict may exist between an incorporated portion of the
				  CPT® publication or HCPCS codes and a code,
				  guideline, identifier, or modifier unique to Arizona, then the Arizona code,
				  guideline, identifier, or modifier shall control.
Except as otherwise noted, unit values assigned to the
				  service codes listed in this document are the product of the Industrial
				  Commission of Arizona and are not associated in any way with the American
				  Medical Association, the American Society of Anesthesiologists, the Centers for
				  Medicare and Medicaid Services, or any other entity or organization.
A. GENERAL GUIDANCE
1. Reimbursements and billing associated with Pharmaceuticals
				  are found in the Pharmaceutical Fee Schedule Section and HCPCS Guidelines of
				  this document.
2. A CPT code shall be billed when a CPT code exists that
				  accurately describes the service provided. If no CPT code exists that
				  accurately describes the service, a HCPCS code shall be billed. A miscellaneous
				  or unlisted code shall not be used when a specific CPT or HCPCS code exists
				  that describes the service. Reimbursement values for unlisted codes are By
				  Report and the bill must be accompanied by documentation to support the amount
				  billed. Exceptions apply to the following services for which HCPCS codes should
				  be used in place of CPT codes:
* Drug testing: CPT codes 80320-80377 may not be used to bill
				  for drug testing. HCPCS codes G0480 -G0483 shall be used for definitive drug
				  testing.
3. Except when governed by a separate contract or network
				  that governs fees pursuant to A.R.S. §
									23-908(J)(1),
				  this Fee Schedule establishes the maximum reimbursement values for services
				  performed by healthcare providers to injured workers under Arizona's workers'
				  compensation law.
4. If a healthcare provider or insurance carrier is referring
				  an injured worker to a medical specialist for evaluation and/or treatment, the
				  medical specialist's diagnosis becomes the foundational diagnosis for billing
				  purposes.
5. Routine progress and routine final reports filed by the
				  attending healthcare provider do not ordinarily command a fee.
6. Payment will be made for only one professional visit in
				  any one day except when the submitted report clearly demonstrates the need for
				  the additional visit and fee.
7. Fees for hospital, office, or home visits, subsequent to
				  the initial visit, are not to be added to coded surgical procedures performed
				  on the same day.
8. Routine office treatment principally by injection of
				  drugs, other than antibiotics, requires authorization by the carrier or
				  self-insured employer for each series of 10 after the first series of
				  10.
9. Except in emergencies, a carrier must be given notice
				  regarding a consultation and the consultant must provide his/her report to the
				  carrier and the attending healthcare provider within a reasonable period of
				  time to facilitate processing of the claim.
10. The Commission requests that carriers notify attending
				  healthcare providers at the same time the claimant is notified that their claim
				  is closed with or without supportive care. If a claim is approved for
				  reopening, the carrier should also notify the attending healthcare provider of
				  that approval.
11. Missed individual appointments for consultants, without
				  prior notification, will be compensated at 50% of the consultation fee.
12. The Commission will investigate an injured worker's
				  complaint of bad faith/unfair claims processing practices, and if appropriate,
				  impose penalties under A.R.S. §
									23-930, in those circumstances
				  where a "peer to peer" review was not conducted by a healthcare provider with
				  appropriate skill, training, and knowledge or where the individual performing
				  the "peer to peer" review was not licensed. The Commission will also
				  investigate an injured workers' complaint of bad faith/unfair claims processing
				  practice, and if appropriate, impose penalties under A.R.S. § 23- 930, for
				  a denial of treatment based on the failure of the treating doctor to
				  participate in a "peer to peer" review, when the treating doctor has not been
				  given reasonable time or opportunity to participate in the "peer to peer"
				  review.
13. As authorized under A.A.C.
				  R20-5-128, the fee for the
				  reproduction of medical records for workers' compensation purposes shall be
				  25¢ per page and $10.00 per hour per person for reasonable clerical costs
				  associated with locating and reproducing the documents.
14. Reimbursement values for telehealth services are governed
				  by the Fee Schedule and no reductions are justified unless specified by the Fee
				  Schedule. The performance of telehealth services is governed by Arizona Revised
				  Statutes, Title 36, Chapter 36. Bills for telehealth services shall include
				  modifier -95 and place of service (POS) code according to the incorporated
				  AMA/CMS guidelines. Reimbursement for telehealth services shall be based on the
				  non-facility (NF) rate regardless of the POS code.
B. PAYMENT AND REVIEW OF BILLINGS
1. Under Arizona workers' compensation law, an insurance
				  carrier, self-insured employer, or their representative is not responsible for
				  payment of a billing for medical, surgical, and hospital benefits that the
				  insurance carrier, employer, or representative received more than 24 months
				  from the date that the medical service was rendered, or from the date on which
				  the provider knew or should have known that the service was rendered, whichever
				  occurs later. A subsequent billing or corrective billing does not restart the
				  limitations period.
See
A.R.S. §
									23-1062.01.
2. It is incumbent upon the insurance carrier, self-insured
				  employer, and third party processing service to inform all parties, including
				  the Commission, regarding changes in addresses for bill processing
				  locations.
3. Under Arizona workers' compensation law, a healthcare
				  provider is entitled to timely payment for services rendered. An insurance
				  carrier, self-insured employer, or claims processing representative shall make
				  a determination whether to deny or pay a medical bill on an accepted claim, in
				  whole or in part, including the decision as to the amount to pay, within thirty
				  days from the date the claim is accepted, if the billing is received before the
				  date of acceptance, or within thirty days from the date of the receipt of the
				  billing if the billing is received after the date of acceptance. All billing
				  denials shall be based on reasonable justification. The insurance carrier,
				  self-insured employer, or claims processing representative shall pay the
				  approved portion of the billing within thirty days after the determination for
				  payment is made. If the billing is not paid within the applicable time period,
				  the insurance carrier, self-insured employer, or claims processing
				  representative shall pay interest to the health provider on the billing at a
				  rate that is equal to the legal rate. Interest shall be calculated beginning on
				  the date that the payment to the healthcare provider is due.
See
A.R.S. §
									23-1062.01.
To ensure timely and accurate payment of a medical billing, a
				  billing must contain the information required under A.R.S. § 23- 1062.01.
				  A billing must contain at least the following information: Correct demographic
				  patient information including claim number, if known; Correct provider
				  information, including name, address, telephone number, and federal taxpayer
				  identification number; Appropriate medical coding with dollar amounts and units
				  clearly stated with all descriptions and dates of services clearly printed; and
				  legible medical reports required for each date of service if the billing is for
				  direct treatment of the injured worker.
4. Payment of a workers' compensation medical billing is
				  governed by A.R.S. §
									23-1062.01, which includes:
a. Timeframes for processing and payment of medical
				  bills;
b. Criteria for billing denials;
c. A provision that the injured worker is not responsible for
				  payment of any portion of a medical bill on an accepted claim or payment of any
				  portion of a medical billing that is being disputed;
d. A provision that the insurance carrier or self-insured
				  employer may establish an internal system for resolving payment
				  disputes;
e. A provision that A.R.S. §
									23-1062.01 does not apply to
				  written contracts entered into between medical providers and insurance carriers
				  and self-insured employers or their representatives that specify payment
				  periods or contractual remedies for untimely payments; and
f. A provision that the Industrial Commission does not have
				  jurisdiction over contract disputes between the parties.
5. Health care providers shall bill the code that most
				  accurately describes the service performed. If an insurance carrier,
				  self-insured employer, or claims processing representative determines that the
				  documentation submitted does not support the procedure code billed, the payment
				  to the health care provider may be appropriately adjusted based on Fee Schedule
				  reimbursement values.
See
A.R.S. §
									23-1062.01. The payer shall
				  provide documentation justifying the adjustment and clearly outline the process
				  a health care provider may follow to appeal the determination. Payers shall not
				  downcode medical billings under the Arizona Physicians' & Pharmaceutical
				  Fee Schedule. Downcoding is defined as a payer changing a code in a payment
				  remittance to a code at a lower service level than was billed by the healthcare
				  provider. As applicable, the health care provider may resubmit the bill with
				  documentation that addresses the reason for the adjustment.
6. "Reasonable justification" to deny a bill does not include
				  the payment/billing policies of other private or public entities (publications)
				  unless the publication has been incorporated by reference in the Fee
				  Schedule.
7. Excluding bundling and unbundling issues, it is not the
				  Commission's intent to restrict an insurance carrier's, self-insured
				  employer's, or third party processing service's ability to address issues not
				  addressed by the Fee Schedule. This includes evaluating unlisted procedures,
				  establishing values for unlisted procedures, establishing values for codes that
				  are listed as "BR" or "RNE", or new CPT® codes
				  that have not been incorporated by the Industrial Commission, or managing
				  issues outside the jurisdiction of the Fee Schedule, such as hospital
				  billings.
8. Healthcare providers shall provide legible medical
				  documentation and reports that are sufficient for insurance
				  carriers/self-insured employers to determine if treatment is being directed
				  towards injuries sustained in an industrial accident or incident. The
				  healthcare provider shall ensure that their patients' medical files include the
				  information required by A.R.S. § 32-1401.2. The healthcare provider is not
				  required to provide copies of documents or reports that they did not author and
				  that are not in their possession
(i.e.,
Employers' First
				  Report of Injury).
9. Treating physicians shall submit a narrative that
				  justifies the billing of a level 4 or 5 E/M service.
10. The Commission has incorporated by reference the Centers
				  for Medicare and Medicaid Services, Evaluation and Management Services Guide,
				  and the most current American Medical Association, Evaluation and Management
				  Code and Guideline Changes. Medical billings shall be prepared and reviewed
				  consistent with how these guidelines are used and interpreted by CMS.
				  Additionally, payers are required to disclose any additional guideline(s)
				  utilized in their Explanation of Reviews (or other similar document.
11. A payer's Explanation of Review (or other similar
				  document) shall contain sufficient information to allow the healthcare provider
				  to determine whether the amount of payment is correct and whom to contact
				  regarding any questions related to the payment. Information in the Explanation
				  of Review (or other similar document) shall include the following:
a. The name of the injured worker;
b. The name of the payer and the name of the third party
				  administrator ("TPA"), if applicable;
c. If applicable, the name, telephone number, and address of
				  all entities that reviewed the medical billing on behalf of the payer;
d. If applicable, the name, telephone number, and address of
				  the party that has a written contract signed by the healthcare provider that
				  allows the contracting party or other third party to access and pay rates that
				  are different from those provided under this Fee Schedule;
e. The amount billed by the healthcare provider;
f. The amount of any reduction due to a written contract with
				  the healthcare provider; and
g. The amount of payment.
12. Nothing in this Fee Schedule precludes a healthcare
				  provider from entering into a separate contract that governs fees. In this
				  instance, reimbursement shall be made according to the applicable contracted
				  charge. In the absence of a separate contract that governs a healthcare
				  provider's fees, reimbursement shall be made according to this Fee Schedule. A
				  payer shall demonstrate that it is entitled to pay the contracted rate in the
				  event of a dispute by providing a valid copy of the governing contract to the
				  healthcare provider. If a payer fails to provide evidence that it is entitled
				  to pay a contracted rate, then the payer shall be required to make payment as
				  provided in this Fee Schedule.
13. Billing and reimbursement guidelines for Pharmaceuticals
				  are found in the Pharmaceutical Fee Schedule Section of this document.
14. The Fee Schedule does not apply to ambulance service
				  providers. Service fees for ground ambulance transportation are set and
				  mandated by the Arizona Department of Health Services through its Arizona
				  Ground Ambulance Service Rate Schedule. A.R.S. §
									36-2239(D) 
				  states "an ambulance service shall not charge, demand or collect any
				  remuneration for any service greater or less than or different from the rate or
				  charge determined and fixed by the department as the rate or charge for that
				  service." Service fees published in the Arizona Ground Ambulance Service Rate
				  Schedule are applicable in the workers' compensation setting.
C. REIMBURSEMENT OF MID-LEVEL MEDICAL
				  PROVIDERS
1. Certified Registered Nurse Anesthetists ("CRNAs") are
				  reimbursed at 85% of the fee schedule.
a. Physician Assistants and Nurse Practitioners are
				  reimbursed at 85% of the fee schedule
except
if services are
				  provided "incident to" a physician's professional services. In that instance,
				  reimbursement is required to be at 100% of the fee schedule. The following
				  criteria are identified as establishing the "incident to" exception:
b. The Physician Assistant and Nurse Practitioner must work
				  under the direct supervision of an appropriately licensed physician,
c. The Physician must initially see that patient and
				  establish a plan of care for that patient ("treatment plan"),
d. Subsequent service provided by the Physician Assistant and
				  Nurse Practitioner must be a part of the documented treatment plan, and
e. The Physician must always be involved in the patient's
				  treatment plan and see the patient often enough to demonstrate that the
				  Physician is actively participating in and managing the patient's care.
2. For purposes of the Fee Schedule, the Commission
				  recognizes that direct supervision of a Physician Assistant or Nurse
				  Practitioner by a Physician can be accomplished through the use of modern
				  technology and telecommunications (telemedicine) and may not require the
				  on-site presence of the Physician when the Physician Assistant or Nurse
				  Practitioner sees the patient. In all instances, however, and regardless of the
				  extent to which telemedicine is used, the Physician must actively participate
				  in and manage the patient's care if services provided by a Physician Assistant
				  or Nurse Practitioner are billed at 100% of the fee schedule under the
				  "incident to" exception.
3. It is the responsibility of the Physician to document if
				  the services provided by a Physician Assistant and Nurse Practitioner are
				  "incident to" the Physician's professional service. If either the incident to
				  criteria is not met, or the documentation submitted fails to support the
				  "incident to" criteria, the reimbursement should be made at 85% of the fee
				  schedule.
D. DIRECTED CARE AND USE OF NETWORKS
The Arizona Workers' Compensation Act only permits private
				  self-insured employers to direct medical care. A.R.S. §
									23-1070(A); See
				  also
Southwest Gas Corp. v. Industrial Commission of Arizona
,
				  200 Ariz. 292, 25 P.3d 1164 (2001). This limitation on the scope of directed
				  care means that employees of private self-insured employers do not have an
				  unrestricted right to choose their own medical providers, while employees of
				  all other employers do (including public self-insured
				  employers).1 Notwithstanding an employee's right to
				  choose, many workers' compensation insurance carriers ("carriers") and public
				  self-insured employers ("employers") have taken advantage of "networks" to
				  reduce their costs. This is done by either creating their own network of
				  "preferred providers" or by contracting with a third party to access private
				  healthcare networks.
Actions or conduct that impair or limit the right of an
				  employee to choose their medical provider may rise to the level of bad faith
				  and/or unfair claims processing practices under A.R.S. §
									23-930. The Commission will
				  investigate a complaint of bad faith/unfair claims processing practices, and if
				  appropriate, impose penalties under A.R.S. §
									23-930, in those circumstances
				  where a carrier, employer, or TPA has engaged in conduct that results in
				  directing a claimant to a "network" provider. The following are examples of
				  conduct that the Commission would consider appropriate for investigation under
				  A.R.S. §
									23-930.
* A claimant is told that they must see a healthcare provider
				  that is "in the network;"
* A claimant is told that care from a "non-network"
				  healthcare provider is not authorized;
* A "network" healthcare provider is told that referrals are
				  required to be made to another "network" healthcare provider;
* A "network" healthcare provider is told that they may not
				  recommend a "non-network" healthcare provider to a patient;
* A "non-network" healthcare provider is told that care will
				  only be authorized if provided by a "network" provider; and
* A "non-network" healthcare provider is told that
				  reimbursement will be made according to "network" discounts.
E. TREATMENT OF INDUSTRIAL INJURIES AND
				  DISEASES
1. An employee who sustains an injury arising out of, or in
				  the course of, employment is entitled, under Arizona law, to select a
				  healthcare provider of his/her own choice unless that employee is employed by a
				  private self-insured employer as described in A.R.S. §
									23-1070. Employers described in
				  A.R.S. §
									23-1070, excluding the State or
				  Political Subdivisions thereof, are allowed to direct medical care.
2. The attending healthcare provider's promptness and
				  professional exactness in the completion and filing of workers' compensation
				  forms are extremely important to the employee being treated. The injured or
				  disabled employee's claim to medical benefits and compensation can rest on the
				  conscientious attention of the healthcare provider in processing the required
				  reports. Rules addressing the completion of these forms are found in Title 20,
				  Chapter 5, Article 1 of the Arizona Administrative Code, which can be obtained
				  at:
http://apps.azsos.gov/public_services/Title_20/20-05.pdf
3. The Commission, the employer, and the insurance carrier
				  may, at any time, designate a healthcare provider or healthcare providers to
				  examine an employee. Additionally, upon application of the employer, employee,
				  or insurance carrier, the Commission may order a change of healthcare provider
				  or a change of conditions of treatment when there are reasonable grounds or a
				  belief that the employee's health or progress can thus be improved.
4. A claimant may not change doctors without the written
				  authorization of the insurance carrier, the Commission, or the attending
				  physician. A claimant may not transfer from one hospital to another without the
				  written authorization of the insurance carrier or the Commission. If the
				  patient's employment requires leaving the locale in which he/she is receiving
				  treatment, the attending physician should arrange for continued treatment and
				  notify the carrier of such arrangement. It is the responsibility of the
				  physician or the hospital to which a patient has transferred to ascertain
				  whether such a change has been authorized.
5. Treatment of conditions unrelated to the injuries
				  sustained in the industrial accident may be denied as unauthorized if the
				  treatment seems directed principally toward the non-industrial condition or if
				  the treatment does not seem necessary for the patient's physical rehabilitation
				  from the industrial injury.
6. If the patient refuses to submit to a medical examination
				  or to cooperate with the healthcare provider's treatments, the carrier or
				  self-insured employer should be notified.
7. If an employee is capable of some form of gainful
				  employment, it is proper for the healthcare provider to release the employee to
				  light work and make a specific report to the carrier or self-insured employer
				  as to the date of such release. It can be to the employee's economic advantage
				  to be released to light work since he/she can receive compensation based on 66
				  2/3% of the difference between one's earnings and one's established wage. On
				  the other hand, it would not be to the employee's economic advantage to be
				  released to light work if, in fact, the employee is not capable of performing
				  such work. The healthcare provider's judgment in such matters is extremely
				  important.
8. If the employee no longer requires active medical care for
				  the industrial injury and is discharged from treatment, the healthcare provider
				  is required to provide a signed report with the date of discharge to the
				  carrier or self-insured employer, even if, as a private patient, the employee
				  may require further medical care for conditions unrelated to the industrial
				  accident. This final report and discharge date are necessary for closing the
				  claim file.
9. When a healthcare provider discharges a claimant from
				  treatment, the healthcare provider shall determine whether the employee has
				  suffered any impairment of function, or disfigurement about the head or face,
				  including injury to or loss of teeth, and include this information in the final
				  signed report provided to the carrier or self-insured employer. The Rules of
				  Procedure Before the Industrial Commission of Arizona require that any rating
				  of the percentage of functional impairment should be made in accordance with
				  the standards of evaluation published in the most recent edition of the
				  American Medical Association Guides to the Evaluation of Permanent Impairment.
				  Additional guidance on appropriate billing and reimbursement for impairment
				  evaluations is found in the Evaluation and Management Section of this
				  document.
10. Once an exposure to a blood-borne pathogen occurs, the
				  workers' compensation insurance carrier/self-insured employer is responsible
				  for payment of the accepted treatment protocol which includes the HBIG
				  vaccination (Hepatitis B Immune Globulin), and, if necessary, the three (3)
				  Hepatitis B vaccinations.
11. When a work-related incident occurs that may have exposed
				  an employee to Hepatitis, the insurance carrier/self-insured employer is
				  responsible for paying for the testing and/or treatment of Hepatitis B or C. As
				  to the treatment of HIV, if a bona fide claim exists under A.R.S. §
									23-1043.02, then the insurance
				  carrier/self-insured employer is responsible for paying for the
				  treatment.
12. It is the employer's responsibility, in accordance with
				  existing OSHA standards, to pay for HIV testing. The insurance carrier may seek
				  reimbursement from the employer for the costs associated with providing the
				  series of three (3) Hepatitis B vaccinations if the employer failed to provide
				  them in violation of federal and state laws.
F. REOPENING OF CLAIMS
1. Whether or not the employee has suffered a permanent
				  disability, on a claim that has been previously accepted, the claim may be
				  reopened on the basis of a new, additional, or previously undiscovered
				  disability or condition, but:
a. The claimant should use the form of petition prescribed by
				  the Commission;
b. The petition must be personally signed by the worker or
				  his authorized representative and must be filed at any office of the Industrial
				  Commission of Arizona;
c. The petition, in order to be considered, must be
				  accompanied by the healthcare provider's medical report.
2. If the claim is reopened, the payment for such reasonable
				  and necessary medical, hospital and laboratory work expenses shall be paid by
				  the insurance carrier if such expenses are incurred within 15 days of the
				  filing of the petition to reopen.
3. No monetary compensation is payable for any period prior
				  to the date of filing of the petition to reopen. Surgical benefits are not
				  payable for any period prior to the date of filing of a petition to reopen,
				  except that surgical benefits are payable for a period prior to the date of
				  filing not to exceed seven (7) days if a bona fide medical emergency precludes
				  the employee from filing a petition to reopen prior to the surgery. Other
				  information relative to reopening rights may be found at A.R.S. §
									23-1061(H).
4. If a claim is approved for reopening, the carrier must
				  notify the attending healthcare provider of that approval.
G. NO-INSURANCE CLAIMS
"No-Insurance" claims are workers' compensation claims
				  involving injuries to employees of employers who do not have workers'
				  compensation insurance coverage as required by Arizona law. In such cases, all
				  claims and reports are to be addressed to the No-Insurance Section of the
				  Special Fund of The Industrial Commission of Arizona.
H. CONSULTATIONS
Workers' compensation cases can present additional medical
				  and legal problems that justify consultation sooner and more frequently than
				  the average private patient. In complex cases and cases requiring an estimate
				  of general or unscheduled disability, consultation with specialists in the
				  appropriate field may be requested by any interested party. The Industrial
				  Commission continues to recognize the necessity for consultations in workers'
				  compensation and establishes relative value units and rates for consultation
				  codes.
I. WITNESS FEES
1. Insurance providers, self-insured employers, and the
				  Special Fund of the Commission are responsible for paying $150.00 for the first
				  hour of testimony (or any portion thereof) and $50.00 for each 20 minute
				  increment following the initial hour (or any portion thereof) to a healthcare
				  provider who testifies at hearing at their request.
2. The Commission is responsible for paying $150.00 for the
				  first hour of testimony (or any portion thereof) and $50.00 for each 20 minute
				  increment following the initial hour (or any portion thereof) to a healthcare
				  provider who testifies at hearing on request of a workers' compensation
				  claimant.
J. DEFINITIONS OF SELECT UNIT VALUES
1. BY REPORT "BR" ITEMS: "BR" in the value column indicates
				  that the value of this service is to be determined "by report" because the
				  service is too unusual or variable to be assigned a unit relativity. Pertinent
				  information concerning the nature, intent, and need for the procedure or
				  service, the time, the skill and equipment necessary, etc., is to be furnished.
				  A detailed clinical record is not necessary.
2. RELATIVITY NOT ESTABLISHED "RNE" ITEMS: "RNE" in the value
				  column indicates new or infrequently performed services for which sufficient
				  data has not been collected to allow the establishment of relativity. "RNE"
				  items are clearly definable and not inherently variable as are BR procedures. A
				  report may be necessary.
3. MATERIALS AND SUPPLIES: A healthcare provider is not
				  entitled to be reimbursed for supplies and materials normally necessary to
				  perform a billable service. Examples of those items that are not reimbursable
				  are listed below. Billing and reimbursement guidelines for materials and
				  supplies that are reimbursable are found in the HCPCS Section of the Fee
				  Schedule.
Drugs that are administered to patients in a clinical setting
				  shall be billed using the appropriate HCPCS code and reimbursed according to
				  the Pharmaceutical Fee Schedule Guidelines. The provisions in this subsection
				  do not apply to hospitals, ambulatory surgery centers, and ambulance service
				  providers.
Examples of supplies that are usually not separately
				  reimbursable include:
Applied hot or cold packs
Eye patches, injections, or debridement trays
Steristrips
Needles
Syringes
Eye/ear trays
Drapes
Sterile gloves
Applied eye wash or eye drops
Creams (massage)
Fluorescein
Ultrasound pads and gel
Tissues
Urine collection kits
Gauze
Cotton balls/fluff
Sterile water
Band-Aids and dressings for simple wound occlusion
Head sheets
Aspiration trays
Sterile trays for laceration repair and more complex
				  surgeries Tape for dressings
4. MODIFIERS: A two-digit (numeric or alpha) sequence that
				  provides the means by which the reporting healthcare provider can specify that
				  a procedure performed has been altered under a special circumstance. This
				  allows defining the modifying circumstance of the service or procedure without
				  creating a separate procedure or listing.
Modifier Examples
Professional Component (PC):
Certain
				  procedures are a combination of a physician, or Professional component and a
				  technical component. When modifier 26 is added to an appropriate code, a PC
				  allowable amount will be paid.
Technical Component (TC):
The TC component
				  reflects the technical portion of the procedure code. When the technical
				  component is provided by a healthcare provider other than the one providing the
				  professional component, the healthcare provider bills for the technical
				  component by adding modifier TC to the applicable code.
K. LIST OF ACRONYMS
AMA
American Medical Association
AS
Assistant Surgeon
AWP
Average Wholesale Price
BR
By Report
CCI
Current Coding Initiative (National)
CF
Conversion Factor
CMS
Centers for Medicare & Medicaid
							 Services
CPT
Current Procedural Terminology
CRNA
Certified Registered Nurse Anesthetist
DME
Durable Medical Equipment
E/M
Evaluation and management services
FCE
Functional Capacity Evaluation
FUD
Follow-up day(s)
HCPCS
Healthcare Common Procedure Coding System
ICD-10-CM
International Classification of Diseases, Tenth
							 Revision, Clinical Modification
IME
Independent medical examination
MPFS
Medicare physician fee schedule
MRI
Magnetic resonance imaging
NCCI
(see CCI)
NP
Nurse Practitioner
OTC
Over-the-counter
PA
Physician Assistant
RBRVS
Resource Based Relative Value Scale
RVU
Relative value unit
PHARMACEUTICAL FEE SCHEDULE
A. GENERAL PROVISIONS AND APPLICABILITY OF THE
				  PHARMACEUTICAL FEE SCHEDULE
1. The Pharmaceutical Fee Schedule (PFS) applies to
				  prescription and over-the-counter (OTC) medications required to treat an
				  injured employee, whether administered by a medical practitioner or dispensed
				  by a pharmacy (including online or mail order pharmacies) or by a medical
				  practitioner
2. Medications are not reimbursable unless "reasonably
				  required" at the time of injury or during the period of disability.
See
A.R.S. §
									23-1062(A);
				  A.A.C. R20-5-1303(A).
				  The Industrial Commission of Arizona has adopted the Official Disability
				  Guidelines (ODG), including ODG's Drug Formulary Appendix A (ODG Formulary), as
				  the standard reference for evidence-based medicine used in treating injured
				  employees within the context of Arizona's workers' compensation system.
				  Effective October 1, 2018, ODG applies to all body parts and conditions.
See
A.A.C.
				  R20-5-1301(B),
				  (E). ODG is to be used as a tool to support
				  clinical decision-making and quality health care delivery to injured employees.
				  The ODG Formulary sets forth pharmaceutical guidelines that are generally
				  considered reasonable and are presumed correct if the guidelines provide
				  recommendations related to a particular medication.
See
A.A.C.
				  R20-5-1301(H).
				  Medical practitioners are encouraged to consult the ODG Formulary before
				  dispensing, administering, or prescribing medications to injured
				  employees.
3. Generic drugs must be dispensed or administered to injured
				  employees when appropriate, consistent with A.R.S. §
									32-1963.01(A)
									1, (B), and (D) through
				  (L)2.
See
A.R.S. §
									23-908(C). For
				  purposes of this subsection, the definitions in A.R.S. § 32- 1963.01(L)
				  apply3. Whenever possible: (1) medical practitioners
				  should prescribe less costly drugs; (2) pharmacies and medical practitioners
				  (under Section VII) should dispense generic drugs with lower AWP values; and
				  (3) medical practitioners (under Section VI) should administer generic drugs
				  with lower AWP values.
B. DEFINITIONS.
1. "Administer" has the meaning set forth in A.R.S.
				  32-1901(1).
2. "Average Wholesale Price" or "AWP" means the wholesale
				  price charged on a specific commodity that is assigned by the drug manufacturer
				  and is listed in a nationally recognized drug pricing file.
3. "Commercially available" means a drug product is widely
				  available for purchase in pharmacies accessible to the general public,
				  including in brick and mortar pharmacies accessible to the general
				  public.
4. "Compound medication" means a pharmaceutical product
				  created by virtue of mixing or combining drugs and/or components to meet the
				  unique needs of an individual patient when the finished product does not
				  recreate a commercially available product.
5. "Dispense" or "dispensing" means to deliver to an ultimate
				  user by or pursuant to the lawful order of a medical practitioner, including
				  the prescribing, administering, packaging, labeling, or compounding necessary
				  to prepare for that delivery.
See
A.R.S. §
									32-1901(27).
6. "Drug" has the meaning set forth in A.R.S. §
									32-1901(31).
7. "Hospital" means any institution for the care and
				  treatment of the sick and injured that is approved and licensed as a hospital
				  by: (1) the Arizona Department of Health Services; or (2) an equivalent
				  regulatory agency in another U.S. state, territory, or district. See A.R.S.
				  §
									32-1901(42).
8. "Medical practitioner" means any person who is
				  permitted/licensed and authorized by law to use and prescribe prescription
				  medications, acting within the scope of such authority, for the treatment of
				  sick and injured human beings or for the diagnosis or prevention of sickness in
				  human beings in the State of Arizona or any U.S. state, territory or district.
See
A.R.S. §
									32-1901(53).
9. "Non-traditional strength" medication means a finished
				  drug product in a strength (
i.e.,
dosage) that is not
				  commercially available in pharmacies accessible to the general public.
10. "Over-the-counter medication" or "OTC medication" means a
				  finished drug product, including label and container according to context,
				  which does not require a prescription order.
11. "Pharmacy" has the meaning set forth in A.R.S. §
									32-1901(71).
12. "Pharmacy accessible to the general public" means a
				  pharmacy that is readily accessible and provides pharmaceutical services
				  (including prescription medication services) to all segments of the general
				  public without restricting services to a defined or exclusive group of
				  consumers, including but not limited to consumers who have access to services
				  because they are treated by or have an affiliation with a specific entity or
				  medical practitioner. This definition includes mail order pharmacies delivering
				  pharmaceutical services to workers' compensation claimants if both of the
				  following apply:
a. The pharmacy does not limit or restrict access to
				  claimants with an affiliation to a medical provider or other entity.
b. Any medical provider or other entity referring a claimant
				  to the pharmacy does not receive or accept any rebate, refund, commission,
				  preference, or other consideration as compensation for the referral.
13. "Pharmacy not accessible to the general public" means a
				  pharmacy that provides pharmaceutical services (including prescription
				  medication services) only to a defined or exclusive group of consumers,
				  including but not limited to consumers who have access to services because they
				  are treated by or have an affiliation with a specific entity or medical
				  practitioner. "Pharmacy not accessible to the general public" does not include
				  a hospital pharmacy. This definition does not include mail order pharmacies
				  delivering pharmaceutical services to workers' compensation claimants if both
				  of the following apply:
a. The pharmacy does not limit or restrict access to
				  claimants with an affiliation to a medical provider or other entity.
b. Any medical provider or other entity referring a claimant
				  to the pharmacy does not receive or accept any rebate, refund, commission,
				  preference, or other consideration as compensation for the referral.
14. "Prescription" means either a prescription order or a
				  prescription medication.
See
A.R.S. §
									32-1901(80).
15. "Prescription medication" means any drug, including label
				  and container according to context, which is dispensed pursuant to a
				  prescription order.
See
A.R.S. §
									32-1901(81).
16. "Prescription order" shall have the meaning set forth in
				  A.R.S. §
									32-1901(84).
17. "Repackaged medication" means a finished drug product
				  removed from the container in which it was distributed by the original
				  manufacturer and placed into a different container without further manipulation
				  of the drug. The term also includes the act of placing the contents of multiple
				  containers of the same finished drug product into one container. The term also
				  includes "co-pack drug" products which contain two or more separate finished
				  medications that are contained in a single package or unit. The term does not
				  include a drug that is manipulated in any other way, including if the drug is
				  reconstituted, diluted, mixed, or combined with another ingredient.
18. "Therapeutically-similar" medication means a medication
				  that is expected to produce a clinical effect comparable to the original
				  product. Key considerations for determining the "most therapeutically-similar"
				  medications are: (1) the similarity of the clinical effects; (2) the extent to
				  which active ingredients overlap; (3) the similarity of the dosage profiles;
				  and (4) the similarity of the mode of administration; and (5) the similarity of
				  the intended strength.
19. "Traditional strength" medication means a finished drug
				  product in a formulation that is commercially available in pharmacies
				  accessible to the general public.
20. "Ultimate user" means a person who lawfully possesses a
				  prescription medication for that person's own use or for the use of a member of
				  that person's household.
See
A.R.S. §
									32-1901(95).
C. GENERAL GUIDELINES FOR BILLING AND REIMBURSEMENT OF
				  PRESCRIPTION MEDICATIONS.
1. Except as permitted in Sections VI and VII of the current
				  PFS, an insurance carrier, self-insured employer, or the Special Fund of the
				  Commission is responsible for the payment of prescription medications only if
				  all of the following apply:
a. The prescription medication is dispensed by an individual
				  who is currently licensed to practice the profession of pharmacy by either: (i)
				  the Arizona State Board of Pharmacy; or (ii) an equivalent regulatory agency in
				  another U.S. state, territory, or district; and
b. The prescription medication is dispensed by a pharmacy
				  accessible to the general public, including online or mail-order pharmacies
				  that are accessible to the general public.
2. Subject to Sections III(G), IV, V, and VI(B),
				  reimbursement for prescription medications shall be based on the actual
				  medication dispensed or administered, including a substituted medication that
				  is dispensed or administered pursuant to A.R.S. §
									32-1963.01.
3. Except as specified in Sections IV and V of the current
				  PFS, a pharmaceutical bill submitted for a prescription medication must include
				  the National Drug Code (NDC) of the original manufacturer registered with the
				  U.S. Food & Drug Administration (FDA), the quantity dispensed, and the
				  reimbursement value of the medication. Under no circumstance shall an NDC other
				  than the original manufacturer's NDC be used.
4. The reimbursement value for prescription medications shall
				  be based on the current PFS reimbursement methodology in the absence of a
				  contractual agreement between the pharmacy or medical practitioner and payer
				  governing reimbursement. Network discounts may not be applied in the absence of
				  a contractual agreement with the pharmacy or medical practitioner authorizing
				  such discounts.
5. The reimbursement value for a prescription medication
				  shall be determined on the date a drug is dispensed from pricing published in
				  the most recent issue, as updated in the most recent update, of a nationally
				  recognized pharmaceutical publication designated by the Commission. For
				  purposes of determining AWP, the Commission has selected
				  Medi-Span®.
6. The reimbursement value for a prescription medication
				  shall be determined by reference to the original manufacturer's NDC and shall
				  be calculated on a per unit basis as follows:
a. Generic drugs:
* (75% of AWP per unit) x (number of units dispensed).
b. Brand name drugs:
* (85% of AWP per unit) x (number of units dispensed).
7. Reimbursement for non-traditional strength prescription
				  medications shall be calculated on a per unit basis, as of the date of
				  dispensing or administering, based on the original manufacturer's NDC and
				  corresponding AWP of the most therapeutically-similar traditional strength form
				  of the same medication. Under no circumstance shall the NDC of the
				  non-traditional strength medication be used.
8. The reimbursement value for OTC medications shall be
				  calculated on a per unit basis, as of the date of dispensing, based on the
				  retail price (per unit) of the OTC medication in settings where the medication
				  is commercially available.
9. Subject to Section III(J), the reimbursement value for OTC
				  medications that are not commercially available in pharmacies accessible to the
				  general public shall be calculated on a per unit basis, as of the date of
				  dispensing, based on the retail price (per unit) of the most
				  therapeutically-similar OTC medication commercially available in pharmacies
				  accessible to the general public. Under no circumstance shall the NDC or AWP of
				  the non-commercially available OTC medication be used.
10. The reimbursement value for OTC medications that are not
				  commercially available may not exceed:
a. Thirty dollars ($30.00) for a thirty-day supply (or a
				  pro-rated amount if the supply is greater or less than thirty days) for a
				  topical cream or lotion.
b. Seventy-five dollars ($75.00) for a thirty-day supply (or
				  a pro-rated amount if the supply is greater or less than thirty days) for
				  topical patches.
D. BILLING AND REIMBURSEMENT FOR REPACKAGED
				  MEDICATIONS.
1. A pharmaceutical bill submitted for a repackaged
				  medication must identify the NDC of the repackaged medication, the NDC of the
				  original manufacturer registered with the U.S. FDA, the quantity dispensed, and
				  the reimbursement value of the repackaged medication. Under no circumstances
				  shall the reimbursement value of a repackaged medication be based upon an NDC
				  other than the original manufacturer's NDC. A repackaged NDC shall not be used
				  for calculating the reimbursement value of a repackaged medication and shall
				  not be considered the original manufacturer's NDC.
2. If a pharmaceutical bill for a repackaged medication is
				  submitted without the original manufacturer's NDC, the payer has the discretion
				  to determine the appropriate NDC (and corresponding AWP) to use or,
				  alternatively, may deny coverage until the appropriate NDC is furnished.
3. The reimbursement value for a repackaged medication shall
				  be based on the current PFS reimbursement methodology contained in Section III
				  of the PFS, utilizing the NDC(s) and corresponding AWP(s) of the original
				  manufacturer(s).
4. Any component of a co-pack drug product for which there is
				  no NDC shall not be reimbursed.
E. BILLING AND REIMBURSEMENT FOR COMPOUND
				  MEDICATIONS.
1. A pharmaceutical bill submitted for a compound medication
				  must identify each reimbursable component ingredient, the applicable NDC of
				  each reimbursable component ingredient, the corresponding quantity of each
				  component ingredient, and the calculated reimbursement value of each component
				  ingredient. All component ingredients of a compound medication must be billed
				  on a single bill.
2. The reimbursement value for a compound medication shall be
				  calculated at the component ingredient level. The reimbursement value for a
				  compound medication shall be based on the sum of the reimbursement values of
				  each component ingredient and the corresponding component ingredient's NDC,
				  based on the current PFS reimbursement methodology set forth in Section
				  III.
3. Any component ingredient in a compound medication for
				  which there is no NDC shall not be reimbursed.
4. Any component ingredient in a topical compound medication
				  that is not FDA approved for topical use shall not be reimbursed.
5. If any component ingredient in a compound medication is a
				  repackaged medication, the reimbursement value for the repackaged medication
				  ingredient shall be determined based on the current PFS reimbursement
				  methodology set forth in Section III, using the AWP corresponding to the NDC of
				  the original manufacturer.
See
Section IV.
6. The maximum reimbursement value for a topical compound
				  medication shall be the lesser of:
a. Two hundred dollars ($200.00) for a thirty-day supply (or
				  a pro-rated amount if the supply is greater or less than thirty days),
				  or
b. The reimbursement value of the compound medication as
				  calculated under this section.
F. BILLING AND REIMBURSEMENT FOR MEDICATIONS
				  ADMINISTERED BY A MEDICAL PRACTITIONER.
1. A pharmaceutical bill submitted for a medication
				  administered by a medical practitioner must comply with billing procedures
				  outlined in Sections III, IV, and V of the current PFS, as applicable.
2. The reimbursement value for a medication administered by a
				  medical practitioner shall be based on the current PFS reimbursement
				  methodology contained in Sections III, IV, and V of the PFS, as
				  applicable.
G. REIMBURSEMENT FOR MEDICATIONS DISPENSED BY A MEDICAL
				  PRACTITIONER OR IN A PHARMACY NOT ACCESSIBLE TO THE GENERAL
				  PUBLIC.
4,5
1. An insurance carrier, self-insured employer, or the
				  Special Fund of the Commission is responsible for the payment of prescription
				  medications that are dispensed by a medical practitioner or in a pharmacy not
				  accessible to the general public if all of the following apply:
a. The prescription medication is dispensed by a medical
				  practitioner or a pharmacy not accessible to the general public to the injured
				  employee within seven days of the date of the industrial injury;
b. The prescription medication is limited to no more than a
				  one-time, ten-day supply;
c. The prescription medication conforms to dosages and
				  formulations that are commercially available in pharmacies accessible to the
				  general public.
2. An insurance carrier, self-insured employer, or the
				  Special Fund of the Commission is responsible for the payment of prescription
				  medications that are dispensed by a medical practitioner or in a pharmacy not
				  accessible to the general public if all of the following apply:
a. The injured employee does not have access to a pharmacy
				  accessible to the general public within 20 miles of the injured employee's home
				  address, work address, or the address of the prescribing medical
				  practitioner;
b. The injured employee cannot reasonably acquire the
				  prescription medication from an online or mail order pharmacy accessible to the
				  general public; and
c. The prescription medication conforms to dosages and
				  formulations which are commercially available in pharmacies accessible to the
				  general public.
3. An insurance carrier, self-insured employer, or the
				  Special Fund of the Commission is responsible for the payment of prescription
				  medications that are dispensed by a medical practitioner or in a pharmacy not
				  accessible to the general public if the dispensing of a prescription medication
				  for an individual claim and specified duration has been preapproved in writing
				  by the insurance carrier, self-insured employer, or the Special Fund of the
				  Commission. Nothing in this section requires an insurance carrier, self-insured
				  employer, or the Special Fund of the Commission to preapprove the dispensing of
				  prescription medications under this subsection.
4. An insurance carrier, self-insured employer, or the
				  Special Fund of the Commission is responsible for the payment of prescription
				  medications that are dispensed by a pharmacy not accessible to the general
				  public if all of the following apply:
a. The prescription medication was dispensed to an injured
				  employee whose workers' compensation claim was initially denied by the carrier,
				  self-insured employer, or the Special Fund of the Commission;
b. The injured employee protested the claim denial by filing
				  a timely request for hearing;
c. The workers' compensation claim was either: (a)
				  subsequently accepted by the carrier, self-insured employer, or the Special
				  Fund of the Commission; or (b) the claim was found to be compensable by the
				  Commission's Administrative Law Judge Division, the Arizona Court of Appeals,
				  or the Arizona Supreme Court;
d. The prescription medication was dispensed during the time
				  period between: (a) the initial claim denial and (b) the subsequent acceptance
				  of the claim or the compensability determination by the Commission's
				  Administrative Law Judge Division, the Arizona Court of Appeals, or the Arizona
				  Supreme Court; and
e. The prescription medication conforms to dosages and
				  formulations that are commercially available in pharmacies accessible to the
				  general public.
5. The guidelines in Section III(A) and this section do not
				  apply to prescription medications dispensed during inpatient hospital care or
				  upon discharge from in-patient hospital care.
6. Subject to the limitations in this section, medications
				  that have been provided as free samples to a medical practitioner may be
				  dispensed to an injured employee when appropriate, but are not
				  reimbursable.
H. DISPENSING FEE.
1. If a prescription medication is dispensed by a pharmacy
				  accessible to the general public pursuant to a prescription order, a dispensing
				  fee of up to seven dollars ($7.00) per prescription medication, repackaged
				  medication, or compound medication may be charged. The dispensing fee does not
				  apply to OTC medications that are not prescribed by a medical
				  practitioner.
2. If a prescription medication is dispensed by a medical
				  practitioner or in a pharmacy not accessible to the general public pursuant to
				  Section VII(A), (B), or (C), a dispensing fee of up to seven dollars ($7.00)
				  per prescription medication, repackaged medication, or compound medication may
				  be charged. If an OTC medication is dispensed by a medical practitioner or by a
				  pharmacy not accessible to the general public, a dispensing fee is not
				  permitted.
3. If a prescription or OTC medication is administered by a
				  medical practitioner, a dispensing fee is not permitted.
I. ADDITIONAL BILLING GUIDELINES.
1. Paper billing by a medical practitioner:
The following is an example of how to report both the
				  repackaged NDC and original NDC on the CMS 1500 form using the shaded area of
				  line 24. The information is reported in the following order: qualifier (N4),
				  NDC code, one space, unit/basis of measurement qualifier, quantity, one space,
				  ORIG, qualifier (N4), NDC code."
Click here to
				  view
If a physician does not bill using the CMS 1500 form or is
				  not able to include all the required information on the CMS 1500 form (due to
				  software/system limitations), then the physician may provide the required
				  information (in the required order) separately or as an attachment to the CMS
				  1500 form.
2. Paper billing by non-physician entities.
A non-physician entity using paper billing to bill for
				  medications shall use the most recent version of the Workers'
				  Compensation/Property & Casualty Universal Claim Form (WC/PC UCF) adopted
				  by the National Council for Prescription Drug Programs.
X. SEVERABILITY CLAUSE.
If any provision of the Pharmaceutical Fee Schedule or the
				  application thereof to any person or circumstances is held invalid, such
				  invalidity shall not affect other provisions or application of the
				  Pharmaceutical Fee Schedule which can be given effect without the invalid
				  provisions or application, and to this end the provisions of this
				  Pharmaceutical Fee Schedule are severable.
ANESTHESIA GUIDELINES
Information regarding publications incorporated by reference
				  is found in the Introduction Section of the Fee Schedule.
The following Commission guidelines are in addition to the
				  CPT® guidelines and represent additional
				  guidance from the Commission relative to unit values for anesthesia services.
				  To the extent that a conflict may exist between an incorporated portion of the
				  CPT®, the most recent edition of Relative Value
				  Guide, or the American Society of Anesthesiologists, and a code, guideline,
				  identifier, or modifier unique to Arizona, then the Arizona code, guideline,
				  identifier or modifier shall control. Codes that are unique to Arizona are
				  preceded by an AZ identifier and numbered in the following format:
				  AZxxx.
A. CERTIFIED REGISTERED NURSE ANESTHETISTS: Are reimbursed at
				  85% of the fee schedule when billed with modifier QZ.
B. ANESTHESIA MODIFIERS: Anesthesia modifiers, which may
				  include physical status and other optional modifiers, may be added to the basic
				  values. Unit values for physical status modifiers are as follows:
Unit Values
P1 A normal healthy patient
0
P2 A patient with mild systemic
							 disease
0
P3 A patient with severe systemic
							 disease
1
P4 A patient with severe systemic disease that is a
							 constant threat to life
2
P5 A moribund patient who is not expected to survive
							 without the operation
3
P6 A declared brain-dead patient whose organs are
							 being removed for donor purposes
0
AA Anesthesia services personally performed by an
				  anesthesiologist are reimbursed at 100% of the lesser of billed charges or the
				  fee schedule calculation.
AD Medical supervision by a physician: more than four (4)
				  concurrent anesthesia procedures reimbursed at 50% of the lesser of billed
				  charges or fee schedule calculation.
QK Medical direction of two, three, or four concurrent
				  anesthesia procedures involving qualified individuals reimbursed at 50% of the
				  lesser of billed charges or fee schedule calculation.
QX Qualified nonphysician anesthetist with medical direction
				  by a physician reimbursed at 50% of fee schedule calculation.
QZ CRNA without medical direction by a physician is
				  reimbursed at 85% of the lesser of billed charges or fee schedule
				  calculation.
C. REPORTING OF TIME: Time reporting is described in the
				  Anesthesia Guidelines of the CPT® publication.
				  In Arizona, time units will be added to the basic value and modifying units as
				  is customary in the local area using the following unit values:
1 unit value is equal to Fifteen (15) minutes or any Seven
				  (7) minute portion thereof.
Show the elapsed time (minutes) in item 24G of the CMS 1500
				  form. Convert hours into minutes and enter the total minutes required for this
				  procedure.
D. UNIT VALUES FOR OTHER QUALIFYING CIRCUMSTANCES: (more than
				  one may be selected)
Qualifying circumstances are described in the Anesthesia
				  Guidelines of the CPT® book. The unit values for
				  these procedures, which are reported as an additional service and may be added
				  to the basic unit values, are as follows:
Code
Unit Value
99100
1
99116
5
99135
5
99140
2
Note:
Healthcare providers who provide
				  additional services that are billed using CPT®
				  codes 62320-62327 or 64400-64530 shall follow the Surgery Guidelines in this
				  Fee Schedule.
ARIZONA PHYSICIANS' FEE
							 SCHEDULE
Anesthesia Codes
							 2024
Anesthesia Conversion Factor
							 $61.00
Code
Category
Base Unit
RBRVS Rate
00100
Anesthesia
5
305.00
00102
Anesthesia
6
366.00
00103
Anesthesia
5
305.00
00104
Anesthesia
4
244.00
00120
Anesthesia
5
305.00
00124
Anesthesia
4
244.00
00126
Anesthesia
4
244.00
00140
Anesthesia
5
305.00
00142
Anesthesia
4
244.00
00144
Anesthesia
6
366.00
00145
Anesthesia
6
366.00
00147
Anesthesia
4
244.00
00148
Anesthesia
4
244.00
00160
Anesthesia
5
305.00
00162
Anesthesia
7
427.00
00164
Anesthesia
4
244.00
00170
Anesthesia
5
305.00
00172
Anesthesia
6
366.00
00174
Anesthesia
6
366.00
00176
Anesthesia
7
427.00
00190
Anesthesia
5
305.00
00192
Anesthesia
7
427.00
00210
Anesthesia
11
671.00
00211
Anesthesia
10
610.00
00212
Anesthesia
5
305.00
00214
Anesthesia
9
549.00
00215
Anesthesia
9
549.00
00216
Anesthesia
15
915.00
00218
Anesthesia
13
793.00
00220
Anesthesia
10
610.00
00222
Anesthesia
6
366.00
00300
Anesthesia
5
305.00
00320
Anesthesia
6
366.00
00322
Anesthesia
3
183.00
00326
Anesthesia
7
427.00
00350
Anesthesia
10
610.00
00352
Anesthesia
5
305.00
00400
Anesthesia
3
183.00
00402
Anesthesia
5
305.00
00404
Anesthesia
5
305.00
00406
Anesthesia
13
793.00
00410
Anesthesia
4
244.00
00450
Anesthesia
5
305.00
00454
Anesthesia
3
183.00
00470
Anesthesia
6
366.00
00472
Anesthesia
10
610.00
00474
Anesthesia
13
793.00
00500
Anesthesia
15
915.00
00520
Anesthesia
6
366.00
00522
Anesthesia
4
244.00
00524
Anesthesia
4
244.00
00528
Anesthesia
8
488.00
00529
Anesthesia
11
671.00
00530
Anesthesia
4
244.00
00532
Anesthesia
4
244.00
00534
Anesthesia
7
427.00
00537
Anesthesia
10
610.00
00539
Anesthesia
18
1098.00
00540
Anesthesia
12
732.00
00541
Anesthesia
15
915.00
00542
Anesthesia
15
915.00
00546
Anesthesia
15
915.00
00548
Anesthesia
17
1037.00
00550
Anesthesia
10
610.00
00560
Anesthesia
15
915.00
00561
Anesthesia
25
1525.00
00562
Anesthesia
20
1220.00
00563
Anesthesia
25
1525.00
00566
Anesthesia
25
1525.00
00567
Anesthesia
18
1098.00
00580
Anesthesia
20
1220.00
00600
Anesthesia
10
610.00
00604
Anesthesia
13
793.00
00620
Anesthesia
10
610.00
00625
Anesthesia
13
793.00
00626
Anesthesia
15
915.00
00630
Anesthesia
8
488.00
00632
Anesthesia
7
427.00
00635
Anesthesia
4
244.00
00640
Anesthesia
3
183.00
00670
Anesthesia
13
793.00
00700
Anesthesia
4
244.00
00702
Anesthesia
4
244.00
00730
Anesthesia
5
305.00
00731
Anesthesia
5
305.00
00732
Anesthesia
6
366.00
00750
Anesthesia
4
244.00
00752
Anesthesia
6
366.00
00754
Anesthesia
7
427.00
00756
Anesthesia
7
427.00
00770
Anesthesia
15
915.00
00790
Anesthesia
7
427.00
00792
Anesthesia
13
793.00
00794
Anesthesia
8
488.00
00796
Anesthesia
30
1830.00
00797
Anesthesia
11
671.00
00800
Anesthesia
4
244.00
00802
Anesthesia
5
305.00
00811
Anesthesia
4
244.00
00812
Anesthesia
3
183.00
00813
Anesthesia
5
305.00
00820
Anesthesia
5
305.00
00830
Anesthesia
4
244.00
00832
Anesthesia
6
366.00
00834
Anesthesia
5
305.00
00836
Anesthesia
6
366.00
00840
Anesthesia
6
366.00
00842
Anesthesia
4
244.00
00844
Anesthesia
7
427.00
00846
Anesthesia
8
488.00
00848
Anesthesia
8
488.00
00851
Anesthesia
6
366.00
00860
Anesthesia
6
366.00
00862
Anesthesia
7
427.00
00864
Anesthesia
8
488.00
00865
Anesthesia
7
427.00
00866
Anesthesia
10
610.00
00868
Anesthesia
10
610.00
00870
Anesthesia
5
305.00
00872
Anesthesia
7
427.00
00873
Anesthesia
5
305.00
00880
Anesthesia
15
915.00
00882
Anesthesia
10
610.00
00902
Anesthesia
5
305.00
00904
Anesthesia
7
427.00
00906
Anesthesia
4
244.00
00908
Anesthesia
6
366.00
00910
Anesthesia
3
183.00
00912
Anesthesia
5
305.00
00914
Anesthesia
5
305.00
00916
Anesthesia
5
305.00
00918
Anesthesia
5
305.00
00920
Anesthesia
3
183.00
00921
Anesthesia
3
183.00
00922
Anesthesia
6
366.00
00924
Anesthesia
4
244.00
00926
Anesthesia
4
244.00
00928
Anesthesia
6
366.00
00930
Anesthesia
4
244.00
00932
Anesthesia
4
244.00
00934
Anesthesia
6
366.00
00936
Anesthesia
8
488.00
00938
Anesthesia
4
244.00
00940
Anesthesia
3
183.00
00942
Anesthesia
4
244.00
00944
Anesthesia
6
366.00
00948
Anesthesia
4
244.00
00950
Anesthesia
5
305.00
00952
Anesthesia
4
244.00
01112
Anesthesia
5
305.00
01120
Anesthesia
6
366.00
01130
Anesthesia
3
183.00
01140
Anesthesia
15
915.00
01150
Anesthesia
10
610.00
01160
Anesthesia
4
244.00
01170
Anesthesia
8
488.00
01173
Anesthesia
12
732.00
01200
Anesthesia
4
244.00
01202
Anesthesia
4
244.00
01210
Anesthesia
6
366.00
01212
Anesthesia
10
610.00
01214
Anesthesia
8
488.00
01215
Anesthesia
10
610.00
01220
Anesthesia
4
244.00
01230
Anesthesia
6
366.00
01232
Anesthesia
5
305.00
01234
Anesthesia
8
488.00
01250
Anesthesia
4
244.00
01260
Anesthesia
3
183.00
01270
Anesthesia
8
488.00
01272
Anesthesia
4
244.00
01274
Anesthesia
6
366.00
01320
Anesthesia
4
244.00
01340
Anesthesia
4
244.00
01360
Anesthesia
5
305.00
01380
Anesthesia
3
183.00
01382
Anesthesia
3
183.00
01390
Anesthesia
3
183.00
01392
Anesthesia
4
244.00
01400
Anesthesia
4
244.00
01402
Anesthesia
7
427.00
01404
Anesthesia
5
305.00
01420
Anesthesia
3
183.00
01430
Anesthesia
3
183.00
01432
Anesthesia
6
366.00
01440
Anesthesia
8
488.00
01442
Anesthesia
8
488.00
01444
Anesthesia
8
488.00
01462
Anesthesia
3
183.00
01464
Anesthesia
3
183.00
01470
Anesthesia
3
183.00
01472
Anesthesia
5
305.00
01474
Anesthesia
5
305.00
01480
Anesthesia
3
183.00
01482
Anesthesia
4
244.00
01484
Anesthesia
4
244.00
01486
Anesthesia
7
427.00
01490
Anesthesia
3
183.00
01500
Anesthesia
8
488.00
01502
Anesthesia
6
366.00
01520
Anesthesia
3
183.00
01522
Anesthesia
5
305.00
01610
Anesthesia
5
305.00
01620
Anesthesia
4
244.00
01622
Anesthesia
4
244.00
01630
Anesthesia
5
305.00
01634
Anesthesia
9
549.00
01636
Anesthesia
15
915.00
01638
Anesthesia
10
610.00
01650
Anesthesia
6
366.00
01652
Anesthesia
10
610.00
01654
Anesthesia
8
488.00
01656
Anesthesia
10
610.00
01670
Anesthesia
4
244.00
01680
Anesthesia
3
183.00
01710
Anesthesia
3
183.00
01712
Anesthesia
5
305.00
01714
Anesthesia
5
305.00
01716
Anesthesia
5
305.00
01730
Anesthesia
3
183.00
01732
Anesthesia
3
183.00
01740
Anesthesia
4
244.00
01742
Anesthesia
5
305.00
01744
Anesthesia
5
305.00
01756
Anesthesia
6
366.00
01758
Anesthesia
5
305.00
01760
Anesthesia
7
427.00
01770
Anesthesia
6
366.00
01772
Anesthesia
6
366.00
01780
Anesthesia
3
183.00
01782
Anesthesia
4
244.00
01810
Anesthesia
3
183.00
01820
Anesthesia
3
183.00
01829
Anesthesia
3
183.00
01830
Anesthesia
3
183.00
01832
Anesthesia
6
366.00
01840
Anesthesia
6
366.00
01842
Anesthesia
6
366.00
01844
Anesthesia
6
366.00
01850
Anesthesia
3
183.00
01852
Anesthesia
4
244.00
01860
Anesthesia
3
183.00
01916
Anesthesia
5
305.00
01920
Anesthesia
7
427.00
01922
Anesthesia
7
427.00
01924
Anesthesia
5
305.00
01925
Anesthesia
7
427.00
01926
Anesthesia
8
488.00
01930
Anesthesia
5
305.00
01931
Anesthesia
7
427.00
01932
Anesthesia
6
366.00
01933
Anesthesia
7
427.00
01937
Anesthesia
4
244.00
01938
Anesthesia
4
244.00
01939
Anesthesia
4
244.00
01940
Anesthesia
4
244.00
01941
Anesthesia
5
305.00
01942
Anesthesia
5
305.00
01951
Anesthesia
3
183.00
01952
Anesthesia
5
305.00
01953
Anesthesia
1
61.00
01958
Anesthesia
5
305.00
01960
Anesthesia
5
305.00
01961
Anesthesia
7
427.00
01962
Anesthesia
8
488.00
01963
Anesthesia
8
488.00
01965
Anesthesia
4
244.00
01966
Anesthesia
4
244.00
01967
Anesthesia
5
305.00
01968
Anesthesia
2
122.00
01969
Anesthesia
5
305.00
01990
Anesthesia
7
427.00
01991
Anesthesia
3
183.00
01992
Anesthesia
5
305.00
01996
Anesthesia
3
183.00
99100
Anesthesia
1
61.00
99116
Anesthesia
5
305.00
99135
Anesthesia
5
305.00
99140
Anesthesia
2
122.00
SURGERY GUIDELINES
Information regarding publications incorporated by reference
				  is found in the Introduction Section of the Fee Schedule.
The following Commission guidelines are in addition to the
				  CPT® guidelines and represent additional
				  guidance from the Commission relative to unit values for surgical services. To
				  the extent that a conflict may exist between CMS, an incorporated portion of
				  the CPT®, and a code, guideline, identifier, or
				  modifier unique to Arizona, then the Arizona code, guideline, identifier, or
				  modifier shall control. Codes that are unique to Arizona are preceded by an AZ
				  identifier and numbered in the following format: AZxxx.
A. MATERIALS AND SUPPLIES: A healthcare provider may charge
				  for materials and supplies as described in the HCPCS Section of this Fee
				  Schedule.
B. MULTIPLE PROCEDURES: It is appropriate to designate
				  multiple procedures that are rendered on the same date by separate entries. The
				  additional procedure(s) or service(s) may be identified by appending modifier
				  51 to the additional procedure or service code(s).
Note:
This
				  modifier should not be appended to designated "add-on" codes.
C. SPECIAL REPORT: A typical request for more detailed
				  information from an insurance carrier regarding a billing does not constitute a
				  "special report", which is defined in the CPT®
				  book.
D. MODIFIERS: Listed services and procedures may be modified
				  under certain circumstances. When applicable, the modifying circumstance should
				  be identified by the addition of the appropriate modifier code, which may be
				  reported in either of two ways. The modifier may be reported by a two-digit
				  number placed after the usual procedure number from which it is separated by a
				  hyphen. Or the modifier may be reported by a separate five-digit code that is
				  used in addition to the procedure code. If more than one modifier is used, the
				  "Multiple Modifiers" code placed first after the procedure code indicates that
				  one or more additional modifier codes will follow.
Modifiers either unique to Arizona or containing explanatory
				  language specific to Arizona are as follows:
22 Increased Procedural Services: Use of this modifier will
				  result in a twenty-five percent (25%) increase in the listed value for the
				  listed procedure.
25 Separately Identifiable Evaluation and Management Service
				  by the same Physician or Other Qualified Health Care Professional on the Same
				  Day of the Procedure or Other Service. It may be necessary to indicate that on
				  the day a procedure or service identified by a
				  CPT® code was performed, the patient's condition
				  required a significant, separately identifiable E/M service above and beyond
				  the other service provided or beyond the other service provided or beyond the
				  usual preoperative and postoperative care associated with the procedure that
				  was performed (see Evaluation and Management Services Guidelines for
				  instructions on determining level of E/M service). As such, different diagnoses
				  are not required for reporting of the E/M services on the same date. The
				  circumstance may be reported by adding modifier 25 to the appropriate level of
				  E/M service.
47 Anesthesia by Surgeon: Used to report anesthesia by the
				  attending or assistant surgeon (does not include local anesthesia).
				  Reimbursement shall be fifty percent (50%) of the base unit as indicated in the
				  Anesthesia section of the Fee Schedule. This modifier shall be allowed no more
				  than once per surgical encounter.
50 Bilateral Procedure: Unless otherwise identified in the
				  listings, when bilateral procedures which add significant time or complexity to
				  patient care are provided at the same operative session, identify and value the
				  first or major procedure as listed. Identify the secondary or lesser
				  procedure(s) by adding this modifier 50 to the usual procedure number(s) and
				  value at fifty percent (50%) of the listed value(s). If, however, the
				  procedures are independently complex and involve different parts of the body,
				  including digits, the bilateral procedure rule would not apply. In such cases,
				  independent procedures would be billed at one hundred percent (100%) of their
				  listed value.
51 Multiple Procedures: When multiple procedures are
				  performed during the same operative session*, the procedures should be valued
				  at the appropriate percent of its listed value, as shown below:
100% (full value) for the first or major procedure 50% for
				  the second and multiple procedure(s) Sixth and subsequent procedures - by
				  report.
*Multiple Procedure Guidelines do not apply to codes
				  specifically identified as "Add-on/Additional Procedures, Global indicator
				  ZZZ".
The major or primary procedure is defined as the procedure
				  with the highest value and is the code that determines the followup days when a
				  surgery has multiple procedures. The second procedure is the procedure with the
				  next highest value, the third the next highest value, and so on. If, however,
				  the procedures are independently complex such as digits, tendons, nerves, or
				  artery repair, the multiple procedure rule would not apply. In such cases,
				  independent procedures would be billed at one hundred percent (100%) of their
				  listed value.
When performing multiple procedures with different global
				  period values during the same operative session, the global period value for
				  the session is the largest global period value.
57 Decision for Surgery: An evaluation and management service
				  that resulted in the initial decision to perform the surgery may be identified
				  by adding modifier 57 to the appropriate level of E/M service.
59 Distinct Procedural Service: Under certain circumstances,
				  it may be necessary to indicate that a procedure or service was distinct or
				  independent from other non-E/M services performed on the same day. Modifier 59
				  is used to identify procedures/services, other than E/M services, that are not
				  normally reported together, but are appropriate under the circumstances.
				  Documentation must support a different session, different procedure or surgery,
				  different site or organ system, separate incision/excision, separate lesion, or
				  separate injury (or area of injury in extensive injuries) not ordinarily
				  encountered or performed on the same day by the same individual. However, when
				  another already established modifier is appropriate it should be used rather
				  than modifier 59. Only if no more descriptive modifier is available, and the
				  use of modifier 59 best explains the circumstances, should modifier 59 be
				  used.
Note:
Modifier 59 should not be appended to an
				  E/M service. To report a separate and distinct E/M service with a non-E/M
				  service performed on the same date, see modifier 25.
Note:
If an epidural or peripheral nerve block
				  injection (62320-62327 or 64400-64530) for postoperative pain management is
				  reported separately on the same date of service as an anesthesia 0XXXX code,
modifier 59
shall be appended to the epidural or peripheral nerve
				  block injection code (62320-62327 or 64400-64530) to indicate that it was
				  administered for postoperative pain management. An epidural or peripheral nerve
				  block injection (6232062327 or 64400-64530) for postoperative pain management
				  in patients receiving general anesthesia, spinal (subarachnoid injection)
				  anesthesia, or postoperative pain management in patients receiving general
				  anesthesia, spinal (subarachnoid injection) anesthesia, or regional anesthesia
				  by epidural injection as described above may be administered preoperatively,
				  intraoperatively, or postoperatively.
62 Two Surgeons: By prior agreement, the total value of
				  services performed by two surgeons working together as primary surgeons may be
				  apportioned in relation to the responsibility and work done, provided the
				  patient is made aware of the fee distribution according to medical ethics. If
				  no apportionment is listed, the fee should be split evenly between the
				  co-surgeons. The total value may be increased by twenty-five percent (25%) in
				  lieu of the usual assistant's charge. Under these circumstances, the services
				  of each surgeon should be identified by adding this modifier 62 to the joint
				  procedure number(s) and valued as agreed upon. (Usual charges for surgical
				  assistance may be warranted if still another physician is required as part of
				  the surgical team.) The value of the procedure should be 125% of the customary
				  value listed. Payment of 125% of the maximum allowable would be divided between
				  the participating surgeons.
Two Surgeons - When 2 surgeons work together as primary
				  surgeons performing distinct part(s) of a procedure, each surgeon should report
				  his/her distinct operative work by adding modifier 62 to the procedure code and
				  any associated add-on codes(s) for that procedure as long as both surgeons
				  continue to work together as primary surgeons. Each surgeon should report the
				  co-surgery once using the same procedure code. If additional procedure(s)
				  (including add-on procedure(s)) are performed during the same surgical session,
				  separate code(s) may be reported with modifier 62 added.
Note:
If a co-surgeon acts as an assistant in
				  the performance of additional procedure(s), other than those reported with
				  modifier 62, during the same surgical session, those services may be reported
				  using separate procedure code(s) with modifier 80, 81, or 82 added, as
				  appropriate.
80 Assistant Surgeon: These services are valued at twenty
				  percent (20%) of the listed value of the surgical procedure(s).
81 Minimum Assistant Surgeon: These services are valued at
				  sixteen percent (16%) of the listed value of the surgical procedure(s).
82 Assistant Surgeon (when qualified resident surgeon not
				  available): These services are valued at sixteen percent (16%) of the listed
				  value of the surgical procedure(s).
AS Use the modifier AS for assistant at surgery services when
				  services are provided by a Physician Assistant (PA), Nurse Practitioner (NP),
				  or Clinical Nurse Specialist (CNS). These services are valued at fourteen
				  percent (14%) of the listed value of the surgical procedure(s). No further
				  adjustment for mid-level medical providers as mentioned in section C of the
				  Introduction shall be applied.
Note:
A Medical Doctor or Doctor of Osteopathic
				  Medicine should not submit the AS modifier. This modifier is only valid for use
				  by a PA, NP, and CNS when billing under their own provider number.
ARIZONA PHYSICIANS' FEE
							 SCHEDULE
Surgery Codes
							 2024
Surgery Conversion Factor
							 $72.00
Code
Category
FY24 NF
							 RVU
FY24 FAC
							 RVU
FY24 NF RBRVS Rate
FY24 FAC RBRVS
							 Rate
10004 00
Surgery
1.57
1.29
113.04
92.88
10005 00
Surgery
4.03
2.16
290.16
155.52
10006 00
Surgery
1.80
1.48
129.60
106.56
10007 00
Surgery
9.11
2.65
655.92
190.80
10008 00
Surgery
4.23
1.52
304.56
109.44
10009 00
Surgery
12.79
3.20
920.88
230.40
10010 00
Surgery
7.05
2.13
507.60
153.36
10011 00
Surgery
-
-
1224.72
600.48
10012 00
Surgery
-
-
740.16
362.88
10021 00
Surgery
3.04
1.63
218.88
117.36
10030 00
Surgery
18.99
3.97
1367.28
285.84
10035 00
Surgery
10.82
2.47
779.04
177.84
10036 00
Surgery
8.85
1.25
637.20
90.00
10040 00
Surgery
3.50
1.55
252.00
111.60
10060 00
Surgery
3.83
3.22
275.76
231.84
10061 00
Surgery
6.47
5.56
465.84
400.32
10080 00
Surgery
7.54
3.18
542.88
228.96
10081 00
Surgery
10.35
5.15
745.20
370.80
10120 00
Surgery
4.59
3.19
330.48
229.68
10121 00
Surgery
7.97
5.52
573.84
397.44
10140 00
Surgery
5.12
3.57
368.64
257.04
10160 00
Surgery
3.91
2.91
281.52
209.52
10180 00
Surgery
7.92
5.39
570.24
388.08
11000 00
Surgery
1.78
0.82
128.16
59.04
11001 00
Surgery
0.82
0.44
59.04
31.68
11004 00
Surgery
16.84
16.84
1212.48
1212.48
11005 00
Surgery
22.95
22.95
1652.40
1652.40
11006 00
Surgery
20.76
20.76
1494.72
1494.72
11008 00
Surgery
8.08
8.08
581.76
581.76
11010 00
Surgery
13.44
8.26
967.68
594.72
11011 00
Surgery
15.01
8.88
1080.72
639.36
11012 00
Surgery
19.54
12.40
1406.88
892.80
11042 00
Surgery
3.90
1.81
280.80
130.32
11043 00
Surgery
6.99
4.58
503.28
329.76
11044 00
Surgery
9.35
6.72
673.20
483.84
11045 00
Surgery
1.20
0.75
86.40
54.00
11046 00
Surgery
2.19
1.63
157.68
117.36
11047 00
Surgery
3.62
2.88
260.64
207.36
11055 00
Surgery
2.14
0.46
154.08
33.12
11056 00
Surgery
2.48
0.65
178.56
46.80
11057 00
Surgery
2.71
0.85
195.12
61.20
11102 00
Surgery
3.02
1.12
217.44
80.64
11103 00
Surgery
1.51
0.65
108.72
46.80
11104 00
Surgery
3.76
1.39
270.72
100.08
11105 00
Surgery
1.79
0.76
128.88
54.72
11106 00
Surgery
4.67
1.68
336.24
120.96
11107 00
Surgery
2.14
0.91
154.08
65.52
11200 00
Surgery
2.79
2.31
200.88
166.32
11201 00
Surgery
0.55
0.48
39.60
34.56
11300 00
Surgery
3.02
1.01
217.44
72.72
11301 00
Surgery
3.65
1.52
262.80
109.44
11302 00
Surgery
4.12
1.77
296.64
127.44
11303 00
Surgery
4.56
2.11
328.32
151.92
11305 00
Surgery
3.16
1.11
227.52
79.92
11306 00
Surgery
3.68
1.45
264.96
104.40
11307 00
Surgery
4.16
1.85
299.52
133.20
11308 00
Surgery
4.38
2.07
315.36
149.04
11310 00
Surgery
3.48
1.35
250.56
97.20
11311 00
Surgery
4.11
1.86
295.92
133.92
11312 00
Surgery
4.67
2.20
336.24
158.40
11313 00
Surgery
5.44
2.85
391.68
205.20
11400 00
Surgery
3.87
2.55
278.64
183.60
11401 00
Surgery
4.71
3.19
339.12
229.68
11402 00
Surgery
5.19
3.49
373.68
251.28
11403 00
Surgery
5.98
4.52
430.56
325.44
11404 00
Surgery
6.77
4.97
487.44
357.84
11406 00
Surgery
9.63
7.49
693.36
539.28
11420 00
Surgery
3.82
2.48
275.04
178.56
11421 00
Surgery
4.82
3.29
347.04
236.88
11422 00
Surgery
5.41
4.10
389.52
295.20
11423 00
Surgery
6.20
4.74
446.40
341.28
11424 00
Surgery
7.18
5.46
516.96
393.12
11426 00
Surgery
9.89
8.06
712.08
580.32
11440 00
Surgery
4.33
3.24
311.76
233.28
11441 00
Surgery
5.26
4.03
378.72
290.16
11442 00
Surgery
5.84
4.44
420.48
319.68
11443 00
Surgery
6.88
5.40
495.36
388.80
11444 00
Surgery
8.54
6.79
614.88
488.88
11446 00
Surgery
11.57
9.53
833.04
686.16
11450 00
Surgery
12.98
7.94
934.56
571.68
11451 00
Surgery
15.81
10.02
1138.32
721.44
11462 00
Surgery
12.62
7.56
908.64
544.32
11463 00
Surgery
16.01
10.07
1152.72
725.04
11470 00
Surgery
13.72
8.68
987.84
624.96
11471 00
Surgery
16.45
10.62
1184.40
764.64
11600 00
Surgery
5.95
3.68
428.40
264.96
11601 00
Surgery
6.89
4.45
496.08
320.40
11602 00
Surgery
7.37
4.83
530.64
347.76
11603 00
Surgery
8.39
5.77
604.08
415.44
11604 00
Surgery
9.35
6.35
673.20
457.20
11606 00
Surgery
13.49
9.46
971.28
681.12
11620 00
Surgery
5.98
3.71
430.56
267.12
11621 00
Surgery
6.91
4.47
497.52
321.84
11622 00
Surgery
7.63
5.07
549.36
365.04
11623 00
Surgery
8.91
6.25
641.52
450.00
11624 00
Surgery
10.15
7.11
730.80
511.92
11626 00
Surgery
12.21
8.69
879.12
625.68
11640 00
Surgery
6.13
3.81
441.36
274.32
11641 00
Surgery
7.14
4.66
514.08
335.52
11642 00
Surgery
8.08
5.45
581.76
392.40
11643 00
Surgery
9.48
6.79
682.56
488.88
11644 00
Surgery
11.70
8.41
842.40
605.52
11646 00
Surgery
15.17
11.61
1092.24
835.92
11719 00
Surgery
0.43
0.22
30.96
15.84
11720 00
Surgery
0.99
0.42
71.28
30.24
11721 00
Surgery
1.34
0.70
96.48
50.40
11730 00
Surgery
3.46
1.60
249.12
115.20
11732 00
Surgery
0.99
0.50
71.28
36.00
11740 00
Surgery
1.74
0.97
125.28
69.84
11750 00
Surgery
4.84
3.06
348.48
220.32
11755 00
Surgery
3.67
1.80
264.24
129.60
11760 00
Surgery
5.56
3.29
400.32
236.88
11762 00
Surgery
8.66
5.61
623.52
403.92
11765 00
Surgery
5.00
2.80
360.00
201.60
11770 00
Surgery
10.67
5.60
768.24
403.20
11771 00
Surgery
19.00
13.62
1368.00
980.64
11772 00
Surgery
23.27
17.51
1675.44
1260.72
11900 00
Surgery
1.73
0.89
124.56
64.08
11901 00
Surgery
2.11
1.35
151.92
97.20
11920 00
Surgery
6.04
3.41
434.88
245.52
11921 00
Surgery
6.67
3.91
480.24
281.52
11922 00
Surgery
1.84
0.86
132.48
61.92
11950 00
Surgery
2.46
1.55
177.12
111.60
11951 00
Surgery
3.27
2.17
235.44
156.24
11952 00
Surgery
4.37
3.05
314.64
219.60
11954 00
Surgery
4.81
3.33
346.32
239.76
11960 00
Surgery
30.59
30.59
2202.48
2202.48
11970 00
Surgery
16.95
16.95
1220.40
1220.40
11971 00
Surgery
16.70
16.70
1202.40
1202.40
11976 00
Surgery
4.37
2.77
314.64
199.44
11980 00
Surgery
2.83
1.65
203.76
118.80
11981 00
Surgery
3.03
1.87
218.16
134.64
11982 00
Surgery
3.34
2.18
240.48
156.96
11983 00
Surgery
4.27
3.08
307.44
221.76
12001 00
Surgery
2.84
1.34
204.48
96.48
12002 00
Surgery
3.44
1.76
247.68
126.72
12004 00
Surgery
4.01
2.20
288.72
158.40
12005 00
Surgery
5.34
2.83
384.48
203.76
12006 00
Surgery
6.16
3.46
443.52
249.12
12007 00
Surgery
6.99
4.30
503.28
309.60
12011 00
Surgery
3.38
1.66
243.36
119.52
12013 00
Surgery
3.52
1.73
253.44
124.56
12014 00
Surgery
4.30
2.24
309.60
161.28
12015 00
Surgery
5.19
2.81
373.68
202.32
12016 00
Surgery
6.58
3.81
473.76
274.32
12017 00
Surgery
4.60
4.60
331.20
331.20
12018 00
Surgery
5.18
5.18
372.96
372.96
12020 00
Surgery
9.03
5.66
650.16
407.52
12021 00
Surgery
5.35
4.25
385.20
306.00
12031 00
Surgery
7.91
4.54
569.52
326.88
12032 00
Surgery
9.14
5.70
658.08
410.40
12034 00
Surgery
10.07
6.15
725.04
442.80
12035 00
Surgery
11.71
7.24
843.12
521.28
12036 00
Surgery
13.05
8.47
939.60
609.84
12037 00
Surgery
14.66
9.84
1055.52
708.48
12041 00
Surgery
7.93
4.35
570.96
313.20
12042 00
Surgery
9.33
5.86
671.76
421.92
12044 00
Surgery
11.52
6.42
829.44
462.24
12045 00
Surgery
12.44
8.22
895.68
591.84
12046 00
Surgery
15.07
9.58
1085.04
689.76
12047 00
Surgery
16.50
10.62
1188.00
764.64
12051 00
Surgery
8.53
5.08
614.16
365.76
12052 00
Surgery
9.49
5.97
683.28
429.84
12053 00
Surgery
10.93
6.44
786.96
463.68
12054 00
Surgery
11.51
6.59
828.72
474.48
12055 00
Surgery
15.13
9.05
1089.36
651.60
12056 00
Surgery
17.42
11.52
1254.24
829.44
12057 00
Surgery
18.23
12.57
1312.56
905.04
13100 00
Surgery
10.23
5.98
736.56
430.56
13101 00
Surgery
11.91
7.36
857.52
529.92
13102 00
Surgery
3.49
2.13
251.28
153.36
13120 00
Surgery
10.66
6.91
767.52
497.52
13121 00
Surgery
12.76
7.68
918.72
552.96
13122 00
Surgery
3.80
2.45
273.60
176.40
13131 00
Surgery
11.65
7.21
838.80
519.12
13132 00
Surgery
14.12
9.00
1016.64
648.00
13133 00
Surgery
5.04
3.72
362.88
267.84
13151 00
Surgery
12.69
8.28
913.68
596.16
13152 00
Surgery
14.90
9.98
1072.80
718.56
13153 00
Surgery
5.54
4.05
398.88
291.60
13160 00
Surgery
23.89
23.89
1720.08
1720.08
14000 00
Surgery
19.23
15.20
1384.56
1094.40
14001 00
Surgery
24.48
19.66
1762.56
1415.52
14020 00
Surgery
21.24
17.06
1529.28
1228.32
14021 00
Surgery
26.15
21.27
1882.80
1531.44
14040 00
Surgery
22.92
18.73
1650.24
1348.56
14041 00
Surgery
27.82
22.84
2003.04
1644.48
14060 00
Surgery
23.16
19.95
1667.52
1436.40
14061 00
Surgery
30.03
24.53
2162.16
1766.16
14301 00
Surgery
32.59
26.05
2346.48
1875.60
14302 00
Surgery
6.40
6.40
460.80
460.80
14350 00
Surgery
20.29
20.29
1460.88
1460.88
15002 00
Surgery
10.30
6.53
741.60
470.16
15003 00
Surgery
2.08
1.34
149.76
96.48
15004 00
Surgery
11.76
7.71
846.72
555.12
15005 00
Surgery
3.48
2.66
250.56
191.52
15040 00
Surgery
7.84
3.74
564.48
269.28
15050 00
Surgery
17.67
13.78
1272.24
992.16
15100 00
Surgery
26.13
21.51
1881.36
1548.72
15101 00
Surgery
5.56
3.30
400.32
237.60
15110 00
Surgery
25.07
21.48
1805.04
1546.56
15111 00
Surgery
3.39
3.02
244.08
217.44
15115 00
Surgery
24.32
20.90
1751.04
1504.80
15116 00
Surgery
4.59
4.11
330.48
295.92
15120 00
Surgery
25.46
20.73
1833.12
1492.56
15121 00
Surgery
6.20
3.92
446.40
282.24
15130 00
Surgery
21.66
17.97
1559.52
1293.84
15131 00
Surgery
2.91
2.65
209.52
190.80
15135 00
Surgery
26.22
22.73
1887.84
1636.56
15136 00
Surgery
2.87
2.65
206.64
190.80
15150 00
Surgery
21.23
19.25
1528.56
1386.00
15151 00
Surgery
3.54
3.24
254.88
233.28
15152 00
Surgery
4.41
4.13
317.52
297.36
15155 00
Surgery
23.87
21.86
1718.64
1573.92
15156 00
Surgery
4.77
4.47
343.44
321.84
15157 00
Surgery
5.30
4.87
381.60
350.64
15200 00
Surgery
25.32
20.25
1823.04
1458.00
15201 00
Surgery
4.19
2.27
301.68
163.44
15220 00
Surgery
23.21
18.34
1671.12
1320.48
15221 00
Surgery
3.87
2.05
278.64
147.60
15240 00
Surgery
28.01
23.92
2016.72
1722.24
15241 00
Surgery
5.23
3.18
376.56
228.96
15260 00
Surgery
30.11
25.35
2167.92
1825.20
15261 00
Surgery
6.14
4.02
442.08
289.44
15271 00
Surgery
4.63
2.50
333.36
180.00
15272 00
Surgery
0.74
0.50
53.28
36.00
15273 00
Surgery
9.26
5.80
666.72
417.60
15274 00
Surgery
2.43
1.32
174.96
95.04
15275 00
Surgery
4.77
2.77
343.44
199.44
15276 00
Surgery
0.97
0.74
69.84
53.28
15277 00
Surgery
10.22
6.61
735.84
475.92
15278 00
Surgery
2.84
1.65
204.48
118.80
15570 00
Surgery
27.28
21.90
1964.16
1576.80
15572 00
Surgery
26.57
22.15
1913.04
1594.80
15574 00
Surgery
26.67
22.23
1920.24
1600.56
15576 00
Surgery
23.49
19.42
1691.28
1398.24
15600 00
Surgery
10.22
6.43
735.84
462.96
15610 00
Surgery
11.12
7.40
800.64
532.80
15620 00
Surgery
13.51
9.87
972.72
710.64
15630 00
Surgery
13.97
10.38
1005.84
747.36
15650 00
Surgery
16.36
12.20
1177.92
878.40
15730 00
Surgery
42.67
27.39
3072.24
1972.08
15731 00
Surgery
33.77
29.92
2431.44
2154.24
15733 00
Surgery
30.85
30.85
2221.20
2221.20
15734 00
Surgery
45.01
45.01
3240.72
3240.72
15736 00
Surgery
36.57
36.57
2633.04
2633.04
15738 00
Surgery
37.99
37.99
2735.28
2735.28
15740 00
Surgery
30.54
25.30
2198.88
1821.60
15750 00
Surgery
28.10
28.10
2023.20
2023.20
15756 00
Surgery
68.22
68.22
4911.84
4911.84
15757 00
Surgery
67.77
67.77
4879.44
4879.44
15758 00
Surgery
67.49
67.49
4859.28
4859.28
15760 00
Surgery
25.48
20.97
1834.56
1509.84
15769 00
Surgery
14.48
14.48
1042.56
1042.56
15770 00
Surgery
20.31
20.31
1462.32
1462.32
15771 00
Surgery
18.43
15.44
1326.96
1111.68
15772 00
Surgery
5.75
4.41
414.00
317.52
15773 00
Surgery
17.98
15.11
1294.56
1087.92
15774 00
Surgery
5.59
4.26
402.48
306.72
15775 00
Surgery
11.30
7.61
813.60
547.92
15776 00
Surgery
15.28
10.43
1100.16
750.96
15777 00
Surgery
6.37
6.37
458.64
458.64
15778 00
Surgery
11.49
11.49
827.28
827.28
15780 00
Surgery
25.50
19.93
1836.00
1434.96
15781 00
Surgery
16.13
12.85
1161.36
925.20
15782 00
Surgery
14.64
11.14
1054.08
802.08
15783 00
Surgery
13.58
10.70
977.76
770.40
15786 00
Surgery
6.90
4.04
496.80
290.88
15787 00
Surgery
0.90
0.49
64.80
35.28
15788 00
Surgery
11.73
6.54
844.56
470.88
15789 00
Surgery
16.06
12.36
1156.32
889.92
15792 00
Surgery
10.11
6.36
727.92
457.92
15793 00
Surgery
14.33
10.77
1031.76
775.44
15819 00
Surgery
24.08
24.08
1733.76
1733.76
15820 00
Surgery
17.44
15.48
1255.68
1114.56
15821 00
Surgery
18.67
16.51
1344.24
1188.72
15822 00
Surgery
13.91
11.99
1001.52
863.28
15823 00
Surgery
18.70
16.52
1346.40
1189.44
15824 00
Surgery
-
-
4861.44
3451.68
15825 00
Surgery
-
-
8507.52
6040.08
15826 00
Surgery
0.00
0.00
BR
BR
15828 00
Surgery
-
-
6886.80
4889.52
15829 00
Surgery
-
-
8223.84
5839.20
15830 00
Surgery
35.19
35.19
2533.68
2533.68
15832 00
Surgery
27.73
27.73
1996.56
1996.56
15833 00
Surgery
26.39
26.39
1900.08
1900.08
15834 00
Surgery
26.86
26.86
1933.92
1933.92
15835 00
Surgery
27.99
27.99
2015.28
2015.28
15836 00
Surgery
24.00
24.00
1728.00
1728.00
15837 00
Surgery
26.14
21.57
1882.08
1553.04
15838 00
Surgery
19.58
19.58
1409.76
1409.76
15839 00
Surgery
26.91
22.26
1937.52
1602.72
15840 00
Surgery
30.38
30.38
2187.36
2187.36
15841 00
Surgery
53.29
53.29
3836.88
3836.88
15842 00
Surgery
80.61
80.61
5803.92
5803.92
15845 00
Surgery
31.94
31.94
2299.68
2299.68
15847 00
Surgery
-
-
1519.20
1078.56
15851 00
Surgery
1.70
1.95
122.40
140.40
15852 00
Surgery
1.33
1.33
95.76
95.76
15853 00
Surgery
0.35
0.35
25.20
25.20
15854 00
Surgery
0.48
0.48
34.56
34.56
15860 00
Surgery
3.16
3.16
227.52
227.52
15876 00
Surgery
-
-
1880.64
1335.60
15877 00
Surgery
-
-
2458.08
1745.28
15878 00
Surgery
0.00
0.00
BR
BR
15879 00
Surgery
-
-
3458.88
2455.92
15920 00
Surgery
19.05
19.05
1371.60
1371.60
15922 00
Surgery
24.02
24.02
1729.44
1729.44
15931 00
Surgery
21.25
21.25
1530.00
1530.00
15933 00
Surgery
26.31
26.31
1894.32
1894.32
15934 00
Surgery
29.62
29.62
2132.64
2132.64
15935 00
Surgery
34.73
34.73
2500.56
2500.56
15936 00
Surgery
27.01
27.01
1944.72
1944.72
15937 00
Surgery
31.15
31.15
2242.80
2242.80
15940 00
Surgery
21.38
21.38
1539.36
1539.36
15941 00
Surgery
27.94
27.94
2011.68
2011.68
15944 00
Surgery
28.12
28.12
2024.64
2024.64
15945 00
Surgery
30.70
30.70
2210.40
2210.40
15946 00
Surgery
48.34
48.34
3480.48
3480.48
15950 00
Surgery
19.21
19.21
1383.12
1383.12
15951 00
Surgery
27.07
27.07
1949.04
1949.04
15952 00
Surgery
27.58
27.58
1985.76
1985.76
15953 00
Surgery
30.37
30.37
2186.64
2186.64
15956 00
Surgery
35.69
35.69
2569.68
2569.68
15958 00
Surgery
35.30
35.30
2541.60
2541.60
15999 00
Surgery
0.00
0.00
BR
BR
16000 00
Surgery
2.40
1.36
172.80
97.92
16020 00
Surgery
2.59
1.68
186.48
120.96
16025 00
Surgery
4.74
3.34
341.28
240.48
16030 00
Surgery
5.94
3.95
427.68
284.40
16035 00
Surgery
5.83
5.83
419.76
419.76
16036 00
Surgery
2.45
2.45
176.40
176.40
17000 00
Surgery
2.04
1.66
146.88
119.52
17003 00
Surgery
0.20
0.06
14.40
4.32
17004 00
Surgery
5.04
2.95
362.88
212.40
17106 00
Surgery
10.40
8.31
748.80
598.32
17107 00
Surgery
13.49
10.81
971.28
778.32
17108 00
Surgery
19.17
15.86
1380.24
1141.92
17110 00
Surgery
3.43
2.07
246.96
149.04
17111 00
Surgery
4.01
2.51
288.72
180.72
17250 00
Surgery
2.62
1.13
188.64
81.36
17260 00
Surgery
3.01
2.12
216.72
152.64
17261 00
Surgery
4.48
2.62
322.56
188.64
17262 00
Surgery
5.38
3.31
387.36
238.32
17263 00
Surgery
5.82
3.66
419.04
263.52
17264 00
Surgery
6.24
3.91
449.28
281.52
17266 00
Surgery
7.09
4.58
510.48
329.76
17270 00
Surgery
4.52
2.87
325.44
206.64
17271 00
Surgery
5.02
3.15
361.44
226.80
17272 00
Surgery
5.69
3.63
409.68
261.36
17273 00
Surgery
6.31
4.10
454.32
295.20
17274 00
Surgery
7.37
5.00
530.64
360.00
17276 00
Surgery
8.55
6.03
615.60
434.16
17280 00
Surgery
4.25
2.61
306.00
187.92
17281 00
Surgery
5.43
3.54
390.96
254.88
17282 00
Surgery
6.20
4.08
446.40
293.76
17283 00
Surgery
7.33
5.10
527.76
367.20
17284 00
Surgery
8.32
5.93
599.04
426.96
17286 00
Surgery
10.67
8.05
768.24
579.60
17311 00
Surgery
20.45
10.52
1472.40
757.44
17312 00
Surgery
12.41
5.60
893.52
403.20
17313 00
Surgery
19.22
9.44
1383.84
679.68
17314 00
Surgery
11.89
5.19
856.08
373.68
17315 00
Surgery
2.40
1.48
172.80
106.56
17340 00
Surgery
1.58
1.47
113.76
105.84
17360 00
Surgery
3.71
2.79
267.12
200.88
17380 00
Surgery
-
-
97.20
69.12
17999 00
Surgery
0.00
0.00
BR
BR
19000 00
Surgery
3.01
1.25
216.72
90.00
19001 00
Surgery
0.79
0.62
56.88
44.64
19020 00
Surgery
14.18
9.52
1020.96
685.44
19030 00
Surgery
4.91
2.23
353.52
160.56
19081 00
Surgery
14.85
4.79
1069.20
344.88
19082 00
Surgery
11.41
2.40
821.52
172.80
19083 00
Surgery
14.80
4.53
1065.60
326.16
19084 00
Surgery
11.23
2.26
808.56
162.72
19085 00
Surgery
22.67
5.26
1632.24
378.72
19086 00
Surgery
17.53
2.62
1262.16
188.64
19100 00
Surgery
4.48
2.06
322.56
148.32
19101 00
Surgery
9.88
6.74
711.36
485.28
19105 00
Surgery
68.01
6.27
4896.72
451.44
19110 00
Surgery
14.71
10.70
1059.12
770.40
19112 00
Surgery
13.93
9.82
1002.96
707.04
19120 00
Surgery
15.73
12.66
1132.56
911.52
19125 00
Surgery
17.33
14.00
1247.76
1008.00
19126 00
Surgery
4.77
4.77
343.44
343.44
19281 00
Surgery
7.21
2.89
519.12
208.08
19282 00
Surgery
5.10
1.45
367.20
104.40
19283 00
Surgery
7.73
2.92
556.56
210.24
19284 00
Surgery
5.65
1.46
406.80
105.12
19285 00
Surgery
10.91
2.47
785.52
177.84
19286 00
Surgery
8.91
1.24
641.52
89.28
19287 00
Surgery
18.82
3.69
1355.04
265.68
19288 00
Surgery
14.49
1.84
1043.28
132.48
19294 00
Surgery
4.89
4.89
352.08
352.08
19296 00
Surgery
107.75
6.28
7758.00
452.16
19297 00
Surgery
2.79
2.79
200.88
200.88
19298 00
Surgery
26.05
9.45
1875.60
680.40
19300 00
Surgery
17.41
13.07
1253.52
941.04
19301 00
Surgery
19.93
19.93
1434.96
1434.96
19302 00
Surgery
27.36
27.36
1969.92
1969.92
19303 00
Surgery
28.88
28.88
2079.36
2079.36
19305 00
Surgery
34.63
34.63
2493.36
2493.36
19306 00
Surgery
36.80
36.80
2649.60
2649.60
19307 00
Surgery
35.55
35.55
2559.60
2559.60
19316 00
Surgery
23.86
23.86
1717.92
1717.92
19318 00
Surgery
32.83
32.83
2363.76
2363.76
19325 00
Surgery
18.56
18.56
1336.32
1336.32
19328 00
Surgery
16.71
16.71
1203.12
1203.12
19330 00
Surgery
19.46
19.46
1401.12
1401.12
19340 00
Surgery
22.87
22.87
1646.64
1646.64
19342 00
Surgery
22.93
22.93
1650.96
1650.96
19350 00
Surgery
25.05
20.29
1803.60
1460.88
19355 00
Surgery
22.76
18.59
1638.72
1338.48
19357 00
Surgery
34.91
34.91
2513.52
2513.52
19361 00
Surgery
46.68
46.68
3360.96
3360.96
19364 00
Surgery
81.23
81.23
5848.56
5848.56
19367 00
Surgery
52.99
52.99
3815.28
3815.28
19368 00
Surgery
64.81
64.81
4666.32
4666.32
19369 00
Surgery
60.23
60.23
4336.56
4336.56
19370 00
Surgery
20.25
20.25
1458.00
1458.00
19371 00
Surgery
21.43
21.43
1542.96
1542.96
19380 00
Surgery
24.31
24.31
1750.32
1750.32
19396 00
Surgery
8.17
4.27
588.24
307.44
19499 00
Surgery
0.00
0.00
BR
BR
20100 00
Surgery
17.99
17.99
1295.28
1295.28
20101 00
Surgery
17.25
6.30
1242.00
453.60
20102 00
Surgery
18.40
7.71
1324.80
555.12
20103 00
Surgery
16.96
10.38
1221.12
747.36
20150 00
Surgery
30.28
30.28
2180.16
2180.16
20200 00
Surgery
6.50
2.86
468.00
205.92
20205 00
Surgery
9.15
4.66
658.80
335.52
20206 00
Surgery
6.55
1.69
471.60
121.68
20220 00
Surgery
6.93
2.57
498.96
185.04
20225 00
Surgery
11.32
3.81
815.04
274.32
20240 00
Surgery
4.18
4.18
300.96
300.96
20245 00
Surgery
10.25
10.25
738.00
738.00
20250 00
Surgery
11.84
11.84
852.48
852.48
20251 00
Surgery
12.66
12.66
911.52
911.52
20500 00
Surgery
3.73
2.69
268.56
193.68
20501 00
Surgery
4.23
1.07
304.56
77.04
20520 00
Surgery
6.58
4.47
473.76
321.84
20525 00
Surgery
13.95
7.45
1004.40
536.40
20526 00
Surgery
2.48
1.70
178.56
122.40
20527 00
Surgery
2.64
1.97
190.08
141.84
20550 00
Surgery
1.74
1.16
125.28
83.52
20551 00
Surgery
1.73
1.15
124.56
82.80
20552 00
Surgery
1.58
1.10
113.76
79.20
20553 00
Surgery
1.82
1.25
131.04
90.00
20555 00
Surgery
10.00
10.00
720.00
720.00
20560 00
Surgery
0.77
0.44
55.44
31.68
20561 00
Surgery
1.11
0.66
79.92
47.52
20600 00
Surgery
1.62
1.07
116.64
77.04
20604 00
Surgery
2.49
1.36
179.28
97.92
20605 00
Surgery
1.66
1.10
119.52
79.20
20606 00
Surgery
2.71
1.55
195.12
111.60
20610 00
Surgery
1.96
1.36
141.12
97.92
20611 00
Surgery
2.99
1.76
215.28
126.72
20612 00
Surgery
1.96
1.23
141.12
88.56
20615 00
Surgery
7.67
4.90
552.24
352.80
20650 00
Surgery
7.01
5.06
504.72
364.32
20660 00
Surgery
7.20
7.20
518.40
518.40
20661 00
Surgery
16.06
16.06
1156.32
1156.32
20662 00
Surgery
15.92
15.92
1146.24
1146.24
20663 00
Surgery
14.71
14.71
1059.12
1059.12
20664 00
Surgery
27.23
27.23
1960.56
1960.56
20665 00
Surgery
3.55
2.94
255.60
211.68
20670 00
Surgery
10.68
4.38
768.96
315.36
20680 00
Surgery
18.11
12.71
1303.92
915.12
20690 00
Surgery
18.04
18.04
1298.88
1298.88
20692 00
Surgery
34.09
34.09
2454.48
2454.48
20693 00
Surgery
13.58
13.58
977.76
977.76
20694 00
Surgery
13.10
10.42
943.20
750.24
20696 00
Surgery
35.09
35.09
2526.48
2526.48
20697 00
Surgery
53.10
53.10
3823.20
3823.20
20700 00
Surgery
2.52
2.52
181.44
181.44
20701 00
Surgery
1.91
1.91
137.52
137.52
20702 00
Surgery
4.24
4.24
305.28
305.28
20703 00
Surgery
3.10
3.10
223.20
223.20
20704 00
Surgery
4.46
4.46
321.12
321.12
20705 00
Surgery
3.69
3.69
265.68
265.68
20802 00
Surgery
82.20
82.20
5918.40
5918.40
20805 00
Surgery
97.57
97.57
7025.04
7025.04
20808 00
Surgery
117.64
117.64
8470.08
8470.08
20816 00
Surgery
61.54
61.54
4430.88
4430.88
20822 00
Surgery
53.24
53.24
3833.28
3833.28
20824 00
Surgery
61.66
61.66
4439.52
4439.52
20827 00
Surgery
54.65
54.65
3934.80
3934.80
20838 00
Surgery
83.42
83.42
6006.24
6006.24
20900 00
Surgery
11.56
5.39
832.32
388.08
20902 00
Surgery
8.22
8.22
591.84
591.84
20910 00
Surgery
14.55
14.55
1047.60
1047.60
20912 00
Surgery
14.62
14.62
1052.64
1052.64
20920 00
Surgery
12.13
12.13
873.36
873.36
20922 00
Surgery
18.63
15.11
1341.36
1087.92
20924 00
Surgery
15.32
15.32
1103.04
1103.04
20930 00
Surgery
-
-
534.96
491.76
20931 00
Surgery
3.30
3.30
237.60
237.60
20932 00
Surgery
22.43
22.43
1614.96
1614.96
20933 00
Surgery
20.57
20.57
1481.04
1481.04
20934 00
Surgery
22.41
22.41
1613.52
1613.52
20936 00
Surgery
-
-
707.04
650.88
20937 00
Surgery
4.98
4.98
358.56
358.56
20938 00
Surgery
5.49
5.49
395.28
395.28
20939 00
Surgery
2.08
2.08
149.76
149.76
20950 00
Surgery
7.96
2.66
573.12
191.52
20955 00
Surgery
73.00
73.00
5256.00
5256.00
20956 00
Surgery
79.03
79.03
5690.16
5690.16
20957 00
Surgery
82.35
82.35
5929.20
5929.20
20962 00
Surgery
80.13
80.13
5769.36
5769.36
20969 00
Surgery
81.12
81.12
5840.64
5840.64
20970 00
Surgery
85.25
85.25
6138.00
6138.00
20972 00
Surgery
85.00
85.00
6120.00
6120.00
20973 00
Surgery
89.77
89.77
6463.44
6463.44
20974 00
Surgery
2.53
1.54
182.16
110.88
20975 00
Surgery
5.29
5.29
380.88
380.88
20979 00
Surgery
1.72
0.95
123.84
68.40
20982 00
Surgery
102.91
10.82
7409.52
779.04
20983 00
Surgery
149.77
10.06
10783.44
724.32
20985 00
Surgery
4.30
4.30
309.60
309.60
20999 00
Surgery
0.00
0.00
BR
BR
21010 00
Surgery
22.21
22.21
1599.12
1599.12
21011 00
Surgery
11.30
7.91
813.60
569.52
21012 00
Surgery
10.29
10.29
740.88
740.88
21013 00
Surgery
16.16
12.17
1163.52
876.24
21014 00
Surgery
15.78
15.78
1136.16
1136.16
21015 00
Surgery
21.04
21.04
1514.88
1514.88
21016 00
Surgery
30.30
30.30
2181.60
2181.60
21025 00
Surgery
23.85
19.89
1717.20
1432.08
21026 00
Surgery
16.12
12.91
1160.64
929.52
21029 00
Surgery
23.31
18.87
1678.32
1358.64
21030 00
Surgery
13.77
10.84
991.44
780.48
21031 00
Surgery
11.52
8.20
829.44
590.40
21032 00
Surgery
11.20
7.85
806.40
565.20
21034 00
Surgery
39.00
33.79
2808.00
2432.88
21040 00
Surgery
13.91
10.88
1001.52
783.36
21044 00
Surgery
25.95
25.95
1868.40
1868.40
21045 00
Surgery
36.00
36.00
2592.00
2592.00
21046 00
Surgery
29.57
29.57
2129.04
2129.04
21047 00
Surgery
36.22
36.22
2607.84
2607.84
21048 00
Surgery
29.83
29.83
2147.76
2147.76
21049 00
Surgery
34.42
34.42
2478.24
2478.24
21050 00
Surgery
25.86
25.86
1861.92
1861.92
21060 00
Surgery
23.44
23.44
1687.68
1687.68
21070 00
Surgery
18.46
18.46
1329.12
1329.12
21073 00
Surgery
11.45
7.21
824.40
519.12
21076 00
Surgery
25.95
21.07
1868.40
1517.04
21077 00
Surgery
63.47
51.84
4569.84
3732.48
21079 00
Surgery
43.54
34.85
3134.88
2509.20
21080 00
Surgery
49.67
39.32
3576.24
2831.04
21081 00
Surgery
45.96
36.10
3309.12
2599.20
21082 00
Surgery
42.93
33.30
3090.96
2397.60
21083 00
Surgery
40.79
30.78
2936.88
2216.16
21084 00
Surgery
46.54
35.61
3350.88
2563.92
21085 00
Surgery
20.42
14.46
1470.24
1041.12
21086 00
Surgery
47.13
38.20
3393.36
2750.40
21087 00
Surgery
47.13
38.20
3393.36
2750.40
21088 00
Surgery
-
-
2025.36
1863.36
21089 00
Surgery
0.00
0.00
BR
BR
21100 00
Surgery
18.59
10.72
1338.48
771.84
21110 00
Surgery
25.71
21.32
1851.12
1535.04
21116 00
Surgery
6.36
1.32
457.92
95.04
21120 00
Surgery
19.94
15.31
1435.68
1102.32
21121 00
Surgery
19.00
15.90
1368.00
1144.80
21122 00
Surgery
22.51
22.51
1620.72
1620.72
21123 00
Surgery
25.28
25.28
1820.16
1820.16
21125 00
Surgery
77.47
20.01
5577.84
1440.72
21127 00
Surgery
119.93
23.18
8634.96
1668.96
21137 00
Surgery
22.61
22.61
1627.92
1627.92
21138 00
Surgery
27.49
27.49
1979.28
1979.28
21139 00
Surgery
32.70
32.70
2354.40
2354.40
21141 00
Surgery
39.75
39.75
2862.00
2862.00
21142 00
Surgery
40.80
40.80
2937.60
2937.60
21143 00
Surgery
42.04
42.04
3026.88
3026.88
21145 00
Surgery
46.17
46.17
3324.24
3324.24
21146 00
Surgery
48.22
48.22
3471.84
3471.84
21147 00
Surgery
50.72
50.72
3651.84
3651.84
21150 00
Surgery
49.26
49.26
3546.72
3546.72
21151 00
Surgery
54.20
54.20
3902.40
3902.40
21154 00
Surgery
58.34
58.34
4200.48
4200.48
21155 00
Surgery
64.70
64.70
4658.40
4658.40
21159 00
Surgery
77.46
77.46
5577.12
5577.12
21160 00
Surgery
83.99
83.99
6047.28
6047.28
21172 00
Surgery
64.35
64.35
4633.20
4633.20
21175 00
Surgery
66.01
66.01
4752.72
4752.72
21179 00
Surgery
45.49
45.49
3275.28
3275.28
21180 00
Surgery
50.77
50.77
3655.44
3655.44
21181 00
Surgery
22.30
22.30
1605.60
1605.60
21182 00
Surgery
63.19
63.19
4549.68
4549.68
21183 00
Surgery
68.72
68.72
4947.84
4947.84
21184 00
Surgery
73.91
73.91
5321.52
5321.52
21188 00
Surgery
47.05
47.05
3387.60
3387.60
21193 00
Surgery
36.70
36.70
2642.40
2642.40
21194 00
Surgery
42.42
42.42
3054.24
3054.24
21195 00
Surgery
39.94
39.94
2875.68
2875.68
21196 00
Surgery
42.66
42.66
3071.52
3071.52
21198 00
Surgery
30.20
30.20
2174.40
2174.40
21199 00
Surgery
30.31
30.31
2182.32
2182.32
21206 00
Surgery
29.00
29.00
2088.00
2088.00
21208 00
Surgery
48.96
22.09
3525.12
1590.48
21209 00
Surgery
23.87
18.21
1718.64
1311.12
21210 00
Surgery
52.64
22.74
3790.08
1637.28
21215 00
Surgery
121.58
23.63
8753.76
1701.36
21230 00
Surgery
22.49
22.49
1619.28
1619.28
21235 00
Surgery
22.25
17.24
1602.00
1241.28
21240 00
Surgery
31.29
31.29
2252.88
2252.88
21242 00
Surgery
30.25
30.25
2178.00
2178.00
21243 00
Surgery
50.05
50.05
3603.60
3603.60
21244 00
Surgery
30.22
30.22
2175.84
2175.84
21245 00
Surgery
36.56
28.28
2632.32
2036.16
21246 00
Surgery
25.36
25.36
1825.92
1825.92
21247 00
Surgery
47.09
47.09
3390.48
3390.48
21248 00
Surgery
29.42
23.74
2118.24
1709.28
21249 00
Surgery
39.86
33.14
2869.92
2386.08
21255 00
Surgery
39.85
39.85
2869.20
2869.20
21256 00
Surgery
37.24
37.24
2681.28
2681.28
21260 00
Surgery
41.00
41.00
2952.00
2952.00
21261 00
Surgery
72.54
72.54
5222.88
5222.88
21263 00
Surgery
67.12
67.12
4832.64
4832.64
21267 00
Surgery
47.94
47.94
3451.68
3451.68
21268 00
Surgery
60.14
60.14
4330.08
4330.08
21270 00
Surgery
30.65
22.49
2206.80
1619.28
21275 00
Surgery
25.37
25.37
1826.64
1826.64
21280 00
Surgery
17.70
17.70
1274.40
1274.40
21282 00
Surgery
12.06
12.06
868.32
868.32
21295 00
Surgery
6.01
6.01
432.72
432.72
21296 00
Surgery
12.36
12.36
889.92
889.92
21299 00
Surgery
0.00
0.00
BR
BR
21315 00
Surgery
4.60
1.79
331.20
128.88
21320 00
Surgery
6.52
2.85
469.44
205.20
21325 00
Surgery
13.45
13.45
968.40
968.40
21330 00
Surgery
16.16
16.16
1163.52
1163.52
21335 00
Surgery
21.64
21.64
1558.08
1558.08
21336 00
Surgery
19.23
19.23
1384.56
1384.56
21337 00
Surgery
12.62
9.14
908.64
658.08
21338 00
Surgery
20.24
20.24
1457.28
1457.28
21339 00
Surgery
22.85
22.85
1645.20
1645.20
21340 00
Surgery
22.74
22.74
1637.28
1637.28
21343 00
Surgery
32.76
32.76
2358.72
2358.72
21344 00
Surgery
41.84
41.84
3012.48
3012.48
21345 00
Surgery
24.33
19.40
1751.76
1396.80
21346 00
Surgery
30.73
30.73
2212.56
2212.56
21347 00
Surgery
31.20
31.20
2246.40
2246.40
21348 00
Surgery
32.94
32.94
2371.68
2371.68
21355 00
Surgery
13.59
9.97
978.48
717.84
21356 00
Surgery
16.49
12.20
1187.28
878.40
21360 00
Surgery
15.93
15.93
1146.96
1146.96
21365 00
Surgery
32.40
32.40
2332.80
2332.80
21366 00
Surgery
38.28
38.28
2756.16
2756.16
21385 00
Surgery
22.06
22.06
1588.32
1588.32
21386 00
Surgery
20.85
20.85
1501.20
1501.20
21387 00
Surgery
23.02
23.02
1657.44
1657.44
21390 00
Surgery
24.14
24.14
1738.08
1738.08
21395 00
Surgery
30.23
30.23
2176.56
2176.56
21400 00
Surgery
6.62
5.18
476.64
372.96
21401 00
Surgery
15.39
10.02
1108.08
721.44
21406 00
Surgery
17.63
17.63
1269.36
1269.36
21407 00
Surgery
19.32
19.32
1391.04
1391.04
21408 00
Surgery
27.12
27.12
1952.64
1952.64
21421 00
Surgery
19.36
16.35
1393.92
1177.20
21422 00
Surgery
18.75
18.75
1350.00
1350.00
21423 00
Surgery
23.95
23.95
1724.40
1724.40
21431 00
Surgery
20.77
20.77
1495.44
1495.44
21432 00
Surgery
21.42
21.42
1542.24
1542.24
21433 00
Surgery
51.86
51.86
3733.92
3733.92
21435 00
Surgery
42.22
42.22
3039.84
3039.84
21436 00
Surgery
60.99
60.99
4391.28
4391.28
21440 00
Surgery
22.82
18.24
1643.04
1313.28
21445 00
Surgery
23.31
18.88
1678.32
1359.36
21450 00
Surgery
17.72
14.42
1275.84
1038.24
21451 00
Surgery
23.05
19.22
1659.60
1383.84
21452 00
Surgery
21.96
13.74
1581.12
989.28
21453 00
Surgery
32.82
27.93
2363.04
2010.96
21454 00
Surgery
14.71
14.71
1059.12
1059.12
21461 00
Surgery
55.01
31.92
3960.72
2298.24
21462 00
Surgery
58.62
34.80
4220.64
2505.60
21465 00
Surgery
23.93
23.93
1722.96
1722.96
21470 00
Surgery
34.98
34.98
2518.56
2518.56
21480 00
Surgery
4.25
0.93
306.00
66.96
21485 00
Surgery
28.73
23.47
2068.56
1689.84
21490 00
Surgery
23.59
23.59
1698.48
1698.48
21497 00
Surgery
21.23
17.65
1528.56
1270.80
21499 00
Surgery
0.00
0.00
BR
BR
21501 00
Surgery
14.77
10.25
1063.44
738.00
21502 00
Surgery
15.31
15.31
1102.32
1102.32
21510 00
Surgery
13.68
13.68
984.96
984.96
21550 00
Surgery
8.04
4.70
578.88
338.40
21552 00
Surgery
13.56
13.56
976.32
976.32
21554 00
Surgery
22.10
22.10
1591.20
1591.20
21555 00
Surgery
13.12
9.34
944.64
672.48
21556 00
Surgery
16.04
16.04
1154.88
1154.88
21557 00
Surgery
28.88
28.88
2079.36
2079.36
21558 00
Surgery
40.25
40.25
2898.00
2898.00
21600 00
Surgery
17.19
17.19
1237.68
1237.68
21601 00
Surgery
34.46
34.46
2481.12
2481.12
21602 00
Surgery
45.89
45.89
3304.08
3304.08
21603 00
Surgery
50.30
50.30
3621.60
3621.60
21610 00
Surgery
36.87
36.87
2654.64
2654.64
21615 00
Surgery
18.66
18.66
1343.52
1343.52
21616 00
Surgery
21.32
21.32
1535.04
1535.04
21620 00
Surgery
15.16
15.16
1091.52
1091.52
21627 00
Surgery
16.55
16.55
1191.60
1191.60
21630 00
Surgery
39.43
39.43
2838.96
2838.96
21632 00
Surgery
36.27
36.27
2611.44
2611.44
21685 00
Surgery
29.60
29.60
2131.20
2131.20
21700 00
Surgery
10.63
10.63
765.36
765.36
21705 00
Surgery
15.85
15.85
1141.20
1141.20
21720 00
Surgery
16.36
16.36
1177.92
1177.92
21725 00
Surgery
16.54
16.54
1190.88
1190.88
21740 00
Surgery
30.59
30.59
2202.48
2202.48
21742 00
Surgery
-
-
3044.88
2801.52
21743 00
Surgery
-
-
5196.24
4780.08
21750 00
Surgery
20.19
20.19
1453.68
1453.68
21811 00
Surgery
17.66
17.66
1271.52
1271.52
21812 00
Surgery
21.31
21.31
1534.32
1534.32
21813 00
Surgery
29.20
29.20
2102.40
2102.40
21820 00
Surgery
4.67
4.61
336.24
331.92
21825 00
Surgery
16.68
16.68
1200.96
1200.96
21899 00
Surgery
0.00
0.00
BR
BR
21920 00
Surgery
7.74
4.67
557.28
336.24
21925 00
Surgery
15.01
11.53
1080.72
830.16
21930 00
Surgery
15.23
11.10
1096.56
799.20
21931 00
Surgery
14.24
14.24
1025.28
1025.28
21932 00
Surgery
20.04
20.04
1442.88
1442.88
21933 00
Surgery
22.29
22.29
1604.88
1604.88
21935 00
Surgery
30.78
30.78
2216.16
2216.16
21936 00
Surgery
42.54
42.54
3062.88
3062.88
22010 00
Surgery
29.55
29.55
2127.60
2127.60
22015 00
Surgery
28.83
28.83
2075.76
2075.76
22100 00
Surgery
28.97
28.97
2085.84
2085.84
22101 00
Surgery
26.72
26.72
1923.84
1923.84
22102 00
Surgery
23.36
23.36
1681.92
1681.92
22103 00
Surgery
4.01
4.01
288.72
288.72
22110 00
Surgery
32.27
32.27
2323.44
2323.44
22112 00
Surgery
34.81
34.81
2506.32
2506.32
22114 00
Surgery
34.81
34.81
2506.32
2506.32
22116 00
Surgery
4.21
4.21
303.12
303.12
22206 00
Surgery
74.06
74.06
5332.32
5332.32
22207 00
Surgery
72.45
72.45
5216.40
5216.40
22208 00
Surgery
17.63
17.63
1269.36
1269.36
22210 00
Surgery
54.26
54.26
3906.72
3906.72
22212 00
Surgery
45.91
45.91
3305.52
3305.52
22214 00
Surgery
45.92
45.92
3306.24
3306.24
22216 00
Surgery
10.81
10.81
778.32
778.32
22220 00
Surgery
49.07
49.07
3533.04
3533.04
22222 00
Surgery
53.80
53.80
3873.60
3873.60
22224 00
Surgery
47.84
47.84
3444.48
3444.48
22226 00
Surgery
10.70
10.70
770.40
770.40
22310 00
Surgery
9.53
9.10
686.16
655.20
22315 00
Surgery
27.36
23.70
1969.92
1706.40
22318 00
Surgery
50.42
50.42
3630.24
3630.24
22319 00
Surgery
55.91
55.91
4025.52
4025.52
22325 00
Surgery
44.95
44.95
3236.40
3236.40
22326 00
Surgery
45.99
45.99
3311.28
3311.28
22327 00
Surgery
46.84
46.84
3372.48
3372.48
22328 00
Surgery
8.42
8.42
606.24
606.24
22505 00
Surgery
3.93
3.93
282.96
282.96
22510 00
Surgery
53.41
12.83
3845.52
923.76
22511 00
Surgery
53.35
12.08
3841.20
869.76
22512 00
Surgery
21.66
6.13
1559.52
441.36
22513 00
Surgery
168.31
15.21
12118.32
1095.12
22514 00
Surgery
167.57
14.18
12065.04
1020.96
22515 00
Surgery
86.20
6.45
6206.40
464.40
22526 00
Surgery
58.60
9.78
4219.20
704.16
22527 00
Surgery
48.10
4.52
3463.20
325.44
22532 00
Surgery
54.33
54.33
3911.76
3911.76
22533 00
Surgery
50.17
50.17
3612.24
3612.24
22534 00
Surgery
10.77
10.77
775.44
775.44
22548 00
Surgery
59.93
59.93
4314.96
4314.96
22551 00
Surgery
51.50
51.50
3708.00
3708.00
22552 00
Surgery
11.85
11.85
853.20
853.20
22554 00
Surgery
38.35
38.35
2761.20
2761.20
22556 00
Surgery
51.05
51.05
3675.60
3675.60
22558 00
Surgery
46.05
46.05
3315.60
3315.60
22585 00
Surgery
9.69
9.69
697.68
697.68
22586 00
Surgery
61.98
61.98
4462.56
4462.56
22590 00
Surgery
48.43
48.43
3486.96
3486.96
22595 00
Surgery
46.30
46.30
3333.60
3333.60
22600 00
Surgery
39.70
39.70
2858.40
2858.40
22610 00
Surgery
39.00
39.00
2808.00
2808.00
22612 00
Surgery
47.79
47.79
3440.88
3440.88
22614 00
Surgery
11.70
11.70
842.40
842.40
22630 00
Surgery
47.39
47.39
3412.08
3412.08
22632 00
Surgery
9.62
9.62
692.64
692.64
22633 00
Surgery
54.69
54.69
3937.68
3937.68
22634 00
Surgery
14.49
14.49
1043.28
1043.28
22800 00
Surgery
41.41
41.41
2981.52
2981.52
22802 00
Surgery
63.92
63.92
4602.24
4602.24
22804 00
Surgery
73.31
73.31
5278.32
5278.32
22808 00
Surgery
55.28
55.28
3980.16
3980.16
22810 00
Surgery
60.23
60.23
4336.56
4336.56
22812 00
Surgery
66.01
66.01
4752.72
4752.72
22818 00
Surgery
64.41
64.41
4637.52
4637.52
22819 00
Surgery
74.14
74.14
5338.08
5338.08
22830 00
Surgery
25.02
25.02
1801.44
1801.44
22836 00
Surgery
51.36
51.36
3697.92
3697.92
22837 00
Surgery
56.57
56.57
4073.04
4073.04
22838 00
Surgery
57.32
57.32
4127.04
4127.04
22840 00
Surgery
22.60
22.60
1627.20
1627.20
22841 00
Surgery
-
-
2187.36
2012.40
22842 00
Surgery
22.81
22.81
1642.32
1642.32
22843 00
Surgery
24.43
24.43
1758.96
1758.96
22844 00
Surgery
29.35
29.35
2113.20
2113.20
22845 00
Surgery
21.72
21.72
1563.84
1563.84
22846 00
Surgery
22.61
22.61
1627.92
1627.92
22847 00
Surgery
23.73
23.73
1708.56
1708.56
22848 00
Surgery
10.74
10.74
773.28
773.28
22849 00
Surgery
39.53
39.53
2846.16
2846.16
22850 00
Surgery
22.38
22.38
1611.36
1611.36
22852 00
Surgery
21.58
21.58
1553.76
1553.76
22853 00
Surgery
7.70
7.70
554.40
554.40
22854 00
Surgery
10.03
10.03
722.16
722.16
22855 00
Surgery
33.62
33.62
2420.64
2420.64
22856 00
Surgery
49.12
49.12
3536.64
3536.64
22857 00
Surgery
52.42
52.42
3774.24
3774.24
22858 00
Surgery
15.11
15.11
1087.92
1087.92
22859 00
Surgery
9.96
9.96
717.12
717.12
22860 00
Surgery
10.25
10.25
738.00
738.00
22861 00
Surgery
70.49
70.49
5075.28
5075.28
22862 00
Surgery
70.54
70.54
5078.88
5078.88
22864 00
Surgery
62.98
62.98
4534.56
4534.56
22865 00
Surgery
68.85
68.85
4957.20
4957.20
22867 00
Surgery
32.47
32.47
2337.84
2337.84
22868 00
Surgery
7.25
7.25
522.00
522.00
22869 00
Surgery
13.01
13.01
936.72
936.72
22870 00
Surgery
3.49
3.49
251.28
251.28
22899 00
Surgery
0.00
0.00
BR
BR
22900 00
Surgery
17.15
17.15
1234.80
1234.80
22901 00
Surgery
20.15
20.15
1450.80
1450.80
22902 00
Surgery
14.28
10.16
1028.16
731.52
22903 00
Surgery
13.35
13.35
961.20
961.20
22904 00
Surgery
31.55
31.55
2271.60
2271.60
22905 00
Surgery
39.96
39.96
2877.12
2877.12
22999 00
Surgery
0.00
0.00
BR
BR
23000 00
Surgery
16.69
10.94
1201.68
787.68
23020 00
Surgery
21.00
21.00
1512.00
1512.00
23030 00
Surgery
13.26
7.73
954.72
556.56
23031 00
Surgery
13.04
6.77
938.88
487.44
23035 00
Surgery
20.61
20.61
1483.92
1483.92
23040 00
Surgery
21.81
21.81
1570.32
1570.32
23044 00
Surgery
17.23
17.23
1240.56
1240.56
23065 00
Surgery
6.81
4.83
490.32
347.76
23066 00
Surgery
17.34
11.28
1248.48
812.16
23071 00
Surgery
12.76
12.76
918.72
918.72
23073 00
Surgery
21.10
21.10
1519.20
1519.20
23075 00
Surgery
15.57
10.04
1121.04
722.88
23076 00
Surgery
16.51
16.51
1188.72
1188.72
23077 00
Surgery
34.05
34.05
2451.60
2451.60
23078 00
Surgery
43.16
43.16
3107.52
3107.52
23100 00
Surgery
15.53
15.53
1118.16
1118.16
23101 00
Surgery
14.05
14.05
1011.60
1011.60
23105 00
Surgery
19.57
19.57
1409.04
1409.04
23106 00
Surgery
15.41
15.41
1109.52
1109.52
23107 00
Surgery
20.27
20.27
1459.44
1459.44
23120 00
Surgery
18.00
18.00
1296.00
1296.00
23125 00
Surgery
21.63
21.63
1557.36
1557.36
23130 00
Surgery
18.89
18.89
1360.08
1360.08
23140 00
Surgery
17.00
17.00
1224.00
1224.00
23145 00
Surgery
21.20
21.20
1526.40
1526.40
23146 00
Surgery
19.07
19.07
1373.04
1373.04
23150 00
Surgery
20.35
20.35
1465.20
1465.20
23155 00
Surgery
24.26
24.26
1746.72
1746.72
23156 00
Surgery
20.70
20.70
1490.40
1490.40
23170 00
Surgery
17.29
17.29
1244.88
1244.88
23172 00
Surgery
17.46
17.46
1257.12
1257.12
23174 00
Surgery
23.30
23.30
1677.60
1677.60
23180 00
Surgery
20.12
20.12
1448.64
1448.64
23182 00
Surgery
20.51
20.51
1476.72
1476.72
23184 00
Surgery
22.57
22.57
1625.04
1625.04
23190 00
Surgery
17.59
17.59
1266.48
1266.48
23195 00
Surgery
22.73
22.73
1636.56
1636.56
23200 00
Surgery
45.25
45.25
3258.00
3258.00
23210 00
Surgery
53.03
53.03
3818.16
3818.16
23220 00
Surgery
58.02
58.02
4177.44
4177.44
23330 00
Surgery
9.10
5.11
655.20
367.92
23333 00
Surgery
14.49
14.49
1043.28
1043.28
23334 00
Surgery
31.97
31.97
2301.84
2301.84
23335 00
Surgery
38.17
38.17
2748.24
2748.24
23350 00
Surgery
4.85
1.47
349.20
105.84
23395 00
Surgery
38.76
38.76
2790.72
2790.72
23397 00
Surgery
34.45
34.45
2480.40
2480.40
23400 00
Surgery
29.44
29.44
2119.68
2119.68
23405 00
Surgery
18.71
18.71
1347.12
1347.12
23406 00
Surgery
22.13
22.13
1593.36
1593.36
23410 00
Surgery
24.86
24.86
1789.92
1789.92
23412 00
Surgery
25.84
25.84
1860.48
1860.48
23415 00
Surgery
21.26
21.26
1530.72
1530.72
23420 00
Surgery
29.53
29.53
2126.16
2126.16
23430 00
Surgery
22.63
22.63
1629.36
1629.36
23440 00
Surgery
23.01
23.01
1656.72
1656.72
23450 00
Surgery
28.61
28.61
2059.92
2059.92
23455 00
Surgery
29.80
29.80
2145.60
2145.60
23460 00
Surgery
32.95
32.95
2372.40
2372.40
23462 00
Surgery
32.24
32.24
2321.28
2321.28
23465 00
Surgery
33.78
33.78
2432.16
2432.16
23466 00
Surgery
33.97
33.97
2445.84
2445.84
23470 00
Surgery
36.10
36.10
2599.20
2599.20
23472 00
Surgery
43.43
43.43
3126.96
3126.96
23473 00
Surgery
48.29
48.29
3476.88
3476.88
23474 00
Surgery
52.12
52.12
3752.64
3752.64
23480 00
Surgery
24.89
24.89
1792.08
1792.08
23485 00
Surgery
28.85
28.85
2077.20
2077.20
23490 00
Surgery
26.10
26.10
1879.20
1879.20
23491 00
Surgery
30.73
30.73
2212.56
2212.56
23500 00
Surgery
7.02
7.18
505.44
516.96
23505 00
Surgery
11.24
10.43
809.28
750.96
23515 00
Surgery
21.93
21.93
1578.96
1578.96
23520 00
Surgery
7.56
7.50
544.32
540.00
23525 00
Surgery
12.41
11.33
893.52
815.76
23530 00
Surgery
17.60
17.60
1267.20
1267.20
23532 00
Surgery
19.14
19.14
1378.08
1378.08
23540 00
Surgery
7.49
7.43
539.28
534.96
23545 00
Surgery
11.30
10.13
813.60
729.36
23550 00
Surgery
17.47
17.47
1257.84
1257.84
23552 00
Surgery
19.79
19.79
1424.88
1424.88
23570 00
Surgery
7.38
7.62
531.36
548.64
23575 00
Surgery
12.81
11.82
922.32
851.04
23585 00
Surgery
29.50
29.50
2124.00
2124.00
23600 00
Surgery
10.45
9.91
752.40
713.52
23605 00
Surgery
14.62
13.26
1052.64
954.72
23615 00
Surgery
26.79
26.79
1928.88
1928.88
23616 00
Surgery
37.29
37.29
2684.88
2684.88
23620 00
Surgery
8.51
8.15
612.72
586.80
23625 00
Surgery
12.06
11.01
868.32
792.72
23630 00
Surgery
23.76
23.76
1710.72
1710.72
23650 00
Surgery
10.42
9.40
750.24
676.80
23655 00
Surgery
12.60
12.60
907.20
907.20
23660 00
Surgery
17.88
17.88
1287.36
1287.36
23665 00
Surgery
13.57
12.46
977.04
897.12
23670 00
Surgery
26.47
26.47
1905.84
1905.84
23675 00
Surgery
17.17
15.52
1236.24
1117.44
23680 00
Surgery
27.90
27.90
2008.80
2008.80
23700 00
Surgery
5.96
5.96
429.12
429.12
23800 00
Surgery
31.07
31.07
2237.04
2237.04
23802 00
Surgery
38.75
38.75
2790.00
2790.00
23900 00
Surgery
41.69
41.69
3001.68
3001.68
23920 00
Surgery
33.95
33.95
2444.40
2444.40
23921 00
Surgery
14.47
14.47
1041.84
1041.84
23929 00
Surgery
0.00
0.00
BR
BR
23930 00
Surgery
10.84
6.53
780.48
470.16
23931 00
Surgery
9.16
4.92
659.52
354.24
23935 00
Surgery
15.74
15.74
1133.28
1133.28
24000 00
Surgery
14.67
14.67
1056.24
1056.24
24006 00
Surgery
21.74
21.74
1565.28
1565.28
24065 00
Surgery
7.83
4.93
563.76
354.96
24066 00
Surgery
18.98
12.91
1366.56
929.52
24071 00
Surgery
12.32
12.32
887.04
887.04
24073 00
Surgery
20.98
20.98
1510.56
1510.56
24075 00
Surgery
16.02
10.05
1153.44
723.60
24076 00
Surgery
16.64
16.64
1198.08
1198.08
24077 00
Surgery
30.98
30.98
2230.56
2230.56
24079 00
Surgery
39.89
39.89
2872.08
2872.08
24100 00
Surgery
12.93
12.93
930.96
930.96
24101 00
Surgery
15.42
15.42
1110.24
1110.24
24102 00
Surgery
18.84
18.84
1356.48
1356.48
24105 00
Surgery
11.12
11.12
800.64
800.64
24110 00
Surgery
18.07
18.07
1301.04
1301.04
24115 00
Surgery
22.45
22.45
1616.40
1616.40
24116 00
Surgery
26.09
26.09
1878.48
1878.48
24120 00
Surgery
16.31
16.31
1174.32
1174.32
24125 00
Surgery
19.04
19.04
1370.88
1370.88
24126 00
Surgery
19.86
19.86
1429.92
1429.92
24130 00
Surgery
15.65
15.65
1126.80
1126.80
24134 00
Surgery
22.75
22.75
1638.00
1638.00
24136 00
Surgery
19.31
19.31
1390.32
1390.32
24138 00
Surgery
21.02
21.02
1513.44
1513.44
24140 00
Surgery
21.40
21.40
1540.80
1540.80
24145 00
Surgery
18.17
18.17
1308.24
1308.24
24147 00
Surgery
19.19
19.19
1381.68
1381.68
24149 00
Surgery
35.78
35.78
2576.16
2576.16
24150 00
Surgery
46.43
46.43
3342.96
3342.96
24152 00
Surgery
40.46
40.46
2913.12
2913.12
24155 00
Surgery
25.83
25.83
1859.76
1859.76
24160 00
Surgery
37.88
37.88
2727.36
2727.36
24164 00
Surgery
22.05
22.05
1587.60
1587.60
24200 00
Surgery
6.65
4.30
478.80
309.60
24201 00
Surgery
18.67
12.27
1344.24
883.44
24220 00
Surgery
5.67
1.96
408.24
141.12
24300 00
Surgery
13.59
13.59
978.48
978.48
24301 00
Surgery
22.82
22.82
1643.04
1643.04
24305 00
Surgery
17.72
17.72
1275.84
1275.84
24310 00
Surgery
14.53
14.53
1046.16
1046.16
24320 00
Surgery
23.71
23.71
1707.12
1707.12
24330 00
Surgery
21.87
21.87
1574.64
1574.64
24331 00
Surgery
23.86
23.86
1717.92
1717.92
24332 00
Surgery
18.83
18.83
1355.76
1355.76
24340 00
Surgery
18.23
18.23
1312.56
1312.56
24341 00
Surgery
22.89
22.89
1648.08
1648.08
24342 00
Surgery
23.51
23.51
1692.72
1692.72
24343 00
Surgery
21.81
21.81
1570.32
1570.32
24344 00
Surgery
33.49
33.49
2411.28
2411.28
24345 00
Surgery
21.71
21.71
1563.12
1563.12
24346 00
Surgery
33.49
33.49
2411.28
2411.28
24357 00
Surgery
12.72
12.72
915.84
915.84
24358 00
Surgery
16.23
16.23
1168.56
1168.56
24359 00
Surgery
20.24
20.24
1457.28
1457.28
24360 00
Surgery
27.38
27.38
1971.36
1971.36
24361 00
Surgery
30.48
30.48
2194.56
2194.56
24362 00
Surgery
32.08
32.08
2309.76
2309.76
24363 00
Surgery
43.61
43.61
3139.92
3139.92
24365 00
Surgery
19.55
19.55
1407.60
1407.60
24366 00
Surgery
20.70
20.70
1490.40
1490.40
24370 00
Surgery
46.19
46.19
3325.68
3325.68
24371 00
Surgery
53.07
53.07
3821.04
3821.04
24400 00
Surgery
25.13
25.13
1809.36
1809.36
24410 00
Surgery
32.01
32.01
2304.72
2304.72
24420 00
Surgery
32.21
32.21
2319.12
2319.12
24430 00
Surgery
31.91
31.91
2297.52
2297.52
24435 00
Surgery
32.74
32.74
2357.28
2357.28
24470 00
Surgery
20.51
20.51
1476.72
1476.72
24495 00
Surgery
27.89
27.89
2008.08
2008.08
24498 00
Surgery
26.29
26.29
1892.88
1892.88
24500 00
Surgery
11.38
10.48
819.36
754.56
24505 00
Surgery
15.70
14.03
1130.40
1010.16
24515 00
Surgery
26.72
26.72
1923.84
1923.84
24516 00
Surgery
26.03
26.03
1874.16
1874.16
24530 00
Surgery
12.00
10.99
864.00
791.28
24535 00
Surgery
19.28
17.68
1388.16
1272.96
24538 00
Surgery
24.05
24.05
1731.60
1731.60
24545 00
Surgery
28.14
28.14
2026.08
2026.08
24546 00
Surgery
31.37
31.37
2258.64
2258.64
24560 00
Surgery
10.43
9.24
750.96
665.28
24565 00
Surgery
16.82
15.34
1211.04
1104.48
24566 00
Surgery
22.03
22.03
1586.16
1586.16
24575 00
Surgery
22.34
22.34
1608.48
1608.48
24576 00
Surgery
11.06
9.85
796.32
709.20
24577 00
Surgery
17.27
15.72
1243.44
1131.84
24579 00
Surgery
25.37
25.37
1826.64
1826.64
24582 00
Surgery
24.93
24.93
1794.96
1794.96
24586 00
Surgery
32.83
32.83
2363.76
2363.76
24587 00
Surgery
32.90
32.90
2368.80
2368.80
24600 00
Surgery
11.78
10.66
848.16
767.52
24605 00
Surgery
14.74
14.74
1061.28
1061.28
24615 00
Surgery
21.71
21.71
1563.12
1563.12
24620 00
Surgery
18.09
18.09
1302.48
1302.48
24635 00
Surgery
20.61
20.61
1483.92
1483.92
24640 00
Surgery
3.16
2.42
227.52
174.24
24650 00
Surgery
8.31
7.74
598.32
557.28
24655 00
Surgery
14.06
12.66
1012.32
911.52
24665 00
Surgery
20.08
20.08
1445.76
1445.76
24666 00
Surgery
22.29
22.29
1604.88
1604.88
24670 00
Surgery
9.19
8.40
661.68
604.80
24675 00
Surgery
14.33
12.97
1031.76
933.84
24685 00
Surgery
19.97
19.97
1437.84
1437.84
24800 00
Surgery
25.34
25.34
1824.48
1824.48
24802 00
Surgery
30.34
30.34
2184.48
2184.48
24900 00
Surgery
22.47
22.47
1617.84
1617.84
24920 00
Surgery
22.29
22.29
1604.88
1604.88
24925 00
Surgery
17.42
17.42
1254.24
1254.24
24930 00
Surgery
23.49
23.49
1691.28
1691.28
24931 00
Surgery
28.16
28.16
2027.52
2027.52
24935 00
Surgery
36.93
36.93
2658.96
2658.96
24940 00
Surgery
0.00
0.00
BR
BR
24999 00
Surgery
0.00
0.00
BR
BR
25000 00
Surgery
10.68
10.68
768.96
768.96
25001 00
Surgery
10.73
10.73
772.56
772.56
25020 00
Surgery
22.42
22.42
1614.24
1614.24
25023 00
Surgery
39.56
39.56
2848.32
2848.32
25024 00
Surgery
23.69
23.69
1705.68
1705.68
25025 00
Surgery
37.04
37.04
2666.88
2666.88
25028 00
Surgery
21.00
21.00
1512.00
1512.00
25031 00
Surgery
11.35
11.35
817.20
817.20
25035 00
Surgery
18.03
18.03
1298.16
1298.16
25040 00
Surgery
17.06
17.06
1228.32
1228.32
25065 00
Surgery
7.73
4.78
556.56
344.16
25066 00
Surgery
11.28
11.28
812.16
812.16
25071 00
Surgery
12.91
12.91
929.52
929.52
25073 00
Surgery
16.33
16.33
1175.76
1175.76
25075 00
Surgery
15.65
9.65
1126.80
694.80
25076 00
Surgery
15.84
15.84
1140.48
1140.48
25077 00
Surgery
25.96
25.96
1869.12
1869.12
25078 00
Surgery
35.16
35.16
2531.52
2531.52
25085 00
Surgery
13.78
13.78
992.16
992.16
25100 00
Surgery
10.79
10.79
776.88
776.88
25101 00
Surgery
12.50
12.50
900.00
900.00
25105 00
Surgery
14.95
14.95
1076.40
1076.40
25107 00
Surgery
18.92
18.92
1362.24
1362.24
25109 00
Surgery
16.41
16.41
1181.52
1181.52
25110 00
Surgery
10.66
10.66
767.52
767.52
25111 00
Surgery
10.04
10.04
722.88
722.88
25112 00
Surgery
12.04
12.04
866.88
866.88
25115 00
Surgery
23.06
23.06
1660.32
1660.32
25116 00
Surgery
18.51
18.51
1332.72
1332.72
25118 00
Surgery
11.80
11.80
849.60
849.60
25119 00
Surgery
15.41
15.41
1109.52
1109.52
25120 00
Surgery
15.39
15.39
1108.08
1108.08
25125 00
Surgery
18.23
18.23
1312.56
1312.56
25126 00
Surgery
18.36
18.36
1321.92
1321.92
25130 00
Surgery
13.87
13.87
998.64
998.64
25135 00
Surgery
17.22
17.22
1239.84
1239.84
25136 00
Surgery
15.28
15.28
1100.16
1100.16
25145 00
Surgery
15.99
15.99
1151.28
1151.28
25150 00
Surgery
17.33
17.33
1247.76
1247.76
25151 00
Surgery
17.86
17.86
1285.92
1285.92
25170 00
Surgery
44.14
44.14
3178.08
3178.08
25210 00
Surgery
15.14
15.14
1090.08
1090.08
25215 00
Surgery
18.93
18.93
1362.96
1362.96
25230 00
Surgery
13.31
13.31
958.32
958.32
25240 00
Surgery
13.23
13.23
952.56
952.56
25246 00
Surgery
5.84
2.16
420.48
155.52
25248 00
Surgery
13.02
13.02
937.44
937.44
25250 00
Surgery
16.36
16.36
1177.92
1177.92
25251 00
Surgery
21.92
21.92
1578.24
1578.24
25259 00
Surgery
13.36
13.36
961.92
961.92
25260 00
Surgery
19.40
19.40
1396.80
1396.80
25263 00
Surgery
19.40
19.40
1396.80
1396.80
25265 00
Surgery
22.96
22.96
1653.12
1653.12
25270 00
Surgery
15.16
15.16
1091.52
1091.52
25272 00
Surgery
17.15
17.15
1234.80
1234.80
25274 00
Surgery
20.27
20.27
1459.44
1459.44
25275 00
Surgery
20.51
20.51
1476.72
1476.72
25280 00
Surgery
17.32
17.32
1247.04
1247.04
25290 00
Surgery
13.40
13.40
964.80
964.80
25295 00
Surgery
16.14
16.14
1162.08
1162.08
25300 00
Surgery
21.07
21.07
1517.04
1517.04
25301 00
Surgery
19.65
19.65
1414.80
1414.80
25310 00
Surgery
18.99
18.99
1367.28
1367.28
25312 00
Surgery
21.84
21.84
1572.48
1572.48
25315 00
Surgery
23.41
23.41
1685.52
1685.52
25316 00
Surgery
27.79
27.79
2000.88
2000.88
25320 00
Surgery
30.13
30.13
2169.36
2169.36
25332 00
Surgery
25.67
25.67
1848.24
1848.24
25335 00
Surgery
28.61
28.61
2059.92
2059.92
25337 00
Surgery
27.02
27.02
1945.44
1945.44
25350 00
Surgery
20.56
20.56
1480.32
1480.32
25355 00
Surgery
23.28
23.28
1676.16
1676.16
25360 00
Surgery
20.03
20.03
1442.16
1442.16
25365 00
Surgery
27.81
27.81
2002.32
2002.32
25370 00
Surgery
30.67
30.67
2208.24
2208.24
25375 00
Surgery
28.89
28.89
2080.08
2080.08
25390 00
Surgery
23.36
23.36
1681.92
1681.92
25391 00
Surgery
30.14
30.14
2170.08
2170.08
25392 00
Surgery
30.66
30.66
2207.52
2207.52
25393 00
Surgery
34.10
34.10
2455.20
2455.20
25394 00
Surgery
23.86
23.86
1717.92
1717.92
25400 00
Surgery
24.35
24.35
1753.20
1753.20
25405 00
Surgery
31.34
31.34
2256.48
2256.48
25415 00
Surgery
29.31
29.31
2110.32
2110.32
25420 00
Surgery
35.22
35.22
2535.84
2535.84
25425 00
Surgery
29.18
29.18
2100.96
2100.96
25426 00
Surgery
33.91
33.91
2441.52
2441.52
25430 00
Surgery
22.32
22.32
1607.04
1607.04
25431 00
Surgery
23.96
23.96
1725.12
1725.12
25440 00
Surgery
23.37
23.37
1682.64
1682.64
25441 00
Surgery
28.43
28.43
2046.96
2046.96
25442 00
Surgery
24.58
24.58
1769.76
1769.76
25443 00
Surgery
23.91
23.91
1721.52
1721.52
25444 00
Surgery
24.98
24.98
1798.56
1798.56
25445 00
Surgery
21.93
21.93
1578.96
1578.96
25446 00
Surgery
35.39
35.39
2548.08
2548.08
25447 00
Surgery
25.32
25.32
1823.04
1823.04
25449 00
Surgery
31.23
31.23
2248.56
2248.56
25450 00
Surgery
18.89
18.89
1360.08
1360.08
25455 00
Surgery
22.27
22.27
1603.44
1603.44
25490 00
Surgery
21.91
21.91
1577.52
1577.52
25491 00
Surgery
22.51
22.51
1620.72
1620.72
25492 00
Surgery
27.51
27.51
1980.72
1980.72
25500 00
Surgery
8.96
8.11
645.12
583.92
25505 00
Surgery
15.84
14.33
1140.48
1031.76
25515 00
Surgery
20.49
20.49
1475.28
1475.28
25520 00
Surgery
17.87
16.84
1286.64
1212.48
25525 00
Surgery
24.08
24.08
1733.76
1733.76
25526 00
Surgery
29.05
29.05
2091.60
2091.60
25530 00
Surgery
8.34
7.65
600.48
550.80
25535 00
Surgery
15.40
14.20
1108.80
1022.40
25545 00
Surgery
19.12
19.12
1376.64
1376.64
25560 00
Surgery
9.13
8.15
657.36
586.80
25565 00
Surgery
16.14
14.41
1162.08
1037.52
25574 00
Surgery
20.62
20.62
1484.64
1484.64
25575 00
Surgery
27.48
27.48
1978.56
1978.56
25600 00
Surgery
10.64
10.18
766.08
732.96
25605 00
Surgery
16.77
15.82
1207.44
1139.04
25606 00
Surgery
20.48
20.48
1474.56
1474.56
25607 00
Surgery
22.60
22.60
1627.20
1627.20
25608 00
Surgery
25.23
25.23
1816.56
1816.56
25609 00
Surgery
31.95
31.95
2300.40
2300.40
25622 00
Surgery
9.67
8.92
696.24
642.24
25624 00
Surgery
15.32
13.86
1103.04
997.92
25628 00
Surgery
21.91
21.91
1577.52
1577.52
25630 00
Surgery
9.59
8.91
690.48
641.52
25635 00
Surgery
14.54
13.18
1046.88
948.96
25645 00
Surgery
17.49
17.49
1259.28
1259.28
25650 00
Surgery
10.34
9.58
744.48
689.76
25651 00
Surgery
15.11
15.11
1087.92
1087.92
25652 00
Surgery
19.06
19.06
1372.32
1372.32
25660 00
Surgery
13.93
13.93
1002.96
1002.96
25670 00
Surgery
18.56
18.56
1336.32
1336.32
25671 00
Surgery
16.46
16.46
1185.12
1185.12
25675 00
Surgery
14.25
12.85
1026.00
925.20
25676 00
Surgery
19.29
19.29
1388.88
1388.88
25680 00
Surgery
16.37
16.37
1178.64
1178.64
25685 00
Surgery
22.39
22.39
1612.08
1612.08
25690 00
Surgery
15.22
15.22
1095.84
1095.84
25695 00
Surgery
19.37
19.37
1394.64
1394.64
25800 00
Surgery
22.23
22.23
1600.56
1600.56
25805 00
Surgery
25.75
25.75
1854.00
1854.00
25810 00
Surgery
26.34
26.34
1896.48
1896.48
25820 00
Surgery
19.79
19.79
1424.88
1424.88
25825 00
Surgery
24.14
24.14
1738.08
1738.08
25830 00
Surgery
31.22
31.22
2247.84
2247.84
25900 00
Surgery
21.83
21.83
1571.76
1571.76
25905 00
Surgery
21.38
21.38
1539.36
1539.36
25907 00
Surgery
18.79
18.79
1352.88
1352.88
25909 00
Surgery
20.87
20.87
1502.64
1502.64
25915 00
Surgery
35.19
35.19
2533.68
2533.68
25920 00
Surgery
22.21
22.21
1599.12
1599.12
25922 00
Surgery
19.71
19.71
1419.12
1419.12
25924 00
Surgery
21.70
21.70
1562.40
1562.40
25927 00
Surgery
26.18
26.18
1884.96
1884.96
25929 00
Surgery
18.31
18.31
1318.32
1318.32
25931 00
Surgery
24.25
24.25
1746.00
1746.00
25999 00
Surgery
0.00
0.00
BR
BR
26010 00
Surgery
10.36
4.30
745.92
309.60
26011 00
Surgery
14.33
5.63
1031.76
405.36
26020 00
Surgery
17.01
17.01
1224.72
1224.72
26025 00
Surgery
12.84
12.84
924.48
924.48
26030 00
Surgery
15.04
15.04
1082.88
1082.88
26034 00
Surgery
16.88
16.88
1215.36
1215.36
26035 00
Surgery
26.20
26.20
1886.40
1886.40
26037 00
Surgery
17.13
17.13
1233.36
1233.36
26040 00
Surgery
9.76
9.76
702.72
702.72
26045 00
Surgery
14.51
14.51
1044.72
1044.72
26055 00
Surgery
17.81
8.98
1282.32
646.56
26060 00
Surgery
7.87
7.87
566.64
566.64
26070 00
Surgery
9.96
9.96
717.12
717.12
26075 00
Surgery
10.43
10.43
750.96
750.96
26080 00
Surgery
12.29
12.29
884.88
884.88
26100 00
Surgery
10.49
10.49
755.28
755.28
26105 00
Surgery
10.55
10.55
759.60
759.60
26110 00
Surgery
10.04
10.04
722.88
722.88
26111 00
Surgery
12.71
12.71
915.12
915.12
26113 00
Surgery
16.71
16.71
1203.12
1203.12
26115 00
Surgery
16.65
10.20
1198.80
734.40
26116 00
Surgery
16.05
16.05
1155.60
1155.60
26117 00
Surgery
22.61
22.61
1627.92
1627.92
26118 00
Surgery
31.71
31.71
2283.12
2283.12
26121 00
Surgery
18.33
18.33
1319.76
1319.76
26123 00
Surgery
25.54
25.54
1838.88
1838.88
26125 00
Surgery
8.00
8.00
576.00
576.00
26130 00
Surgery
14.43
14.43
1038.96
1038.96
26135 00
Surgery
16.94
16.94
1219.68
1219.68
26140 00
Surgery
15.59
15.59
1122.48
1122.48
26145 00
Surgery
15.82
15.82
1139.04
1139.04
26160 00
Surgery
18.60
9.74
1339.20
701.28
26170 00
Surgery
12.56
12.56
904.32
904.32
26180 00
Surgery
13.84
13.84
996.48
996.48
26185 00
Surgery
17.13
17.13
1233.36
1233.36
26200 00
Surgery
13.84
13.84
996.48
996.48
26205 00
Surgery
18.49
18.49
1331.28
1331.28
26210 00
Surgery
13.78
13.78
992.16
992.16
26215 00
Surgery
17.37
17.37
1250.64
1250.64
26230 00
Surgery
15.31
15.31
1102.32
1102.32
26235 00
Surgery
15.11
15.11
1087.92
1087.92
26236 00
Surgery
13.57
13.57
977.04
977.04
26250 00
Surgery
32.23
32.23
2320.56
2320.56
26260 00
Surgery
24.18
24.18
1740.96
1740.96
26262 00
Surgery
19.25
19.25
1386.00
1386.00
26320 00
Surgery
10.74
10.74
773.28
773.28
26340 00
Surgery
11.05
11.05
795.60
795.60
26341 00
Surgery
3.56
2.38
256.32
171.36
26350 00
Surgery
22.72
22.72
1635.84
1635.84
26352 00
Surgery
25.26
25.26
1818.72
1818.72
26356 00
Surgery
24.25
24.25
1746.00
1746.00
26357 00
Surgery
27.15
27.15
1954.80
1954.80
26358 00
Surgery
29.92
29.92
2154.24
2154.24
26370 00
Surgery
23.80
23.80
1713.60
1713.60
26372 00
Surgery
27.77
27.77
1999.44
1999.44
26373 00
Surgery
26.73
26.73
1924.56
1924.56
26390 00
Surgery
26.64
26.64
1918.08
1918.08
26392 00
Surgery
30.36
30.36
2185.92
2185.92
26410 00
Surgery
18.31
18.31
1318.32
1318.32
26412 00
Surgery
21.77
21.77
1567.44
1567.44
26415 00
Surgery
25.83
25.83
1859.76
1859.76
26416 00
Surgery
27.95
27.95
2012.40
2012.40
26418 00
Surgery
19.04
19.04
1370.88
1370.88
26420 00
Surgery
22.58
22.58
1625.76
1625.76
26426 00
Surgery
15.45
15.45
1112.40
1112.40
26428 00
Surgery
24.22
24.22
1743.84
1743.84
26432 00
Surgery
16.57
16.57
1193.04
1193.04
26433 00
Surgery
17.41
17.41
1253.52
1253.52
26434 00
Surgery
21.18
21.18
1524.96
1524.96
26437 00
Surgery
20.30
20.30
1461.60
1461.60
26440 00
Surgery
19.78
19.78
1424.16
1424.16
26442 00
Surgery
30.07
30.07
2165.04
2165.04
26445 00
Surgery
18.38
18.38
1323.36
1323.36
26449 00
Surgery
21.40
21.40
1540.80
1540.80
26450 00
Surgery
14.17
14.17
1020.24
1020.24
26455 00
Surgery
14.08
14.08
1013.76
1013.76
26460 00
Surgery
13.79
13.79
992.88
992.88
26471 00
Surgery
20.10
20.10
1447.20
1447.20
26474 00
Surgery
19.87
19.87
1430.64
1430.64
26476 00
Surgery
19.63
19.63
1413.36
1413.36
26477 00
Surgery
19.17
19.17
1380.24
1380.24
26478 00
Surgery
20.03
20.03
1442.16
1442.16
26479 00
Surgery
20.59
20.59
1482.48
1482.48
26480 00
Surgery
23.87
23.87
1718.64
1718.64
26483 00
Surgery
26.46
26.46
1905.12
1905.12
26485 00
Surgery
25.40
25.40
1828.80
1828.80
26489 00
Surgery
29.26
29.26
2106.72
2106.72
26490 00
Surgery
25.49
25.49
1835.28
1835.28
26492 00
Surgery
28.19
28.19
2029.68
2029.68
26494 00
Surgery
25.60
25.60
1843.20
1843.20
26496 00
Surgery
27.54
27.54
1982.88
1982.88
26497 00
Surgery
27.50
27.50
1980.00
1980.00
26498 00
Surgery
35.70
35.70
2570.40
2570.40
26499 00
Surgery
26.48
26.48
1906.56
1906.56
26500 00
Surgery
20.95
20.95
1508.40
1508.40
26502 00
Surgery
23.00
23.00
1656.00
1656.00
26508 00
Surgery
20.62
20.62
1484.64
1484.64
26510 00
Surgery
19.51
19.51
1404.72
1404.72
26516 00
Surgery
22.61
22.61
1627.92
1627.92
26517 00
Surgery
26.32
26.32
1895.04
1895.04
26518 00
Surgery
26.65
26.65
1918.80
1918.80
26520 00
Surgery
20.73
20.73
1492.56
1492.56
26525 00
Surgery
20.85
20.85
1501.20
1501.20
26530 00
Surgery
16.61
16.61
1195.92
1195.92
26531 00
Surgery
19.30
19.30
1389.60
1389.60
26535 00
Surgery
13.46
13.46
969.12
969.12
26536 00
Surgery
22.79
22.79
1640.88
1640.88
26540 00
Surgery
21.28
21.28
1532.16
1532.16
26541 00
Surgery
25.39
25.39
1828.08
1828.08
26542 00
Surgery
21.97
21.97
1581.84
1581.84
26545 00
Surgery
22.36
22.36
1609.92
1609.92
26546 00
Surgery
31.52
31.52
2269.44
2269.44
26548 00
Surgery
24.31
24.31
1750.32
1750.32
26550 00
Surgery
49.81
49.81
3586.32
3586.32
26551 00
Surgery
98.83
98.83
7115.76
7115.76
26553 00
Surgery
98.17
98.17
7068.24
7068.24
26554 00
Surgery
114.23
114.23
8224.56
8224.56
26555 00
Surgery
41.90
41.90
3016.80
3016.80
26556 00
Surgery
102.14
102.14
7354.08
7354.08
26560 00
Surgery
19.38
19.38
1395.36
1395.36
26561 00
Surgery
29.81
29.81
2146.32
2146.32
26562 00
Surgery
41.69
41.69
3001.68
3001.68
26565 00
Surgery
21.62
21.62
1556.64
1556.64
26567 00
Surgery
21.88
21.88
1575.36
1575.36
26568 00
Surgery
28.22
28.22
2031.84
2031.84
26580 00
Surgery
46.59
46.59
3354.48
3354.48
26587 00
Surgery
31.64
31.64
2278.08
2278.08
26590 00
Surgery
43.26
43.26
3114.72
3114.72
26591 00
Surgery
14.91
14.91
1073.52
1073.52
26593 00
Surgery
19.63
19.63
1413.36
1413.36
26596 00
Surgery
24.87
24.87
1790.64
1790.64
26600 00
Surgery
9.47
9.02
681.84
649.44
26605 00
Surgery
10.34
9.32
744.48
671.04
26607 00
Surgery
15.58
15.58
1121.76
1121.76
26608 00
Surgery
14.84
14.84
1068.48
1068.48
26615 00
Surgery
17.63
17.63
1269.36
1269.36
26641 00
Surgery
13.10
11.92
943.20
858.24
26645 00
Surgery
13.51
12.29
972.72
884.88
26650 00
Surgery
14.83
14.83
1067.76
1067.76
26665 00
Surgery
19.16
19.16
1379.52
1379.52
26670 00
Surgery
10.98
9.80
790.56
705.60
26675 00
Surgery
14.40
13.13
1036.80
945.36
26676 00
Surgery
15.71
15.71
1131.12
1131.12
26685 00
Surgery
17.65
17.65
1270.80
1270.80
26686 00
Surgery
19.02
19.02
1369.44
1369.44
26700 00
Surgery
10.64
9.80
766.08
705.60
26705 00
Surgery
13.65
12.35
982.80
889.20
26706 00
Surgery
13.78
13.78
992.16
992.16
26715 00
Surgery
17.57
17.57
1265.04
1265.04
26720 00
Surgery
6.35
5.97
457.20
429.84
26725 00
Surgery
10.71
9.53
771.12
686.16
26727 00
Surgery
14.63
14.63
1053.36
1053.36
26735 00
Surgery
18.22
18.22
1311.84
1311.84
26740 00
Surgery
7.34
6.94
528.48
499.68
26742 00
Surgery
11.65
10.44
838.80
751.68
26746 00
Surgery
22.59
22.59
1626.48
1626.48
26750 00
Surgery
5.93
6.00
426.96
432.00
26755 00
Surgery
10.01
8.57
720.72
617.04
26756 00
Surgery
13.10
13.10
943.20
943.20
26765 00
Surgery
15.48
15.48
1114.56
1114.56
26770 00
Surgery
9.08
8.25
653.76
594.00
26775 00
Surgery
12.36
11.09
889.92
798.48
26776 00
Surgery
13.87
13.87
998.64
998.64
26785 00
Surgery
16.79
16.79
1208.88
1208.88
26820 00
Surgery
25.23
25.23
1816.56
1816.56
26841 00
Surgery
23.59
23.59
1698.48
1698.48
26842 00
Surgery
25.30
25.30
1821.60
1821.60
26843 00
Surgery
23.80
23.80
1713.60
1713.60
26844 00
Surgery
26.15
26.15
1882.80
1882.80
26850 00
Surgery
22.34
22.34
1608.48
1608.48
26852 00
Surgery
25.35
25.35
1825.20
1825.20
26860 00
Surgery
18.67
18.67
1344.24
1344.24
26861 00
Surgery
3.03
3.03
218.16
218.16
26862 00
Surgery
23.34
23.34
1680.48
1680.48
26863 00
Surgery
6.76
6.76
486.72
486.72
26910 00
Surgery
23.15
23.15
1666.80
1666.80
26951 00
Surgery
21.40
21.40
1540.80
1540.80
26952 00
Surgery
20.81
20.81
1498.32
1498.32
26989 00
Surgery
0.00
0.00
BR
BR
26990 00
Surgery
20.68
20.68
1488.96
1488.96
26991 00
Surgery
21.45
16.06
1544.40
1156.32
26992 00
Surgery
30.59
30.59
2202.48
2202.48
27000 00
Surgery
11.87
11.87
854.64
854.64
27001 00
Surgery
16.47
16.47
1185.84
1185.84
27003 00
Surgery
18.31
18.31
1318.32
1318.32
27005 00
Surgery
21.88
21.88
1575.36
1575.36
27006 00
Surgery
21.69
21.69
1561.68
1561.68
27025 00
Surgery
28.12
28.12
2024.64
2024.64
27027 00
Surgery
26.78
26.78
1928.16
1928.16
27030 00
Surgery
28.30
28.30
2037.60
2037.60
27033 00
Surgery
29.36
29.36
2113.92
2113.92
27035 00
Surgery
33.90
33.90
2440.80
2440.80
27036 00
Surgery
30.82
30.82
2219.04
2219.04
27040 00
Surgery
10.20
5.99
734.40
431.28
27041 00
Surgery
21.46
21.46
1545.12
1545.12
27043 00
Surgery
14.23
14.23
1024.56
1024.56
27045 00
Surgery
22.16
22.16
1595.52
1595.52
27047 00
Surgery
15.00
11.01
1080.00
792.72
27048 00
Surgery
18.57
18.57
1337.04
1337.04
27049 00
Surgery
42.88
42.88
3087.36
3087.36
27050 00
Surgery
12.48
12.48
898.56
898.56
27052 00
Surgery
17.71
17.71
1275.12
1275.12
27054 00
Surgery
20.96
20.96
1509.12
1509.12
27057 00
Surgery
30.42
30.42
2190.24
2190.24
27059 00
Surgery
54.36
54.36
3913.92
3913.92
27060 00
Surgery
14.30
14.30
1029.60
1029.60
27062 00
Surgery
13.90
13.90
1000.80
1000.80
27065 00
Surgery
15.99
15.99
1151.28
1151.28
27066 00
Surgery
24.76
24.76
1782.72
1782.72
27067 00
Surgery
31.34
31.34
2256.48
2256.48
27070 00
Surgery
26.77
26.77
1927.44
1927.44
27071 00
Surgery
29.42
29.42
2118.24
2118.24
27075 00
Surgery
62.38
62.38
4491.36
4491.36
27076 00
Surgery
75.30
75.30
5421.60
5421.60
27077 00
Surgery
83.94
83.94
6043.68
6043.68
27078 00
Surgery
61.52
61.52
4429.44
4429.44
27080 00
Surgery
15.48
15.48
1114.56
1114.56
27086 00
Surgery
9.40
5.15
676.80
370.80
27087 00
Surgery
18.68
18.68
1344.96
1344.96
27090 00
Surgery
25.13
25.13
1809.36
1809.36
27091 00
Surgery
47.84
47.84
3444.48
3444.48
27093 00
Surgery
6.90
2.01
496.80
144.72
27095 00
Surgery
9.16
2.43
659.52
174.96
27096 00
Surgery
4.93
2.47
354.96
177.84
27097 00
Surgery
20.80
20.80
1497.60
1497.60
27098 00
Surgery
21.18
21.18
1524.96
1524.96
27100 00
Surgery
25.23
25.23
1816.56
1816.56
27105 00
Surgery
26.42
26.42
1902.24
1902.24
27110 00
Surgery
29.39
29.39
2116.08
2116.08
27111 00
Surgery
27.39
27.39
1972.08
1972.08
27120 00
Surgery
39.13
39.13
2817.36
2817.36
27122 00
Surgery
33.31
33.31
2398.32
2398.32
27125 00
Surgery
34.13
34.13
2457.36
2457.36
27130 00
Surgery
38.63
38.63
2781.36
2781.36
27132 00
Surgery
50.16
50.16
3611.52
3611.52
27134 00
Surgery
57.04
57.04
4106.88
4106.88
27137 00
Surgery
43.99
43.99
3167.28
3167.28
27138 00
Surgery
45.68
45.68
3288.96
3288.96
27140 00
Surgery
27.16
27.16
1955.52
1955.52
27146 00
Surgery
38.55
38.55
2775.60
2775.60
27147 00
Surgery
44.00
44.00
3168.00
3168.00
27151 00
Surgery
47.51
47.51
3420.72
3420.72
27156 00
Surgery
51.16
51.16
3683.52
3683.52
27158 00
Surgery
42.10
42.10
3031.20
3031.20
27161 00
Surgery
36.80
36.80
2649.60
2649.60
27165 00
Surgery
41.32
41.32
2975.04
2975.04
27170 00
Surgery
35.23
35.23
2536.56
2536.56
27175 00
Surgery
20.26
20.26
1458.72
1458.72
27176 00
Surgery
27.94
27.94
2011.68
2011.68
27177 00
Surgery
33.71
33.71
2427.12
2427.12
27178 00
Surgery
27.94
27.94
2011.68
2011.68
27179 00
Surgery
29.60
29.60
2131.20
2131.20
27181 00
Surgery
33.85
33.85
2437.20
2437.20
27185 00
Surgery
21.87
21.87
1574.64
1574.64
27187 00
Surgery
30.13
30.13
2169.36
2169.36
27197 00
Surgery
4.04
4.04
290.88
290.88
27198 00
Surgery
9.50
9.50
684.00
684.00
27200 00
Surgery
5.91
5.98
425.52
430.56
27202 00
Surgery
16.07
16.07
1157.04
1157.04
27215 00
Surgery
18.18
18.18
1308.96
1308.96
27216 00
Surgery
26.84
26.84
1932.48
1932.48
27217 00
Surgery
25.24
25.24
1817.28
1817.28
27218 00
Surgery
34.59
34.59
2490.48
2490.48
27220 00
Surgery
12.80
12.63
921.60
909.36
27222 00
Surgery
29.64
29.64
2134.08
2134.08
27226 00
Surgery
31.94
31.94
2299.68
2299.68
27227 00
Surgery
49.58
49.58
3569.76
3569.76
27228 00
Surgery
56.31
56.31
4054.32
4054.32
27230 00
Surgery
15.01
14.73
1080.72
1060.56
27232 00
Surgery
21.96
21.96
1581.12
1581.12
27235 00
Surgery
27.43
27.43
1974.96
1974.96
27236 00
Surgery
35.99
35.99
2591.28
2591.28
27238 00
Surgery
14.39
14.39
1036.08
1036.08
27240 00
Surgery
28.82
28.82
2075.04
2075.04
27244 00
Surgery
37.00
37.00
2664.00
2664.00
27245 00
Surgery
36.95
36.95
2660.40
2660.40
27246 00
Surgery
12.04
11.92
866.88
858.24
27248 00
Surgery
22.54
22.54
1622.88
1622.88
27250 00
Surgery
5.37
5.37
386.64
386.64
27252 00
Surgery
22.70
22.70
1634.40
1634.40
27253 00
Surgery
28.40
28.40
2044.80
2044.80
27254 00
Surgery
38.31
38.31
2758.32
2758.32
27256 00
Surgery
9.62
7.27
692.64
523.44
27257 00
Surgery
10.92
10.92
786.24
786.24
27258 00
Surgery
33.57
33.57
2417.04
2417.04
27259 00
Surgery
46.41
46.41
3341.52
3341.52
27265 00
Surgery
12.90
12.90
928.80
928.80
27266 00
Surgery
17.79
17.79
1280.88
1280.88
27267 00
Surgery
13.61
13.61
979.92
979.92
27268 00
Surgery
16.66
16.66
1199.52
1199.52
27269 00
Surgery
37.30
37.30
2685.60
2685.60
27275 00
Surgery
5.61
5.61
403.92
403.92
27278 00
Surgery
BR
BR
BR
BR
27279 00
Surgery
24.16
24.16
1739.52
1739.52
27280 00
Surgery
41.14
41.14
2962.08
2962.08
27282 00
Surgery
26.09
26.09
1878.48
1878.48
27284 00
Surgery
48.11
48.11
3463.92
3463.92
27286 00
Surgery
49.33
49.33
3551.76
3551.76
27290 00
Surgery
48.82
48.82
3515.04
3515.04
27295 00
Surgery
37.94
37.94
2731.68
2731.68
27299 00
Surgery
0.00
0.00
BR
BR
27301 00
Surgery
20.42
15.49
1470.24
1115.28
27303 00
Surgery
19.53
19.53
1406.16
1406.16
27305 00
Surgery
14.78
14.78
1064.16
1064.16
27306 00
Surgery
10.48
10.48
754.56
754.56
27307 00
Surgery
12.43
12.43
894.96
894.96
27310 00
Surgery
22.29
22.29
1604.88
1604.88
27323 00
Surgery
8.28
5.29
596.16
380.88
27324 00
Surgery
12.55
12.55
903.60
903.60
27325 00
Surgery
17.27
17.27
1243.44
1243.44
27326 00
Surgery
16.01
16.01
1152.72
1152.72
27327 00
Surgery
15.13
9.62
1089.36
692.64
27328 00
Surgery
18.94
18.94
1363.68
1363.68
27329 00
Surgery
31.38
31.38
2259.36
2259.36
27330 00
Surgery
13.00
13.00
936.00
936.00
27331 00
Surgery
14.62
14.62
1052.64
1052.64
27332 00
Surgery
19.71
19.71
1419.12
1419.12
27333 00
Surgery
18.03
18.03
1298.16
1298.16
27334 00
Surgery
20.92
20.92
1506.24
1506.24
27335 00
Surgery
23.30
23.30
1677.60
1677.60
27337 00
Surgery
12.74
12.74
917.28
917.28
27339 00
Surgery
22.87
22.87
1646.64
1646.64
27340 00
Surgery
11.55
11.55
831.60
831.60
27345 00
Surgery
14.90
14.90
1072.80
1072.80
27347 00
Surgery
16.14
16.14
1162.08
1162.08
27350 00
Surgery
19.96
19.96
1437.12
1437.12
27355 00
Surgery
18.55
18.55
1335.60
1335.60
27356 00
Surgery
22.53
22.53
1622.16
1622.16
27357 00
Surgery
24.86
24.86
1789.92
1789.92
27358 00
Surgery
8.15
8.15
586.80
586.80
27360 00
Surgery
27.38
27.38
1971.36
1971.36
27364 00
Surgery
46.97
46.97
3381.84
3381.84
27365 00
Surgery
61.50
61.50
4428.00
4428.00
27369 00
Surgery
5.49
1.19
395.28
85.68
27372 00
Surgery
17.73
12.19
1276.56
877.68
27380 00
Surgery
18.99
18.99
1367.28
1367.28
27381 00
Surgery
24.91
24.91
1793.52
1793.52
27385 00
Surgery
18.53
18.53
1334.16
1334.16
27386 00
Surgery
26.00
26.00
1872.00
1872.00
27390 00
Surgery
13.84
13.84
996.48
996.48
27391 00
Surgery
17.70
17.70
1274.40
1274.40
27392 00
Surgery
21.74
21.74
1565.28
1565.28
27393 00
Surgery
15.33
15.33
1103.76
1103.76
27394 00
Surgery
19.98
19.98
1438.56
1438.56
27395 00
Surgery
26.78
26.78
1928.16
1928.16
27396 00
Surgery
18.88
18.88
1359.36
1359.36
27397 00
Surgery
27.78
27.78
2000.16
2000.16
27400 00
Surgery
21.20
21.20
1526.40
1526.40
27403 00
Surgery
19.69
19.69
1417.68
1417.68
27405 00
Surgery
20.61
20.61
1483.92
1483.92
27407 00
Surgery
24.23
24.23
1744.56
1744.56
27409 00
Surgery
29.28
29.28
2108.16
2108.16
27412 00
Surgery
49.57
49.57
3569.04
3569.04
27415 00
Surgery
41.40
41.40
2980.80
2980.80
27416 00
Surgery
29.65
29.65
2134.80
2134.80
27418 00
Surgery
24.93
24.93
1794.96
1794.96
27420 00
Surgery
22.82
22.82
1643.04
1643.04
27422 00
Surgery
22.56
22.56
1624.32
1624.32
27424 00
Surgery
22.78
22.78
1640.16
1640.16
27425 00
Surgery
13.96
13.96
1005.12
1005.12
27427 00
Surgery
21.55
21.55
1551.60
1551.60
27428 00
Surgery
33.84
33.84
2436.48
2436.48
27429 00
Surgery
38.14
38.14
2746.08
2746.08
27430 00
Surgery
22.59
22.59
1626.48
1626.48
27435 00
Surgery
24.54
24.54
1766.88
1766.88
27437 00
Surgery
20.16
20.16
1451.52
1451.52
27438 00
Surgery
25.50
25.50
1836.00
1836.00
27440 00
Surgery
24.23
24.23
1744.56
1744.56
27441 00
Surgery
25.00
25.00
1800.00
1800.00
27442 00
Surgery
26.32
26.32
1895.04
1895.04
27443 00
Surgery
24.79
24.79
1784.88
1784.88
27445 00
Surgery
37.79
37.79
2720.88
2720.88
27446 00
Surgery
34.59
34.59
2490.48
2490.48
27447 00
Surgery
38.57
38.57
2777.04
2777.04
27448 00
Surgery
25.12
25.12
1808.64
1808.64
27450 00
Surgery
30.51
30.51
2196.72
2196.72
27454 00
Surgery
38.99
38.99
2807.28
2807.28
27455 00
Surgery
29.08
29.08
2093.76
2093.76
27457 00
Surgery
28.53
28.53
2054.16
2054.16
27465 00
Surgery
37.59
37.59
2706.48
2706.48
27466 00
Surgery
35.76
35.76
2574.72
2574.72
27468 00
Surgery
40.38
40.38
2907.36
2907.36
27470 00
Surgery
35.66
35.66
2567.52
2567.52
27472 00
Surgery
38.13
38.13
2745.36
2745.36
27475 00
Surgery
20.22
20.22
1455.84
1455.84
27477 00
Surgery
22.31
22.31
1606.32
1606.32
27479 00
Surgery
27.81
27.81
2002.32
2002.32
27485 00
Surgery
20.46
20.46
1473.12
1473.12
27486 00
Surgery
42.25
42.25
3042.00
3042.00
27487 00
Surgery
52.61
52.61
3787.92
3787.92
27488 00
Surgery
36.21
36.21
2607.12
2607.12
27495 00
Surgery
34.10
34.10
2455.20
2455.20
27496 00
Surgery
16.82
16.82
1211.04
1211.04
27497 00
Surgery
17.73
17.73
1276.56
1276.56
27498 00
Surgery
20.05
20.05
1443.60
1443.60
27499 00
Surgery
21.39
21.39
1540.08
1540.08
27500 00
Surgery
16.07
14.74
1157.04
1061.28
27501 00
Surgery
15.48
15.25
1114.56
1098.00
27502 00
Surgery
22.85
22.85
1645.20
1645.20
27503 00
Surgery
24.27
24.27
1747.44
1747.44
27506 00
Surgery
40.34
40.34
2904.48
2904.48
27507 00
Surgery
29.17
29.17
2100.24
2100.24
27508 00
Surgery
16.20
15.33
1166.40
1103.76
27509 00
Surgery
20.57
20.57
1481.04
1481.04
27510 00
Surgery
20.76
20.76
1494.72
1494.72
27511 00
Surgery
29.99
29.99
2159.28
2159.28
27513 00
Surgery
37.09
37.09
2670.48
2670.48
27514 00
Surgery
29.08
29.08
2093.76
2093.76
27516 00
Surgery
16.06
15.01
1156.32
1080.72
27517 00
Surgery
21.06
21.06
1516.32
1516.32
27519 00
Surgery
26.85
26.85
1933.20
1933.20
27520 00
Surgery
10.21
9.42
735.12
678.24
27524 00
Surgery
22.89
22.89
1648.08
1648.08
27530 00
Surgery
9.65
9.06
694.80
652.32
27532 00
Surgery
19.08
17.78
1373.76
1280.16
27535 00
Surgery
27.04
27.04
1946.88
1946.88
27536 00
Surgery
35.84
35.84
2580.48
2580.48
27538 00
Surgery
14.99
13.93
1079.28
1002.96
27540 00
Surgery
24.69
24.69
1777.68
1777.68
27550 00
Surgery
15.82
14.51
1139.04
1044.72
27552 00
Surgery
19.41
19.41
1397.52
1397.52
27556 00
Surgery
26.43
26.43
1902.96
1902.96
27557 00
Surgery
31.43
31.43
2262.96
2262.96
27558 00
Surgery
35.71
35.71
2571.12
2571.12
27560 00
Surgery
11.67
10.64
840.24
766.08
27562 00
Surgery
15.10
15.10
1087.20
1087.20
27566 00
Surgery
27.06
27.06
1948.32
1948.32
27570 00
Surgery
4.70
4.70
338.40
338.40
27580 00
Surgery
44.50
44.50
3204.00
3204.00
27590 00
Surgery
23.44
23.44
1687.68
1687.68
27591 00
Surgery
29.14
29.14
2098.08
2098.08
27592 00
Surgery
20.07
20.07
1445.04
1445.04
27594 00
Surgery
15.22
15.22
1095.84
1095.84
27596 00
Surgery
21.33
21.33
1535.76
1535.76
27598 00
Surgery
20.79
20.79
1496.88
1496.88
27599 00
Surgery
0.00
0.00
BR
BR
27600 00
Surgery
12.06
12.06
868.32
868.32
27601 00
Surgery
13.41
13.41
965.52
965.52
27602 00
Surgery
14.28
14.28
1028.16
1028.16
27603 00
Surgery
15.84
11.82
1140.48
851.04
27604 00
Surgery
13.57
9.80
977.04
705.60
27605 00
Surgery
9.89
5.52
712.08
397.44
27606 00
Surgery
8.14
8.14
586.08
586.08
27607 00
Surgery
18.16
18.16
1307.52
1307.52
27610 00
Surgery
19.58
19.58
1409.76
1409.76
27612 00
Surgery
17.37
17.37
1250.64
1250.64
27613 00
Surgery
7.66
4.89
551.52
352.08
27614 00
Surgery
17.81
12.63
1282.32
909.36
27615 00
Surgery
30.54
30.54
2198.88
2198.88
27616 00
Surgery
37.89
37.89
2728.08
2728.08
27618 00
Surgery
14.69
9.32
1057.68
671.04
27619 00
Surgery
14.29
14.29
1028.88
1028.88
27620 00
Surgery
13.64
13.64
982.08
982.08
27625 00
Surgery
17.38
17.38
1251.36
1251.36
27626 00
Surgery
18.79
18.79
1352.88
1352.88
27630 00
Surgery
16.26
10.88
1170.72
783.36
27632 00
Surgery
12.39
12.39
892.08
892.08
27634 00
Surgery
20.34
20.34
1464.48
1464.48
27635 00
Surgery
17.61
17.61
1267.92
1267.92
27637 00
Surgery
22.68
22.68
1632.96
1632.96
27638 00
Surgery
22.49
22.49
1619.28
1619.28
27640 00
Surgery
25.16
25.16
1811.52
1811.52
27641 00
Surgery
19.76
19.76
1422.72
1422.72
27645 00
Surgery
53.03
53.03
3818.16
3818.16
27646 00
Surgery
46.12
46.12
3320.64
3320.64
27647 00
Surgery
29.78
29.78
2144.16
2144.16
27648 00
Surgery
6.33
1.53
455.76
110.16
27650 00
Surgery
19.94
19.94
1435.68
1435.68
27652 00
Surgery
20.32
20.32
1463.04
1463.04
27654 00
Surgery
21.69
21.69
1561.68
1561.68
27656 00
Surgery
15.91
10.39
1145.52
748.08
27658 00
Surgery
11.24
11.24
809.28
809.28
27659 00
Surgery
14.35
14.35
1033.20
1033.20
27664 00
Surgery
11.04
11.04
794.88
794.88
27665 00
Surgery
12.92
12.92
930.24
930.24
27675 00
Surgery
15.05
15.05
1083.60
1083.60
27676 00
Surgery
18.50
18.50
1332.00
1332.00
27680 00
Surgery
12.80
12.80
921.60
921.60
27681 00
Surgery
15.44
15.44
1111.68
1111.68
27685 00
Surgery
19.83
14.17
1427.76
1020.24
27686 00
Surgery
16.16
16.16
1163.52
1163.52
27687 00
Surgery
13.81
13.81
994.32
994.32
27690 00
Surgery
19.34
19.34
1392.48
1392.48
27691 00
Surgery
22.52
22.52
1621.44
1621.44
27692 00
Surgery
3.03
3.03
218.16
218.16
27695 00
Surgery
14.79
14.79
1064.88
1064.88
27696 00
Surgery
16.61
16.61
1195.92
1195.92
27698 00
Surgery
19.31
19.31
1390.32
1390.32
27700 00
Surgery
21.65
21.65
1558.80
1558.80
27702 00
Surgery
29.04
29.04
2090.88
2090.88
27703 00
Surgery
33.47
33.47
2409.84
2409.84
27704 00
Surgery
17.22
17.22
1239.84
1239.84
27705 00
Surgery
22.70
22.70
1634.40
1634.40
27707 00
Surgery
12.40
12.40
892.80
892.80
27709 00
Surgery
34.53
34.53
2486.16
2486.16
27712 00
Surgery
33.32
33.32
2399.04
2399.04
27715 00
Surgery
32.41
32.41
2333.52
2333.52
27720 00
Surgery
26.42
26.42
1902.24
1902.24
27722 00
Surgery
27.14
27.14
1954.08
1954.08
27724 00
Surgery
37.74
37.74
2717.28
2717.28
27725 00
Surgery
36.75
36.75
2646.00
2646.00
27726 00
Surgery
28.85
28.85
2077.20
2077.20
27727 00
Surgery
31.42
31.42
2262.24
2262.24
27730 00
Surgery
17.98
17.98
1294.56
1294.56
27732 00
Surgery
13.94
13.94
1003.68
1003.68
27734 00
Surgery
20.06
20.06
1444.32
1444.32
27740 00
Surgery
21.57
21.57
1553.04
1553.04
27742 00
Surgery
23.65
23.65
1702.80
1702.80
27745 00
Surgery
22.61
22.61
1627.92
1627.92
27750 00
Surgery
10.88
10.10
783.36
727.20
27752 00
Surgery
16.55
15.10
1191.60
1087.20
27756 00
Surgery
17.65
17.65
1270.80
1270.80
27758 00
Surgery
27.17
27.17
1956.24
1956.24
27759 00
Surgery
30.13
30.13
2169.36
2169.36
27760 00
Surgery
10.43
9.62
750.96
692.64
27762 00
Surgery
15.17
13.66
1092.24
983.52
27766 00
Surgery
18.42
18.42
1326.24
1326.24
27767 00
Surgery
9.07
9.06
653.04
652.32
27768 00
Surgery
13.88
13.88
999.36
999.36
27769 00
Surgery
22.05
22.05
1587.60
1587.60
27780 00
Surgery
9.69
8.92
697.68
642.24
27781 00
Surgery
13.64
12.54
982.08
902.88
27784 00
Surgery
21.76
21.76
1566.72
1566.72
27786 00
Surgery
9.80
8.97
705.60
645.84
27788 00
Surgery
13.24
11.95
953.28
860.40
27792 00
Surgery
19.62
19.62
1412.64
1412.64
27808 00
Surgery
10.52
9.57
757.44
689.04
27810 00
Surgery
14.76
13.27
1062.72
955.44
27814 00
Surgery
23.19
23.19
1669.68
1669.68
27816 00
Surgery
10.38
9.21
747.36
663.12
27818 00
Surgery
15.31
13.63
1102.32
981.36
27822 00
Surgery
26.48
26.48
1906.56
1906.56
27823 00
Surgery
29.81
29.81
2146.32
2146.32
27824 00
Surgery
9.85
9.51
709.20
684.72
27825 00
Surgery
16.82
15.13
1211.04
1089.36
27826 00
Surgery
25.88
25.88
1863.36
1863.36
27827 00
Surgery
33.89
33.89
2440.08
2440.08
27828 00
Surgery
40.05
40.05
2883.60
2883.60
27829 00
Surgery
21.48
21.48
1546.56
1546.56
27830 00
Surgery
12.15
11.21
874.80
807.12
27831 00
Surgery
12.65
12.65
910.80
910.80
27832 00
Surgery
23.08
23.08
1661.76
1661.76
27840 00
Surgery
12.00
12.00
864.00
864.00
27842 00
Surgery
15.11
15.11
1087.92
1087.92
27846 00
Surgery
22.08
22.08
1589.76
1589.76
27848 00
Surgery
23.90
23.90
1720.80
1720.80
27860 00
Surgery
4.95
4.95
356.40
356.40
27870 00
Surgery
30.43
30.43
2190.96
2190.96
27871 00
Surgery
20.98
20.98
1510.56
1510.56
27880 00
Surgery
26.84
26.84
1932.48
1932.48
27881 00
Surgery
25.21
25.21
1815.12
1815.12
27882 00
Surgery
17.70
17.70
1274.40
1274.40
27884 00
Surgery
17.39
17.39
1252.08
1252.08
27886 00
Surgery
19.47
19.47
1401.84
1401.84
27888 00
Surgery
17.12
17.12
1232.64
1232.64
27889 00
Surgery
19.18
19.18
1380.96
1380.96
27892 00
Surgery
16.21
16.21
1167.12
1167.12
27893 00
Surgery
18.75
18.75
1350.00
1350.00
27894 00
Surgery
24.51
24.51
1764.72
1764.72
27899 00
Surgery
0.00
0.00
BR
BR
28001 00
Surgery
5.13
2.86
369.36
205.92
28002 00
Surgery
7.36
4.19
529.92
301.68
28003 00
Surgery
11.31
7.71
814.32
555.12
28005 00
Surgery
17.23
17.23
1240.56
1240.56
28008 00
Surgery
12.83
8.91
923.76
641.52
28010 00
Surgery
7.09
6.32
510.48
455.04
28011 00
Surgery
9.55
8.47
687.60
609.84
28020 00
Surgery
16.29
11.08
1172.88
797.76
28022 00
Surgery
14.63
9.93
1053.36
714.96
28024 00
Surgery
13.88
9.35
999.36
673.20
28035 00
Surgery
15.87
10.87
1142.64
782.64
28039 00
Surgery
14.33
10.23
1031.76
736.56
28041 00
Surgery
13.63
13.63
981.36
981.36
28043 00
Surgery
11.51
7.91
828.72
569.52
28045 00
Surgery
14.42
10.50
1038.24
756.00
28046 00
Surgery
21.04
21.04
1514.88
1514.88
28047 00
Surgery
31.12
31.12
2240.64
2240.64
28050 00
Surgery
12.48
8.45
898.56
608.40
28052 00
Surgery
11.69
7.75
841.68
558.00
28054 00
Surgery
10.99
7.09
791.28
510.48
28055 00
Surgery
11.77
11.77
847.44
847.44
28060 00
Surgery
15.57
10.92
1121.04
786.24
28062 00
Surgery
17.33
12.22
1247.76
879.84
28070 00
Surgery
15.23
10.38
1096.56
747.36
28072 00
Surgery
14.75
9.87
1062.00
710.64
28080 00
Surgery
16.04
11.50
1154.88
828.00
28086 00
Surgery
15.75
10.62
1134.00
764.64
28088 00
Surgery
13.95
8.93
1004.40
642.96
28090 00
Surgery
14.00
9.36
1008.00
673.92
28092 00
Surgery
12.71
8.28
915.12
596.16
28100 00
Surgery
18.40
12.67
1324.80
912.24
28102 00
Surgery
18.65
18.65
1342.80
1342.80
28103 00
Surgery
11.69
11.69
841.68
841.68
28104 00
Surgery
15.78
10.75
1136.16
774.00
28106 00
Surgery
12.85
12.85
925.20
925.20
28107 00
Surgery
15.21
10.46
1095.12
753.12
28108 00
Surgery
13.03
8.75
938.16
630.00
28110 00
Surgery
13.90
8.91
1000.80
641.52
28111 00
Surgery
14.25
9.64
1026.00
694.08
28112 00
Surgery
14.47
9.49
1041.84
683.28
28113 00
Surgery
17.56
12.93
1264.32
930.96
28114 00
Surgery
32.06
25.31
2308.32
1822.32
28116 00
Surgery
23.12
17.60
1664.64
1267.20
28118 00
Surgery
18.20
12.82
1310.40
923.04
28119 00
Surgery
15.81
11.05
1138.32
795.60
28120 00
Surgery
20.15
15.01
1450.80
1080.72
28122 00
Surgery
17.80
13.30
1281.60
957.60
28124 00
Surgery
14.34
10.14
1032.48
730.08
28126 00
Surgery
11.76
7.61
846.72
547.92
28130 00
Surgery
18.71
18.71
1347.12
1347.12
28140 00
Surgery
17.06
12.84
1228.32
924.48
28150 00
Surgery
12.57
8.47
905.04
609.84
28153 00
Surgery
12.15
8.01
874.80
576.72
28160 00
Surgery
12.26
8.10
882.72
583.20
28171 00
Surgery
33.38
33.38
2403.36
2403.36
28173 00
Surgery
21.75
21.75
1566.00
1566.00
28175 00
Surgery
14.14
14.14
1018.08
1018.08
28190 00
Surgery
7.22
4.00
519.84
288.00
28192 00
Surgery
13.76
9.38
990.72
675.36
28193 00
Surgery
15.61
11.04
1123.92
794.88
28200 00
Surgery
14.84
9.91
1068.48
713.52
28202 00
Surgery
17.92
12.94
1290.24
931.68
28208 00
Surgery
14.57
9.75
1049.04
702.00
28210 00
Surgery
17.83
12.84
1283.76
924.48
28220 00
Surgery
13.54
9.26
974.88
666.72
28222 00
Surgery
16.16
11.22
1163.52
807.84
28225 00
Surgery
12.41
8.04
893.52
578.88
28226 00
Surgery
18.62
12.22
1340.64
879.84
28230 00
Surgery
12.97
8.63
933.84
621.36
28232 00
Surgery
11.32
7.32
815.04
527.04
28234 00
Surgery
12.32
8.20
887.04
590.40
28238 00
Surgery
20.17
14.79
1452.24
1064.88
28240 00
Surgery
13.30
8.90
957.60
640.80
28250 00
Surgery
17.70
12.50
1274.40
900.00
28260 00
Surgery
21.95
16.37
1580.40
1178.64
28261 00
Surgery
32.29
25.47
2324.88
1833.84
28262 00
Surgery
41.32
33.39
2975.04
2404.08
28264 00
Surgery
26.18
20.24
1884.96
1457.28
28270 00
Surgery
14.61
10.13
1051.92
729.36
28272 00
Surgery
11.48
7.61
826.56
547.92
28280 00
Surgery
15.16
10.44
1091.52
751.68
28285 00
Surgery
16.23
11.73
1168.56
844.56
28286 00
Surgery
13.30
9.02
957.60
649.44
28288 00
Surgery
18.15
13.21
1306.80
951.12
28289 00
Surgery
20.68
13.98
1488.96
1006.56
28291 00
Surgery
20.67
14.52
1488.24
1045.44
28292 00
Surgery
21.02
14.72
1513.44
1059.84
28295 00
Surgery
31.44
18.23
2263.68
1312.56
28296 00
Surgery
26.52
15.53
1909.44
1118.16
28297 00
Surgery
30.67
18.19
2208.24
1309.68
28298 00
Surgery
25.08
15.38
1805.76
1107.36
28299 00
Surgery
30.37
18.01
2186.64
1296.72
28300 00
Surgery
19.70
19.70
1418.40
1418.40
28302 00
Surgery
21.78
21.78
1568.16
1568.16
28304 00
Surgery
24.92
18.58
1794.24
1337.76
28305 00
Surgery
20.40
20.40
1468.80
1468.80
28306 00
Surgery
18.36
12.36
1321.92
889.92
28307 00
Surgery
23.66
15.79
1703.52
1136.88
28308 00
Surgery
17.19
11.78
1237.68
848.16
28309 00
Surgery
27.34
27.34
1968.48
1968.48
28310 00
Surgery
16.43
11.03
1182.96
794.16
28312 00
Surgery
16.37
10.48
1178.64
754.56
28313 00
Surgery
15.89
10.98
1144.08
790.56
28315 00
Surgery
14.35
9.87
1033.20
710.64
28320 00
Surgery
18.68
18.68
1344.96
1344.96
28322 00
Surgery
23.69
17.53
1705.68
1262.16
28340 00
Surgery
17.02
12.32
1225.44
887.04
28341 00
Surgery
19.75
14.64
1422.00
1054.08
28344 00
Surgery
12.58
8.46
905.76
609.12
28345 00
Surgery
15.39
10.94
1108.08
787.68
28360 00
Surgery
33.27
33.27
2395.44
2395.44
28400 00
Surgery
7.70
7.15
554.40
514.80
28405 00
Surgery
14.00
12.56
1008.00
904.32
28406 00
Surgery
18.07
18.07
1301.04
1301.04
28415 00
Surgery
33.87
33.87
2438.64
2438.64
28420 00
Surgery
39.20
39.20
2822.40
2822.40
28430 00
Surgery
7.46
6.55
537.12
471.60
28435 00
Surgery
11.51
10.20
828.72
734.40
28436 00
Surgery
15.24
15.24
1097.28
1097.28
28445 00
Surgery
31.70
31.70
2282.40
2282.40
28446 00
Surgery
36.98
36.98
2662.56
2662.56
28450 00
Surgery
6.56
5.94
472.32
427.68
28455 00
Surgery
7.84
7.02
564.48
505.44
28456 00
Surgery
11.40
11.40
820.80
820.80
28465 00
Surgery
19.48
19.48
1402.56
1402.56
28470 00
Surgery
6.77
6.38
487.44
459.36
28475 00
Surgery
8.04
7.08
578.88
509.76
28476 00
Surgery
11.85
11.85
853.20
853.20
28485 00
Surgery
17.14
17.14
1234.08
1234.08
28490 00
Surgery
4.40
3.87
316.80
278.64
28495 00
Surgery
5.56
4.62
400.32
332.64
28496 00
Surgery
15.27
8.43
1099.44
606.96
28505 00
Surgery
19.63
15.05
1413.36
1083.60
28510 00
Surgery
3.76
3.75
270.72
270.00
28515 00
Surgery
5.10
4.45
367.20
320.40
28525 00
Surgery
17.17
12.39
1236.24
892.08
28530 00
Surgery
3.62
3.16
260.64
227.52
28531 00
Surgery
9.92
5.52
714.24
397.44
28540 00
Surgery
6.05
5.43
435.60
390.96
28545 00
Surgery
9.63
8.44
693.36
607.68
28546 00
Surgery
17.79
10.88
1280.88
783.36
28555 00
Surgery
26.03
20.10
1874.16
1447.20
28570 00
Surgery
7.36
6.17
529.92
444.24
28575 00
Surgery
11.76
10.54
846.72
758.88
28576 00
Surgery
11.96
11.96
861.12
861.12
28585 00
Surgery
27.08
21.41
1949.76
1541.52
28600 00
Surgery
5.77
4.95
415.44
356.40
28605 00
Surgery
10.65
9.50
766.80
684.00
28606 00
Surgery
12.00
12.00
864.00
864.00
28615 00
Surgery
25.14
25.14
1810.08
1810.08
28630 00
Surgery
4.73
3.37
340.56
242.64
28635 00
Surgery
5.21
3.97
375.12
285.84
28636 00
Surgery
10.73
6.80
772.56
489.60
28645 00
Surgery
19.64
14.77
1414.08
1063.44
28660 00
Surgery
3.86
2.88
277.92
207.36
28665 00
Surgery
4.61
3.84
331.92
276.48
28666 00
Surgery
5.30
5.30
381.60
381.60
28675 00
Surgery
17.39
12.59
1252.08
906.48
28705 00
Surgery
36.72
36.72
2643.84
2643.84
28715 00
Surgery
28.39
28.39
2044.08
2044.08
28725 00
Surgery
23.56
23.56
1696.32
1696.32
28730 00
Surgery
21.93
21.93
1578.96
1578.96
28735 00
Surgery
23.43
23.43
1686.96
1686.96
28737 00
Surgery
20.89
20.89
1504.08
1504.08
28740 00
Surgery
24.84
18.65
1788.48
1342.80
28750 00
Surgery
23.44
17.43
1687.68
1254.96
28755 00
Surgery
15.16
10.15
1091.52
730.80
28760 00
Surgery
23.19
17.31
1669.68
1246.32
28800 00
Surgery
15.88
15.88
1143.36
1143.36
28805 00
Surgery
21.17
21.17
1524.24
1524.24
28810 00
Surgery
12.74
12.74
917.28
917.28
28820 00
Surgery
8.89
5.30
640.08
381.60
28825 00
Surgery
8.75
5.17
630.00
372.24
28890 00
Surgery
9.41
6.76
677.52
486.72
28899 00
Surgery
0.00
0.00
BR
BR
29000 00
Surgery
11.08
6.05
797.76
435.60
29010 00
Surgery
8.52
4.84
613.44
348.48
29015 00
Surgery
9.12
5.44
656.64
391.68
29035 00
Surgery
8.03
4.35
578.16
313.20
29040 00
Surgery
9.13
5.23
657.36
376.56
29044 00
Surgery
8.96
5.05
645.12
363.60
29046 00
Surgery
9.79
5.67
704.88
408.24
29049 00
Surgery
3.07
2.11
221.04
151.92
29055 00
Surgery
6.94
4.16
499.68
299.52
29058 00
Surgery
3.79
2.82
272.88
203.04
29065 00
Surgery
2.98
2.06
214.56
148.32
29075 00
Surgery
2.69
1.89
193.68
136.08
29085 00
Surgery
2.95
2.04
212.40
146.88
29086 00
Surgery
2.36
1.49
169.92
107.28
29105 00
Surgery
2.54
1.25
182.88
90.00
29125 00
Surgery
2.05
1.22
147.60
87.84
29126 00
Surgery
2.40
1.49
172.80
107.28
29130 00
Surgery
1.28
0.87
92.16
62.64
29131 00
Surgery
1.65
1.04
118.80
74.88
29200 00
Surgery
0.96
0.54
69.12
38.88
29240 00
Surgery
0.89
0.53
64.08
38.16
29260 00
Surgery
0.87
0.56
62.64
40.32
29280 00
Surgery
0.90
0.60
64.80
43.20
29305 00
Surgery
7.67
4.78
552.24
344.16
29325 00
Surgery
8.47
5.35
609.84
385.20
29345 00
Surgery
4.13
2.98
297.36
214.56
29355 00
Surgery
4.33
3.20
311.76
230.40
29358 00
Surgery
4.98
3.11
358.56
223.92
29365 00
Surgery
3.82
2.65
275.04
190.80
29405 00
Surgery
2.46
1.77
177.12
127.44
29425 00
Surgery
2.30
1.63
165.60
117.36
29435 00
Surgery
3.80
2.61
273.60
187.92
29440 00
Surgery
1.31
0.84
94.32
60.48
29445 00
Surgery
3.88
2.95
279.36
212.40
29450 00
Surgery
4.41
3.37
317.52
242.64
29505 00
Surgery
2.75
1.58
198.00
113.76
29515 00
Surgery
2.21
1.50
159.12
108.00
29520 00
Surgery
1.04
0.54
74.88
38.88
29530 00
Surgery
0.88
0.53
63.36
38.16
29540 00
Surgery
0.84
0.51
60.48
36.72
29550 00
Surgery
0.58
0.33
41.76
23.76
29580 00
Surgery
1.92
0.78
138.24
56.16
29581 00
Surgery
2.64
0.79
190.08
56.88
29584 00
Surgery
2.40
0.46
172.80
33.12
29700 00
Surgery
1.95
0.99
140.40
71.28
29705 00
Surgery
1.92
1.33
138.24
95.76
29710 00
Surgery
3.74
2.46
269.28
177.12
29720 00
Surgery
2.65
1.31
190.80
94.32
29730 00
Surgery
1.98
1.34
142.56
96.48
29740 00
Surgery
3.02
2.06
217.44
148.32
29750 00
Surgery
3.25
2.30
234.00
165.60
29799 00
Surgery
0.00
0.00
BR
BR
29800 00
Surgery
16.21
16.21
1167.12
1167.12
29804 00
Surgery
17.87
17.87
1286.64
1286.64
29805 00
Surgery
14.26
14.26
1026.72
1026.72
29806 00
Surgery
32.02
32.02
2305.44
2305.44
29807 00
Surgery
31.27
31.27
2251.44
2251.44
29819 00
Surgery
17.87
17.87
1286.64
1286.64
29820 00
Surgery
16.23
16.23
1168.56
1168.56
29821 00
Surgery
18.03
18.03
1298.16
1298.16
29822 00
Surgery
16.50
16.50
1188.00
1188.00
29823 00
Surgery
18.04
18.04
1298.88
1298.88
29824 00
Surgery
20.59
20.59
1482.48
1482.48
29825 00
Surgery
17.83
17.83
1283.76
1283.76
29826 00
Surgery
5.10
5.10
367.20
367.20
29827 00
Surgery
32.26
32.26
2322.72
2322.72
29828 00
Surgery
27.71
27.71
1995.12
1995.12
29830 00
Surgery
13.93
13.93
1002.96
1002.96
29834 00
Surgery
14.99
14.99
1079.28
1079.28
29835 00
Surgery
15.56
15.56
1120.32
1120.32
29836 00
Surgery
17.80
17.80
1281.60
1281.60
29837 00
Surgery
16.00
16.00
1152.00
1152.00
29838 00
Surgery
18.13
18.13
1305.36
1305.36
29840 00
Surgery
13.77
13.77
991.44
991.44
29843 00
Surgery
14.89
14.89
1072.08
1072.08
29844 00
Surgery
15.23
15.23
1096.56
1096.56
29845 00
Surgery
17.88
17.88
1287.36
1287.36
29846 00
Surgery
15.94
15.94
1147.68
1147.68
29847 00
Surgery
16.61
16.61
1195.92
1195.92
29848 00
Surgery
15.68
15.68
1128.96
1128.96
29850 00
Surgery
19.03
19.03
1370.16
1370.16
29851 00
Surgery
28.14
28.14
2026.08
2026.08
29855 00
Surgery
23.66
23.66
1703.52
1703.52
29856 00
Surgery
30.01
30.01
2160.72
2160.72
29860 00
Surgery
19.92
19.92
1434.24
1434.24
29861 00
Surgery
21.66
21.66
1559.52
1559.52
29862 00
Surgery
24.73
24.73
1780.56
1780.56
29863 00
Surgery
24.71
24.71
1779.12
1779.12
29866 00
Surgery
31.87
31.87
2294.64
2294.64
29867 00
Surgery
38.62
38.62
2780.64
2780.64
29868 00
Surgery
50.20
50.20
3614.40
3614.40
29870 00
Surgery
16.80
12.54
1209.60
902.88
29871 00
Surgery
15.72
15.72
1131.84
1131.84
29873 00
Surgery
16.44
16.44
1183.68
1183.68
29874 00
Surgery
16.40
16.40
1180.80
1180.80
29875 00
Surgery
15.15
15.15
1090.80
1090.80
29876 00
Surgery
19.85
19.85
1429.20
1429.20
29877 00
Surgery
18.89
18.89
1360.08
1360.08
29879 00
Surgery
20.12
20.12
1448.64
1448.64
29880 00
Surgery
17.12
17.12
1232.64
1232.64
29881 00
Surgery
16.50
16.50
1188.00
1188.00
29882 00
Surgery
20.90
20.90
1504.80
1504.80
29883 00
Surgery
25.56
25.56
1840.32
1840.32
29884 00
Surgery
18.86
18.86
1357.92
1357.92
29885 00
Surgery
23.00
23.00
1656.00
1656.00
29886 00
Surgery
19.40
19.40
1396.80
1396.80
29887 00
Surgery
22.92
22.92
1650.24
1650.24
29888 00
Surgery
29.42
29.42
2118.24
2118.24
29889 00
Surgery
37.04
37.04
2666.88
2666.88
29891 00
Surgery
20.44
20.44
1471.68
1471.68
29892 00
Surgery
19.41
19.41
1397.52
1397.52
29893 00
Surgery
20.02
13.29
1441.44
956.88
29894 00
Surgery
15.30
15.30
1101.60
1101.60
29895 00
Surgery
14.03
14.03
1010.16
1010.16
29897 00
Surgery
15.02
15.02
1081.44
1081.44
29898 00
Surgery
16.96
16.96
1221.12
1221.12
29899 00
Surgery
30.32
30.32
2183.04
2183.04
29900 00
Surgery
15.47
15.47
1113.84
1113.84
29901 00
Surgery
16.56
16.56
1192.32
1192.32
29902 00
Surgery
17.55
17.55
1263.60
1263.60
29904 00
Surgery
19.47
19.47
1401.84
1401.84
29905 00
Surgery
15.52
15.52
1117.44
1117.44
29906 00
Surgery
19.79
19.79
1424.88
1424.88
29907 00
Surgery
26.61
26.61
1915.92
1915.92
29914 00
Surgery
29.98
29.98
2158.56
2158.56
29915 00
Surgery
30.73
30.73
2212.56
2212.56
29916 00
Surgery
30.60
30.60
2203.20
2203.20
29999 00
Surgery
0.00
0.00
BR
BR
30000 00
Surgery
7.99
3.67
575.28
264.24
30020 00
Surgery
8.14
3.72
586.08
267.84
30100 00
Surgery
4.24
2.06
305.28
148.32
30110 00
Surgery
7.52
4.03
541.44
290.16
30115 00
Surgery
14.11
14.11
1015.92
1015.92
30117 00
Surgery
29.73
12.50
2140.56
900.00
30118 00
Surgery
21.44
21.44
1543.68
1543.68
30120 00
Surgery
15.42
12.68
1110.24
912.96
30124 00
Surgery
9.25
9.25
666.00
666.00
30125 00
Surgery
19.81
19.81
1426.32
1426.32
30130 00
Surgery
12.60
12.60
907.20
907.20
30140 00
Surgery
8.91
5.33
641.52
383.76
30150 00
Surgery
24.16
24.16
1739.52
1739.52
30160 00
Surgery
24.64
24.64
1774.08
1774.08
30200 00
Surgery
3.33
1.80
239.76
129.60
30210 00
Surgery
4.57
3.12
329.04
224.64
30220 00
Surgery
9.16
3.89
659.52
280.08
30300 00
Surgery
6.34
3.72
456.48
267.84
30310 00
Surgery
6.30
6.30
453.60
453.60
30320 00
Surgery
14.79
14.79
1064.88
1064.88
30400 00
Surgery
37.04
37.04
2666.88
2666.88
30410 00
Surgery
42.60
42.60
3067.20
3067.20
30420 00
Surgery
43.81
43.81
3154.32
3154.32
30430 00
Surgery
32.40
32.40
2332.80
2332.80
30435 00
Surgery
40.34
40.34
2904.48
2904.48
30450 00
Surgery
52.62
52.62
3788.64
3788.64
30460 00
Surgery
24.95
24.95
1796.40
1796.40
30462 00
Surgery
47.91
47.91
3449.52
3449.52
30465 00
Surgery
31.00
31.00
2232.00
2232.00
30468 00
Surgery
74.99
5.06
5399.28
364.32
30469 00
Surgery
73.29
4.51
5276.88
324.72
30520 00
Surgery
20.43
20.43
1470.96
1470.96
30540 00
Surgery
22.36
22.36
1609.92
1609.92
30545 00
Surgery
30.27
30.27
2179.44
2179.44
30560 00
Surgery
9.70
4.58
698.40
329.76
30580 00
Surgery
18.30
13.84
1317.60
996.48
30600 00
Surgery
15.55
11.56
1119.60
832.32
30620 00
Surgery
20.42
20.42
1470.24
1470.24
30630 00
Surgery
20.24
20.24
1457.28
1457.28
30801 00
Surgery
6.59
4.60
474.48
331.20
30802 00
Surgery
8.38
6.12
603.36
440.64
30901 00
Surgery
4.70
1.69
338.40
121.68
30903 00
Surgery
7.32
2.30
527.04
165.60
30905 00
Surgery
10.51
3.16
756.72
227.52
30906 00
Surgery
11.28
3.96
812.16
285.12
30915 00
Surgery
18.26
18.26
1314.72
1314.72
30920 00
Surgery
26.34
26.34
1896.48
1896.48
30930 00
Surgery
3.59
3.59
258.48
258.48
30999 00
Surgery
0.00
0.00
BR
BR
31000 00
Surgery
5.61
3.35
403.92
241.20
31002 00
Surgery
5.71
5.71
411.12
411.12
31020 00
Surgery
12.65
10.31
910.80
742.32
31030 00
Surgery
19.33
15.50
1391.76
1116.00
31032 00
Surgery
17.96
17.96
1293.12
1293.12
31040 00
Surgery
24.35
24.35
1753.20
1753.20
31050 00
Surgery
15.64
15.64
1126.08
1126.08
31051 00
Surgery
20.98
20.98
1510.56
1510.56
31070 00
Surgery
14.40
14.40
1036.80
1036.80
31075 00
Surgery
25.01
25.01
1800.72
1800.72
31080 00
Surgery
32.90
32.90
2368.80
2368.80
31081 00
Surgery
35.25
35.25
2538.00
2538.00
31084 00
Surgery
36.48
36.48
2626.56
2626.56
31085 00
Surgery
37.58
37.58
2705.76
2705.76
31086 00
Surgery
35.52
35.52
2557.44
2557.44
31087 00
Surgery
33.82
33.82
2435.04
2435.04
31090 00
Surgery
33.46
33.46
2409.12
2409.12
31200 00
Surgery
18.90
18.90
1360.80
1360.80
31201 00
Surgery
23.55
23.55
1695.60
1695.60
31205 00
Surgery
28.33
28.33
2039.76
2039.76
31225 00
Surgery
54.07
54.07
3893.04
3893.04
31230 00
Surgery
60.32
60.32
4343.04
4343.04
31231 00
Surgery
5.63
1.93
405.36
138.96
31233 00
Surgery
8.25
4.06
594.00
292.32
31235 00
Surgery
9.38
4.78
675.36
344.16
31237 00
Surgery
7.74
4.79
557.28
344.88
31238 00
Surgery
7.54
5.01
542.88
360.72
31239 00
Surgery
18.18
18.18
1308.96
1308.96
31240 00
Surgery
4.76
4.76
342.72
342.72
31241 00
Surgery
13.27
13.27
955.44
955.44
31242 00
Surgery
75.08
4.72
5405.76
339.84
31243 00
Surgery
72.88
4.72
5247.36
339.84
31253 00
Surgery
14.88
14.88
1071.36
1071.36
31254 00
Surgery
13.13
7.25
945.36
522.00
31255 00
Surgery
9.63
9.63
693.36
693.36
31256 00
Surgery
5.37
5.37
386.64
386.64
31257 00
Surgery
13.28
13.28
956.16
956.16
31259 00
Surgery
14.03
14.03
1010.16
1010.16
31267 00
Surgery
7.92
7.92
570.24
570.24
31276 00
Surgery
11.27
11.27
811.44
811.44
31287 00
Surgery
6.00
6.00
432.00
432.00
31288 00
Surgery
6.98
6.98
502.56
502.56
31290 00
Surgery
34.24
34.24
2465.28
2465.28
31291 00
Surgery
36.73
36.73
2644.56
2644.56
31292 00
Surgery
29.67
29.67
2136.24
2136.24
31293 00
Surgery
32.22
32.22
2319.84
2319.84
31294 00
Surgery
36.78
36.78
2648.16
2648.16
31295 00
Surgery
49.29
4.71
3548.88
339.12
31296 00
Surgery
50.05
5.35
3603.60
385.20
31297 00
Surgery
48.86
4.30
3517.92
309.60
31298 00
Surgery
92.68
7.63
6672.96
549.36
31299 00
Surgery
0.00
0.00
BR
BR
31300 00
Surgery
37.62
37.62
2708.64
2708.64
31360 00
Surgery
61.66
61.66
4439.52
4439.52
31365 00
Surgery
76.00
76.00
5472.00
5472.00
31367 00
Surgery
65.18
65.18
4692.96
4692.96
31368 00
Surgery
72.03
72.03
5186.16
5186.16
31370 00
Surgery
61.18
61.18
4404.96
4404.96
31375 00
Surgery
58.16
58.16
4187.52
4187.52
31380 00
Surgery
57.36
57.36
4129.92
4129.92
31382 00
Surgery
62.79
62.79
4520.88
4520.88
31390 00
Surgery
83.83
83.83
6035.76
6035.76
31395 00
Surgery
87.94
87.94
6331.68
6331.68
31400 00
Surgery
30.49
30.49
2195.28
2195.28
31420 00
Surgery
25.09
25.09
1806.48
1806.48
31500 00
Surgery
4.17
4.17
300.24
300.24
31502 00
Surgery
1.04
1.04
74.88
74.88
31505 00
Surgery
2.70
1.49
194.40
107.28
31510 00
Surgery
6.50
3.63
468.00
261.36
31511 00
Surgery
6.35
4.03
457.20
290.16
31512 00
Surgery
6.54
3.88
470.88
279.36
31513 00
Surgery
3.93
3.93
282.96
282.96
31515 00
Surgery
6.40
3.32
460.80
239.04
31520 00
Surgery
4.68
4.68
336.96
336.96
31525 00
Surgery
7.54
4.79
542.88
344.88
31526 00
Surgery
4.69
4.69
337.68
337.68
31527 00
Surgery
5.81
5.81
418.32
418.32
31528 00
Surgery
4.31
4.31
310.32
310.32
31529 00
Surgery
4.81
4.81
346.32
346.32
31530 00
Surgery
5.93
5.93
426.96
426.96
31531 00
Surgery
6.29
6.29
452.88
452.88
31535 00
Surgery
5.64
5.64
406.08
406.08
31536 00
Surgery
6.26
6.26
450.72
450.72
31540 00
Surgery
7.18
7.18
516.96
516.96
31541 00
Surgery
7.83
7.83
563.76
563.76
31545 00
Surgery
10.76
10.76
774.72
774.72
31546 00
Surgery
16.30
16.30
1173.60
1173.60
31551 00
Surgery
46.42
46.42
3342.24
3342.24
31552 00
Surgery
44.81
44.81
3226.32
3226.32
31553 00
Surgery
50.55
50.55
3639.60
3639.60
31554 00
Surgery
50.57
50.57
3641.04
3641.04
31560 00
Surgery
9.28
9.28
668.16
668.16
31561 00
Surgery
10.15
10.15
730.80
730.80
31570 00
Surgery
10.34
6.83
744.48
491.76
31571 00
Surgery
7.41
7.41
533.52
533.52
31572 00
Surgery
15.71
5.39
1131.12
388.08
31573 00
Surgery
8.66
4.45
623.52
320.40
31574 00
Surgery
28.02
4.47
2017.44
321.84
31575 00
Surgery
3.88
2.06
279.36
148.32
31576 00
Surgery
8.14
3.58
586.08
257.76
31577 00
Surgery
8.23
3.99
592.56
287.28
31578 00
Surgery
9.22
4.47
663.84
321.84
31579 00
Surgery
5.95
3.58
428.40
257.76
31580 00
Surgery
38.63
38.63
2781.36
2781.36
31584 00
Surgery
42.45
42.45
3056.40
3056.40
31587 00
Surgery
36.38
36.38
2619.36
2619.36
31590 00
Surgery
27.91
27.91
2009.52
2009.52
31591 00
Surgery
33.19
33.19
2389.68
2389.68
31592 00
Surgery
52.08
52.08
3749.76
3749.76
31599 00
Surgery
0.00
0.00
BR
BR
31600 00
Surgery
9.07
9.07
653.04
653.04
31601 00
Surgery
13.41
13.41
965.52
965.52
31603 00
Surgery
9.51
9.51
684.72
684.72
31605 00
Surgery
9.79
9.79
704.88
704.88
31610 00
Surgery
28.81
28.81
2074.32
2074.32
31611 00
Surgery
16.21
16.21
1167.12
1167.12
31612 00
Surgery
2.80
1.43
201.60
102.96
31613 00
Surgery
12.80
12.80
921.60
921.60
31614 00
Surgery
21.48
21.48
1546.56
1546.56
31615 00
Surgery
5.18
3.46
372.96
249.12
31622 00
Surgery
7.48
3.90
538.56
280.80
31623 00
Surgery
8.21
3.87
591.12
278.64
31624 00
Surgery
7.64
3.92
550.08
282.24
31625 00
Surgery
10.43
4.58
750.96
329.76
31626 00
Surgery
23.44
5.78
1687.68
416.16
31627 00
Surgery
31.81
2.82
2290.32
203.04
31628 00
Surgery
11.11
5.15
799.92
370.80
31629 00
Surgery
13.52
5.47
973.44
393.84
31630 00
Surgery
5.82
5.82
419.04
419.04
31631 00
Surgery
6.63
6.63
477.36
477.36
31632 00
Surgery
1.93
1.43
138.96
102.96
31633 00
Surgery
2.40
1.84
172.80
132.48
31634 00
Surgery
43.82
5.51
3155.04
396.72
31635 00
Surgery
8.77
5.15
631.44
370.80
31636 00
Surgery
6.34
6.34
456.48
456.48
31637 00
Surgery
2.22
2.22
159.84
159.84
31638 00
Surgery
7.20
7.20
518.40
518.40
31640 00
Surgery
7.24
7.24
521.28
521.28
31641 00
Surgery
7.44
7.44
535.68
535.68
31643 00
Surgery
4.96
4.96
357.12
357.12
31645 00
Surgery
8.21
4.32
591.12
311.04
31646 00
Surgery
4.17
4.17
300.24
300.24
31647 00
Surgery
6.01
6.01
432.72
432.72
31648 00
Surgery
5.80
5.80
417.60
417.60
31649 00
Surgery
1.95
1.95
140.40
140.40
31651 00
Surgery
2.22
2.22
159.84
159.84
31652 00
Surgery
37.10
6.45
2671.20
464.40
31653 00
Surgery
38.51
7.15
2772.72
514.80
31654 00
Surgery
3.60
1.96
259.20
141.12
31660 00
Surgery
5.55
5.55
399.60
399.60
31661 00
Surgery
5.86
5.86
421.92
421.92
31717 00
Surgery
8.55
3.12
615.60
224.64
31720 00
Surgery
1.43
1.43
102.96
102.96
31725 00
Surgery
2.32
2.32
167.04
167.04
31730 00
Surgery
31.41
4.39
2261.52
316.08
31750 00
Surgery
40.58
40.58
2921.76
2921.76
31755 00
Surgery
52.03
52.03
3746.16
3746.16
31760 00
Surgery
40.77
40.77
2935.44
2935.44
31766 00
Surgery
52.43
52.43
3774.96
3774.96
31770 00
Surgery
39.24
39.24
2825.28
2825.28
31775 00
Surgery
41.35
41.35
2977.20
2977.20
31780 00
Surgery
35.98
35.98
2590.56
2590.56
31781 00
Surgery
43.08
43.08
3101.76
3101.76
31785 00
Surgery
32.22
32.22
2319.84
2319.84
31786 00
Surgery
42.61
42.61
3067.92
3067.92
31800 00
Surgery
21.29
21.29
1532.88
1532.88
31805 00
Surgery
24.35
24.35
1753.20
1753.20
31820 00
Surgery
13.45
10.06
968.40
724.32
31825 00
Surgery
18.59
14.70
1338.48
1058.40
31830 00
Surgery
15.00
11.15
1080.00
802.80
31899 00
Surgery
0.00
0.00
BR
BR
32035 00
Surgery
21.92
21.92
1578.24
1578.24
32036 00
Surgery
23.61
23.61
1699.92
1699.92
32096 00
Surgery
23.72
23.72
1707.84
1707.84
32097 00
Surgery
23.76
23.76
1710.72
1710.72
32098 00
Surgery
22.47
22.47
1617.84
1617.84
32100 00
Surgery
24.07
24.07
1733.04
1733.04
32110 00
Surgery
43.81
43.81
3154.32
3154.32
32120 00
Surgery
25.94
25.94
1867.68
1867.68
32124 00
Surgery
27.39
27.39
1972.08
1972.08
32140 00
Surgery
29.41
29.41
2117.52
2117.52
32141 00
Surgery
44.92
44.92
3234.24
3234.24
32150 00
Surgery
30.22
30.22
2175.84
2175.84
32151 00
Surgery
29.84
29.84
2148.48
2148.48
32160 00
Surgery
23.73
23.73
1708.56
1708.56
32200 00
Surgery
33.89
33.89
2440.08
2440.08
32215 00
Surgery
23.89
23.89
1720.08
1720.08
32220 00
Surgery
47.42
47.42
3414.24
3414.24
32225 00
Surgery
29.52
29.52
2125.44
2125.44
32310 00
Surgery
27.29
27.29
1964.88
1964.88
32320 00
Surgery
47.56
47.56
3424.32
3424.32
32400 00
Surgery
5.04
2.46
362.88
177.12
32408 00
Surgery
25.18
4.46
1812.96
321.12
32440 00
Surgery
46.40
46.40
3340.80
3340.80
32442 00
Surgery
89.83
89.83
6467.76
6467.76
32445 00
Surgery
104.02
104.02
7489.44
7489.44
32480 00
Surgery
43.74
43.74
3149.28
3149.28
32482 00
Surgery
46.75
46.75
3366.00
3366.00
32484 00
Surgery
42.34
42.34
3048.48
3048.48
32486 00
Surgery
68.94
68.94
4963.68
4963.68
32488 00
Surgery
70.52
70.52
5077.44
5077.44
32491 00
Surgery
43.63
43.63
3141.36
3141.36
32501 00
Surgery
7.14
7.14
514.08
514.08
32503 00
Surgery
53.00
53.00
3816.00
3816.00
32504 00
Surgery
60.35
60.35
4345.20
4345.20
32505 00
Surgery
27.61
27.61
1987.92
1987.92
32506 00
Surgery
4.58
4.58
329.76
329.76
32507 00
Surgery
4.57
4.57
329.04
329.04
32540 00
Surgery
51.08
51.08
3677.76
3677.76
32550 00
Surgery
23.04
6.00
1658.88
432.00
32551 00
Surgery
4.59
4.59
330.48
330.48
32552 00
Surgery
5.46
4.66
393.12
335.52
32553 00
Surgery
15.04
5.13
1082.88
369.36
32554 00
Surgery
7.01
2.61
504.72
187.92
32555 00
Surgery
9.35
3.20
673.20
230.40
32556 00
Surgery
22.10
3.66
1591.20
263.52
32557 00
Surgery
19.60
4.37
1411.20
314.64
32560 00
Surgery
7.56
2.24
544.32
161.28
32561 00
Surgery
2.84
1.98
204.48
142.56
32562 00
Surgery
2.54
1.77
182.88
127.44
32601 00
Surgery
9.09
9.09
654.48
654.48
32604 00
Surgery
14.12
14.12
1016.64
1016.64
32606 00
Surgery
13.59
13.59
978.48
978.48
32607 00
Surgery
9.07
9.07
653.04
653.04
32608 00
Surgery
11.15
11.15
802.80
802.80
32609 00
Surgery
7.55
7.55
543.60
543.60
32650 00
Surgery
19.89
19.89
1432.08
1432.08
32651 00
Surgery
32.44
32.44
2335.68
2335.68
32652 00
Surgery
49.13
49.13
3537.36
3537.36
32653 00
Surgery
31.34
31.34
2256.48
2256.48
32654 00
Surgery
35.01
35.01
2520.72
2520.72
32655 00
Surgery
28.37
28.37
2042.64
2042.64
32656 00
Surgery
23.86
23.86
1717.92
1717.92
32658 00
Surgery
21.25
21.25
1530.00
1530.00
32659 00
Surgery
21.84
21.84
1572.48
1572.48
32661 00
Surgery
23.72
23.72
1707.84
1707.84
32662 00
Surgery
26.53
26.53
1910.16
1910.16
32663 00
Surgery
41.29
41.29
2972.88
2972.88
32664 00
Surgery
25.17
25.17
1812.24
1812.24
32665 00
Surgery
36.40
36.40
2620.80
2620.80
32666 00
Surgery
25.82
25.82
1859.04
1859.04
32667 00
Surgery
4.59
4.59
330.48
330.48
32668 00
Surgery
4.59
4.59
330.48
330.48
32669 00
Surgery
39.65
39.65
2854.80
2854.80
32670 00
Surgery
47.21
47.21
3399.12
3399.12
32671 00
Surgery
52.25
52.25
3762.00
3762.00
32672 00
Surgery
44.80
44.80
3225.60
3225.60
32673 00
Surgery
35.94
35.94
2587.68
2587.68
32674 00
Surgery
6.31
6.31
454.32
454.32
32701 00
Surgery
6.16
6.16
443.52
443.52
32800 00
Surgery
27.97
27.97
2013.84
2013.84
32810 00
Surgery
26.80
26.80
1929.60
1929.60
32815 00
Surgery
82.63
82.63
5949.36
5949.36
32820 00
Surgery
39.52
39.52
2845.44
2845.44
32850 00
Surgery
0.00
0.00
BR
BR
32851 00
Surgery
96.40
96.40
6940.80
6940.80
32852 00
Surgery
103.74
103.74
7469.28
7469.28
32853 00
Surgery
134.66
134.66
9695.52
9695.52
32854 00
Surgery
142.56
142.56
10264.32
10264.32
32855 00
Surgery
-
-
1803.60
1514.88
32856 00
Surgery
-
-
1998.72
1679.04
32900 00
Surgery
40.28
40.28
2900.16
2900.16
32905 00
Surgery
39.48
39.48
2842.56
2842.56
32906 00
Surgery
48.65
48.65
3502.80
3502.80
32940 00
Surgery
36.50
36.50
2628.00
2628.00
32960 00
Surgery
3.79
2.67
272.88
192.24
32994 00
Surgery
142.37
12.77
10250.64
919.44
32997 00
Surgery
9.88
9.88
711.36
711.36
32998 00
Surgery
90.90
12.79
6544.80
920.88
32999 00
Surgery
0.00
0.00
BR
BR
33016 00
Surgery
6.87
6.87
494.64
494.64
33017 00
Surgery
7.25
7.25
522.00
522.00
33018 00
Surgery
8.47
8.47
609.84
609.84
33019 00
Surgery
6.15
6.15
442.80
442.80
33020 00
Surgery
24.37
24.37
1754.64
1754.64
33025 00
Surgery
22.81
22.81
1642.32
1642.32
33030 00
Surgery
58.92
58.92
4242.24
4242.24
33031 00
Surgery
72.75
72.75
5238.00
5238.00
33050 00
Surgery
29.87
29.87
2150.64
2150.64
33120 00
Surgery
61.46
61.46
4425.12
4425.12
33130 00
Surgery
40.18
40.18
2892.96
2892.96
33140 00
Surgery
45.64
45.64
3286.08
3286.08
33141 00
Surgery
3.86
3.86
277.92
277.92
33202 00
Surgery
22.81
22.81
1642.32
1642.32
33203 00
Surgery
23.97
23.97
1725.84
1725.84
33206 00
Surgery
13.41
13.41
965.52
965.52
33207 00
Surgery
14.09
14.09
1014.48
1014.48
33208 00
Surgery
15.25
15.25
1098.00
1098.00
33210 00
Surgery
4.72
4.72
339.84
339.84
33211 00
Surgery
4.94
4.94
355.68
355.68
33212 00
Surgery
9.55
9.55
687.60
687.60
33213 00
Surgery
10.00
10.00
720.00
720.00
33214 00
Surgery
14.13
14.13
1017.36
1017.36
33215 00
Surgery
9.17
9.17
660.24
660.24
33216 00
Surgery
10.98
10.98
790.56
790.56
33217 00
Surgery
10.90
10.90
784.80
784.80
33218 00
Surgery
11.52
11.52
829.44
829.44
33220 00
Surgery
11.26
11.26
810.72
810.72
33221 00
Surgery
10.56
10.56
760.32
760.32
33222 00
Surgery
10.18
10.18
732.96
732.96
33223 00
Surgery
12.09
12.09
870.48
870.48
33224 00
Surgery
14.99
14.99
1079.28
1079.28
33225 00
Surgery
13.51
13.51
972.72
972.72
33226 00
Surgery
14.35
14.35
1033.20
1033.20
33227 00
Surgery
10.03
10.03
722.16
722.16
33228 00
Surgery
10.47
10.47
753.84
753.84
33229 00
Surgery
11.01
11.01
792.72
792.72
33230 00
Surgery
11.05
11.05
795.60
795.60
33231 00
Surgery
11.84
11.84
852.48
852.48
33233 00
Surgery
6.92
6.92
498.24
498.24
33234 00
Surgery
14.28
14.28
1028.16
1028.16
33235 00
Surgery
18.77
18.77
1351.44
1351.44
33236 00
Surgery
23.20
23.20
1670.40
1670.40
33237 00
Surgery
24.89
24.89
1792.08
1792.08
33238 00
Surgery
28.16
28.16
2027.52
2027.52
33240 00
Surgery
10.88
10.88
783.36
783.36
33241 00
Surgery
6.37
6.37
458.64
458.64
33243 00
Surgery
40.65
40.65
2926.80
2926.80
33244 00
Surgery
25.44
25.44
1831.68
1831.68
33249 00
Surgery
26.85
26.85
1933.20
1933.20
33250 00
Surgery
42.78
42.78
3080.16
3080.16
33251 00
Surgery
48.07
48.07
3461.04
3461.04
33254 00
Surgery
40.21
40.21
2895.12
2895.12
33255 00
Surgery
47.73
47.73
3436.56
3436.56
33256 00
Surgery
56.51
56.51
4068.72
4068.72
33257 00
Surgery
17.25
17.25
1242.00
1242.00
33258 00
Surgery
19.16
19.16
1379.52
1379.52
33259 00
Surgery
25.06
25.06
1804.32
1804.32
33261 00
Surgery
47.29
47.29
3404.88
3404.88
33262 00
Surgery
10.99
10.99
791.28
791.28
33263 00
Surgery
11.42
11.42
822.24
822.24
33264 00
Surgery
11.91
11.91
857.52
857.52
33265 00
Surgery
40.18
40.18
2892.96
2892.96
33266 00
Surgery
54.20
54.20
3902.40
3902.40
33267 00
Surgery
30.80
30.80
2217.60
2217.60
33268 00
Surgery
3.79
3.79
272.88
272.88
33269 00
Surgery
24.50
24.50
1764.00
1764.00
33270 00
Surgery
16.50
16.50
1188.00
1188.00
33271 00
Surgery
13.43
13.43
966.96
966.96
33272 00
Surgery
10.26
10.26
738.72
738.72
33273 00
Surgery
11.89
11.89
856.08
856.08
33274 00
Surgery
14.08
14.08
1013.76
1013.76
33275 00
Surgery
14.88
14.88
1071.36
1071.36
33276 00
Surgery
17.05
17.05
1227.60
1227.60
33277 00
Surgery
8.92
8.92
642.24
642.24
33278 00
Surgery
16.97
16.97
1221.84
1221.84
33279 00
Surgery
10.26
10.26
738.72
738.72
33280 00
Surgery
6.17
6.17
444.24
444.24
33281 00
Surgery
11.09
11.09
798.48
798.48
33285 00
Surgery
124.35
2.57
8953.20
185.04
33286 00
Surgery
3.87
2.52
278.64
181.44
33287 00
Surgery
11.44
11.44
823.68
823.68
33288 00
Surgery
15.08
15.08
1085.76
1085.76
33289 00
Surgery
9.79
9.79
704.88
704.88
33300 00
Surgery
71.80
71.80
5169.60
5169.60
33305 00
Surgery
120.18
120.18
8652.96
8652.96
33310 00
Surgery
34.42
34.42
2478.24
2478.24
33315 00
Surgery
56.40
56.40
4060.80
4060.80
33320 00
Surgery
31.63
31.63
2277.36
2277.36
33321 00
Surgery
34.95
34.95
2516.40
2516.40
33322 00
Surgery
41.26
41.26
2970.72
2970.72
33330 00
Surgery
41.86
41.86
3013.92
3013.92
33335 00
Surgery
54.77
54.77
3943.44
3943.44
33340 00
Surgery
22.84
22.84
1644.48
1644.48
33361 00
Surgery
35.42
35.42
2550.24
2550.24
33362 00
Surgery
38.60
38.60
2779.20
2779.20
33363 00
Surgery
40.06
40.06
2884.32
2884.32
33364 00
Surgery
39.88
39.88
2871.36
2871.36
33365 00
Surgery
41.73
41.73
3004.56
3004.56
33366 00
Surgery
45.92
45.92
3306.24
3306.24
33367 00
Surgery
17.79
17.79
1280.88
1280.88
33368 00
Surgery
21.56
21.56
1552.32
1552.32
33369 00
Surgery
28.46
28.46
2049.12
2049.12
33370 00
Surgery
3.90
3.90
280.80
280.80
33390 00
Surgery
56.48
56.48
4066.56
4066.56
33391 00
Surgery
66.94
66.94
4819.68
4819.68
33404 00
Surgery
51.33
51.33
3695.76
3695.76
33405 00
Surgery
66.76
66.76
4806.72
4806.72
33406 00
Surgery
84.81
84.81
6106.32
6106.32
33410 00
Surgery
74.68
74.68
5376.96
5376.96
33411 00
Surgery
98.41
98.41
7085.52
7085.52
33412 00
Surgery
91.94
91.94
6619.68
6619.68
33413 00
Surgery
94.25
94.25
6786.00
6786.00
33414 00
Surgery
63.21
63.21
4551.12
4551.12
33415 00
Surgery
59.62
59.62
4292.64
4292.64
33416 00
Surgery
59.56
59.56
4288.32
4288.32
33417 00
Surgery
49.33
49.33
3551.76
3551.76
33418 00
Surgery
52.84
52.84
3804.48
3804.48
33419 00
Surgery
12.38
12.38
891.36
891.36
33420 00
Surgery
42.63
42.63
3069.36
3069.36
33422 00
Surgery
48.85
48.85
3517.20
3517.20
33425 00
Surgery
80.23
80.23
5776.56
5776.56
33426 00
Surgery
70.08
70.08
5045.76
5045.76
33427 00
Surgery
71.66
71.66
5159.52
5159.52
33430 00
Surgery
82.37
82.37
5930.64
5930.64
33440 00
Surgery
99.41
99.41
7157.52
7157.52
33460 00
Surgery
70.17
70.17
5052.24
5052.24
33463 00
Surgery
90.29
90.29
6500.88
6500.88
33464 00
Surgery
71.63
71.63
5157.36
5157.36
33465 00
Surgery
80.89
80.89
5824.08
5824.08
33468 00
Surgery
72.07
72.07
5189.04
5189.04
33471 00
Surgery
39.22
39.22
2823.84
2823.84
33474 00
Surgery
64.23
64.23
4624.56
4624.56
33475 00
Surgery
68.21
68.21
4911.12
4911.12
33476 00
Surgery
45.09
45.09
3246.48
3246.48
33477 00
Surgery
38.37
38.37
2762.64
2762.64
33478 00
Surgery
46.55
46.55
3351.60
3351.60
33496 00
Surgery
48.87
48.87
3518.64
3518.64
33500 00
Surgery
45.83
45.83
3299.76
3299.76
33501 00
Surgery
32.84
32.84
2364.48
2364.48
33502 00
Surgery
37.90
37.90
2728.80
2728.80
33503 00
Surgery
39.40
39.40
2836.80
2836.80
33504 00
Surgery
43.42
43.42
3126.24
3126.24
33505 00
Surgery
60.51
60.51
4356.72
4356.72
33506 00
Surgery
60.35
60.35
4345.20
4345.20
33507 00
Surgery
50.66
50.66
3647.52
3647.52
33508 00
Surgery
0.47
0.47
33.84
33.84
33509 00
Surgery
5.05
5.05
363.60
363.60
33510 00
Surgery
56.88
56.88
4095.36
4095.36
33511 00
Surgery
62.46
62.46
4497.12
4497.12
33512 00
Surgery
71.15
71.15
5122.80
5122.80
33513 00
Surgery
72.65
72.65
5230.80
5230.80
33514 00
Surgery
76.38
76.38
5499.36
5499.36
33516 00
Surgery
79.05
79.05
5691.60
5691.60
33517 00
Surgery
5.48
5.48
394.56
394.56
33518 00
Surgery
12.00
12.00
864.00
864.00
33519 00
Surgery
15.88
15.88
1143.36
1143.36
33521 00
Surgery
19.03
19.03
1370.16
1370.16
33522 00
Surgery
21.39
21.39
1540.08
1540.08
33523 00
Surgery
24.07
24.07
1733.04
1733.04
33530 00
Surgery
15.32
15.32
1103.04
1103.04
33533 00
Surgery
55.09
55.09
3966.48
3966.48
33534 00
Surgery
64.69
64.69
4657.68
4657.68
33535 00
Surgery
71.87
71.87
5174.64
5174.64
33536 00
Surgery
77.44
77.44
5575.68
5575.68
33542 00
Surgery
77.04
77.04
5546.88
5546.88
33545 00
Surgery
89.68
89.68
6456.96
6456.96
33548 00
Surgery
86.37
86.37
6218.64
6218.64
33572 00
Surgery
6.75
6.75
486.00
486.00
33600 00
Surgery
50.82
50.82
3659.04
3659.04
33602 00
Surgery
49.34
49.34
3552.48
3552.48
33606 00
Surgery
52.52
52.52
3781.44
3781.44
33608 00
Surgery
53.19
53.19
3829.68
3829.68
33610 00
Surgery
52.46
52.46
3777.12
3777.12
33611 00
Surgery
57.40
57.40
4132.80
4132.80
33612 00
Surgery
58.94
58.94
4243.68
4243.68
33615 00
Surgery
58.91
58.91
4241.52
4241.52
33617 00
Surgery
63.79
63.79
4592.88
4592.88
33619 00
Surgery
81.02
81.02
5833.44
5833.44
33620 00
Surgery
48.54
48.54
3494.88
3494.88
33621 00
Surgery
27.48
27.48
1978.56
1978.56
33622 00
Surgery
100.70
100.70
7250.40
7250.40
33641 00
Surgery
48.30
48.30
3477.60
3477.60
33645 00
Surgery
51.00
51.00
3672.00
3672.00
33647 00
Surgery
53.48
53.48
3850.56
3850.56
33660 00
Surgery
51.71
51.71
3723.12
3723.12
33665 00
Surgery
56.31
56.31
4054.32
4054.32
33670 00
Surgery
57.92
57.92
4170.24
4170.24
33675 00
Surgery
58.00
58.00
4176.00
4176.00
33676 00
Surgery
59.54
59.54
4286.88
4286.88
33677 00
Surgery
61.82
61.82
4451.04
4451.04
33681 00
Surgery
54.50
54.50
3924.00
3924.00
33684 00
Surgery
55.57
55.57
4001.04
4001.04
33688 00
Surgery
55.33
55.33
3983.76
3983.76
33690 00
Surgery
35.66
35.66
2567.52
2567.52
33692 00
Surgery
57.46
57.46
4137.12
4137.12
33694 00
Surgery
57.40
57.40
4132.80
4132.80
33697 00
Surgery
60.46
60.46
4353.12
4353.12
33702 00
Surgery
45.73
45.73
3292.56
3292.56
33710 00
Surgery
60.33
60.33
4343.76
4343.76
33720 00
Surgery
45.76
45.76
3294.72
3294.72
33724 00
Surgery
45.31
45.31
3262.32
3262.32
33726 00
Surgery
59.78
59.78
4304.16
4304.16
33730 00
Surgery
59.16
59.16
4259.52
4259.52
33732 00
Surgery
48.76
48.76
3510.72
3510.72
33735 00
Surgery
38.46
38.46
2769.12
2769.12
33736 00
Surgery
41.69
41.69
3001.68
3001.68
33737 00
Surgery
38.47
38.47
2769.84
2769.84
33741 00
Surgery
21.99
21.99
1583.28
1583.28
33745 00
Surgery
31.42
31.42
2262.24
2262.24
33746 00
Surgery
12.56
12.56
904.32
904.32
33750 00
Surgery
37.30
37.30
2685.60
2685.60
33755 00
Surgery
39.07
39.07
2813.04
2813.04
33762 00
Surgery
37.89
37.89
2728.08
2728.08
33764 00
Surgery
39.07
39.07
2813.04
2813.04
33766 00
Surgery
39.35
39.35
2833.20
2833.20
33767 00
Surgery
41.99
41.99
3023.28
3023.28
33768 00
Surgery
12.18
12.18
876.96
876.96
33770 00
Surgery
62.19
62.19
4477.68
4477.68
33771 00
Surgery
63.91
63.91
4601.52
4601.52
33774 00
Surgery
53.20
53.20
3830.40
3830.40
33775 00
Surgery
54.73
54.73
3940.56
3940.56
33776 00
Surgery
57.91
57.91
4169.52
4169.52
33777 00
Surgery
55.74
55.74
4013.28
4013.28
33778 00
Surgery
69.24
69.24
4985.28
4985.28
33779 00
Surgery
68.24
68.24
4913.28
4913.28
33780 00
Surgery
69.55
69.55
5007.60
5007.60
33781 00
Surgery
67.83
67.83
4883.76
4883.76
33782 00
Surgery
94.71
94.71
6819.12
6819.12
33783 00
Surgery
102.35
102.35
7369.20
7369.20
33786 00
Surgery
66.96
66.96
4821.12
4821.12
33788 00
Surgery
45.22
45.22
3255.84
3255.84
33800 00
Surgery
29.16
29.16
2099.52
2099.52
33802 00
Surgery
32.24
32.24
2321.28
2321.28
33803 00
Surgery
34.01
34.01
2448.72
2448.72
33813 00
Surgery
36.77
36.77
2647.44
2647.44
33814 00
Surgery
45.12
45.12
3248.64
3248.64
33820 00
Surgery
28.66
28.66
2063.52
2063.52
33822 00
Surgery
30.21
30.21
2175.12
2175.12
33824 00
Surgery
35.03
35.03
2522.16
2522.16
33840 00
Surgery
36.73
36.73
2644.56
2644.56
33845 00
Surgery
39.57
39.57
2849.04
2849.04
33851 00
Surgery
37.72
37.72
2715.84
2715.84
33852 00
Surgery
41.43
41.43
2982.96
2982.96
33853 00
Surgery
54.16
54.16
3899.52
3899.52
33858 00
Surgery
99.45
99.45
7160.40
7160.40
33859 00
Surgery
71.49
71.49
5147.28
5147.28
33863 00
Surgery
92.18
92.18
6636.96
6636.96
33864 00
Surgery
94.14
94.14
6778.08
6778.08
33866 00
Surgery
26.88
26.88
1935.36
1935.36
33871 00
Surgery
95.42
95.42
6870.24
6870.24
33875 00
Surgery
80.54
80.54
5798.88
5798.88
33877 00
Surgery
105.63
105.63
7605.36
7605.36
33880 00
Surgery
52.26
52.26
3762.72
3762.72
33881 00
Surgery
44.89
44.89
3232.08
3232.08
33883 00
Surgery
32.58
32.58
2345.76
2345.76
33884 00
Surgery
11.52
11.52
829.44
829.44
33886 00
Surgery
28.13
28.13
2025.36
2025.36
33889 00
Surgery
23.22
23.22
1671.84
1671.84
33891 00
Surgery
28.08
28.08
2021.76
2021.76
33894 00
Surgery
28.71
28.71
2067.12
2067.12
33895 00
Surgery
22.85
22.85
1645.20
1645.20
33897 00
Surgery
16.98
16.98
1222.56
1222.56
33900 00
Surgery
16.96
16.96
1221.12
1221.12
33901 00
Surgery
22.29
22.29
1604.88
1604.88
33902 00
Surgery
21.52
21.52
1549.44
1549.44
33903 00
Surgery
25.36
25.36
1825.92
1825.92
33904 00
Surgery
8.52
8.52
613.44
613.44
33910 00
Surgery
76.53
76.53
5510.16
5510.16
33915 00
Surgery
40.34
40.34
2904.48
2904.48
33916 00
Surgery
122.14
122.14
8794.08
8794.08
33917 00
Surgery
43.18
43.18
3108.96
3108.96
33920 00
Surgery
53.31
53.31
3838.32
3838.32
33922 00
Surgery
41.15
41.15
2962.80
2962.80
33924 00
Surgery
8.34
8.34
600.48
600.48
33925 00
Surgery
50.51
50.51
3636.72
3636.72
33926 00
Surgery
70.98
70.98
5110.56
5110.56
33927 00
Surgery
74.60
74.60
5371.20
5371.20
33928 00
Surgery
0.00
0.00
BR
BR
33929 00
Surgery
0.00
0.00
BR
BR
33930 00
Surgery
0.00
0.00
BR
BR
33933 00
Surgery
0.00
0.00
BR
BR
33935 00
Surgery
144.09
144.09
10374.48
10374.48
33940 00
Surgery
0.00
0.00
BR
BR
33944 00
Surgery
-
-
1205.28
1036.80
33945 00
Surgery
142.73
142.73
10276.56
10276.56
33946 00
Surgery
9.07
9.07
653.04
653.04
33947 00
Surgery
10.04
10.04
722.88
722.88
33948 00
Surgery
6.97
6.97
501.84
501.84
33949 00
Surgery
6.81
6.81
490.32
490.32
33951 00
Surgery
12.31
12.31
886.32
886.32
33952 00
Surgery
12.50
12.50
900.00
900.00
33953 00
Surgery
13.75
13.75
990.00
990.00
33954 00
Surgery
13.92
13.92
1002.24
1002.24
33955 00
Surgery
24.08
24.08
1733.76
1733.76
33956 00
Surgery
24.46
24.46
1761.12
1761.12
33957 00
Surgery
5.36
5.36
385.92
385.92
33958 00
Surgery
5.36
5.36
385.92
385.92
33959 00
Surgery
6.83
6.83
491.76
491.76
33962 00
Surgery
6.83
6.83
491.76
491.76
33963 00
Surgery
13.59
13.59
978.48
978.48
33964 00
Surgery
14.35
14.35
1033.20
1033.20
33965 00
Surgery
5.36
5.36
385.92
385.92
33966 00
Surgery
6.94
6.94
499.68
499.68
33967 00
Surgery
7.57
7.57
545.04
545.04
33968 00
Surgery
0.99
0.99
71.28
71.28
33969 00
Surgery
7.93
7.93
570.96
570.96
33970 00
Surgery
10.32
10.32
743.04
743.04
33971 00
Surgery
20.94
20.94
1507.68
1507.68
33973 00
Surgery
14.59
14.59
1050.48
1050.48
33974 00
Surgery
26.31
26.31
1894.32
1894.32
33975 00
Surgery
38.16
38.16
2747.52
2747.52
33976 00
Surgery
46.07
46.07
3317.04
3317.04
33977 00
Surgery
32.92
32.92
2370.24
2370.24
33978 00
Surgery
38.80
38.80
2793.60
2793.60
33979 00
Surgery
56.86
56.86
4093.92
4093.92
33980 00
Surgery
52.24
52.24
3761.28
3761.28
33981 00
Surgery
24.12
24.12
1736.64
1736.64
33982 00
Surgery
56.72
56.72
4083.84
4083.84
33983 00
Surgery
66.75
66.75
4806.00
4806.00
33984 00
Surgery
8.30
8.30
597.60
597.60
33985 00
Surgery
14.92
14.92
1074.24
1074.24
33986 00
Surgery
15.32
15.32
1103.04
1103.04
33987 00
Surgery
6.06
6.06
436.32
436.32
33988 00
Surgery
22.58
22.58
1625.76
1625.76
33989 00
Surgery
14.35
14.35
1033.20
1033.20
33990 00
Surgery
10.55
10.55
759.60
759.60
33991 00
Surgery
13.24
13.24
953.28
953.28
33992 00
Surgery
5.50
5.50
396.00
396.00
33993 00
Surgery
4.86
4.86
349.92
349.92
33995 00
Surgery
10.38
10.38
747.36
747.36
33997 00
Surgery
4.72
4.72
339.84
339.84
33999 00
Surgery
0.00
0.00
BR
BR
34001 00
Surgery
26.83
26.83
1931.76
1931.76
34051 00
Surgery
29.30
29.30
2109.60
2109.60
34101 00
Surgery
17.50
17.50
1260.00
1260.00
34111 00
Surgery
17.48
17.48
1258.56
1258.56
34151 00
Surgery
40.77
40.77
2935.44
2935.44
34201 00
Surgery
29.93
29.93
2154.96
2154.96
34203 00
Surgery
27.81
27.81
2002.32
2002.32
34401 00
Surgery
44.04
44.04
3170.88
3170.88
34421 00
Surgery
20.42
20.42
1470.24
1470.24
34451 00
Surgery
42.08
42.08
3029.76
3029.76
34471 00
Surgery
31.66
31.66
2279.52
2279.52
34490 00
Surgery
16.92
16.92
1218.24
1218.24
34501 00
Surgery
26.33
26.33
1895.76
1895.76
34502 00
Surgery
45.58
45.58
3281.76
3281.76
34510 00
Surgery
29.97
29.97
2157.84
2157.84
34520 00
Surgery
29.03
29.03
2090.16
2090.16
34530 00
Surgery
27.66
27.66
1991.52
1991.52
34701 00
Surgery
36.11
36.11
2599.92
2599.92
34702 00
Surgery
53.93
53.93
3882.96
3882.96
34703 00
Surgery
40.11
40.11
2887.92
2887.92
34704 00
Surgery
66.86
66.86
4813.92
4813.92
34705 00
Surgery
44.60
44.60
3211.20
3211.20
34706 00
Surgery
66.47
66.47
4785.84
4785.84
34707 00
Surgery
33.92
33.92
2442.24
2442.24
34708 00
Surgery
53.17
53.17
3828.24
3828.24
34709 00
Surgery
9.39
9.39
676.08
676.08
34710 00
Surgery
23.30
23.30
1677.60
1677.60
34711 00
Surgery
8.58
8.58
617.76
617.76
34712 00
Surgery
19.20
19.20
1382.40
1382.40
34713 00
Surgery
3.59
3.59
258.48
258.48
34714 00
Surgery
7.87
7.87
566.64
566.64
34715 00
Surgery
8.71
8.71
627.12
627.12
34716 00
Surgery
10.87
10.87
782.64
782.64
34717 00
Surgery
12.91
12.91
929.52
929.52
34718 00
Surgery
36.18
36.18
2604.96
2604.96
34808 00
Surgery
5.91
5.91
425.52
425.52
34812 00
Surgery
6.01
6.01
432.72
432.72
34813 00
Surgery
6.85
6.85
493.20
493.20
34820 00
Surgery
9.82
9.82
707.04
707.04
34830 00
Surgery
51.60
51.60
3715.20
3715.20
34831 00
Surgery
56.43
56.43
4062.96
4062.96
34832 00
Surgery
55.47
55.47
3993.84
3993.84
34833 00
Surgery
11.46
11.46
825.12
825.12
34834 00
Surgery
3.77
3.77
271.44
271.44
34839 00
Surgery
0.00
0.00
Bundled Code
Bundled Code
34841 00
Surgery
0.00
0.00
BR
BR
34842 00
Surgery
0.00
0.00
BR
BR
34843 00
Surgery
-
-
5652.00
4860.72
34844 00
Surgery
-
-
6176.16
5311.44
34845 00
Surgery
0.00
0.00
BR
BR
34846 00
Surgery
-
-
6033.60
5189.04
34847 00
Surgery
-
-
6742.80
5798.88
34848 00
Surgery
-
-
8928.00
7678.08
35001 00
Surgery
32.93
32.93
2370.96
2370.96
35002 00
Surgery
33.39
33.39
2404.08
2404.08
35005 00
Surgery
29.24
29.24
2105.28
2105.28
35011 00
Surgery
29.68
29.68
2136.96
2136.96
35013 00
Surgery
37.25
37.25
2682.00
2682.00
35021 00
Surgery
37.06
37.06
2668.32
2668.32
35022 00
Surgery
42.37
42.37
3050.64
3050.64
35045 00
Surgery
28.49
28.49
2051.28
2051.28
35081 00
Surgery
50.67
50.67
3648.24
3648.24
35082 00
Surgery
63.25
63.25
4554.00
4554.00
35091 00
Surgery
52.04
52.04
3746.88
3746.88
35092 00
Surgery
75.93
75.93
5466.96
5466.96
35102 00
Surgery
55.09
55.09
3966.48
3966.48
35103 00
Surgery
64.85
64.85
4669.20
4669.20
35111 00
Surgery
38.94
38.94
2803.68
2803.68
35112 00
Surgery
47.85
47.85
3445.20
3445.20
35121 00
Surgery
46.28
46.28
3332.16
3332.16
35122 00
Surgery
55.35
55.35
3985.20
3985.20
35131 00
Surgery
40.48
40.48
2914.56
2914.56
35132 00
Surgery
47.85
47.85
3445.20
3445.20
35141 00
Surgery
32.00
32.00
2304.00
2304.00
35142 00
Surgery
38.65
38.65
2782.80
2782.80
35151 00
Surgery
36.38
36.38
2619.36
2619.36
35152 00
Surgery
40.94
40.94
2947.68
2947.68
35180 00
Surgery
23.06
23.06
1660.32
1660.32
35182 00
Surgery
52.91
52.91
3809.52
3809.52
35184 00
Surgery
28.30
28.30
2037.60
2037.60
35188 00
Surgery
39.12
39.12
2816.64
2816.64
35189 00
Surgery
44.23
44.23
3184.56
3184.56
35190 00
Surgery
22.29
22.29
1604.88
1604.88
35201 00
Surgery
27.52
27.52
1981.44
1981.44
35206 00
Surgery
23.38
23.38
1683.36
1683.36
35207 00
Surgery
22.75
22.75
1638.00
1638.00
35211 00
Surgery
41.09
41.09
2958.48
2958.48
35216 00
Surgery
62.15
62.15
4474.80
4474.80
35221 00
Surgery
43.51
43.51
3132.72
3132.72
35226 00
Surgery
24.35
24.35
1753.20
1753.20
35231 00
Surgery
37.04
37.04
2666.88
2666.88
35236 00
Surgery
29.44
29.44
2119.68
2119.68
35241 00
Surgery
42.19
42.19
3037.68
3037.68
35246 00
Surgery
45.87
45.87
3302.64
3302.64
35251 00
Surgery
51.25
51.25
3690.00
3690.00
35256 00
Surgery
29.69
29.69
2137.68
2137.68
35261 00
Surgery
28.79
28.79
2072.88
2072.88
35266 00
Surgery
25.46
25.46
1833.12
1833.12
35271 00
Surgery
40.87
40.87
2942.64
2942.64
35276 00
Surgery
42.87
42.87
3086.64
3086.64
35281 00
Surgery
47.61
47.61
3427.92
3427.92
35286 00
Surgery
27.20
27.20
1958.40
1958.40
35301 00
Surgery
33.10
33.10
2383.20
2383.20
35302 00
Surgery
32.73
32.73
2356.56
2356.56
35303 00
Surgery
35.88
35.88
2583.36
2583.36
35304 00
Surgery
37.35
37.35
2689.20
2689.20
35305 00
Surgery
35.93
35.93
2586.96
2586.96
35306 00
Surgery
12.97
12.97
933.84
933.84
35311 00
Surgery
45.54
45.54
3278.88
3278.88
35321 00
Surgery
26.38
26.38
1899.36
1899.36
35331 00
Surgery
42.60
42.60
3067.20
3067.20
35341 00
Surgery
40.63
40.63
2925.36
2925.36
35351 00
Surgery
37.64
37.64
2710.08
2710.08
35355 00
Surgery
30.11
30.11
2167.92
2167.92
35361 00
Surgery
44.60
44.60
3211.20
3211.20
35363 00
Surgery
47.54
47.54
3422.88
3422.88
35371 00
Surgery
23.87
23.87
1718.64
1718.64
35372 00
Surgery
28.60
28.60
2059.20
2059.20
35390 00
Surgery
4.63
4.63
333.36
333.36
35400 00
Surgery
4.31
4.31
310.32
310.32
35500 00
Surgery
9.28
9.28
668.16
668.16
35501 00
Surgery
42.72
42.72
3075.84
3075.84
35506 00
Surgery
37.30
37.30
2685.60
2685.60
35508 00
Surgery
38.95
38.95
2804.40
2804.40
35509 00
Surgery
41.31
41.31
2974.32
2974.32
35510 00
Surgery
36.02
36.02
2593.44
2593.44
35511 00
Surgery
32.82
32.82
2363.04
2363.04
35512 00
Surgery
35.32
35.32
2543.04
2543.04
35515 00
Surgery
38.95
38.95
2804.40
2804.40
35516 00
Surgery
35.74
35.74
2573.28
2573.28
35518 00
Surgery
33.45
33.45
2408.40
2408.40
35521 00
Surgery
36.00
36.00
2592.00
2592.00
35522 00
Surgery
34.26
34.26
2466.72
2466.72
35523 00
Surgery
36.05
36.05
2595.60
2595.60
35525 00
Surgery
33.18
33.18
2388.96
2388.96
35526 00
Surgery
50.72
50.72
3651.84
3651.84
35531 00
Surgery
57.07
57.07
4109.04
4109.04
35533 00
Surgery
44.15
44.15
3178.80
3178.80
35535 00
Surgery
55.70
55.70
4010.40
4010.40
35536 00
Surgery
49.47
49.47
3561.84
3561.84
35537 00
Surgery
61.00
61.00
4392.00
4392.00
35538 00
Surgery
68.31
68.31
4918.32
4918.32
35539 00
Surgery
64.12
64.12
4616.64
4616.64
35540 00
Surgery
71.44
71.44
5143.68
5143.68
35556 00
Surgery
40.76
40.76
2934.72
2934.72
35558 00
Surgery
36.30
36.30
2613.60
2613.60
35560 00
Surgery
49.91
49.91
3593.52
3593.52
35563 00
Surgery
38.80
38.80
2793.60
2793.60
35565 00
Surgery
38.42
38.42
2766.24
2766.24
35566 00
Surgery
48.60
48.60
3499.20
3499.20
35570 00
Surgery
43.18
43.18
3108.96
3108.96
35571 00
Surgery
38.73
38.73
2788.56
2788.56
35572 00
Surgery
10.01
10.01
720.72
720.72
35583 00
Surgery
42.18
42.18
3036.96
3036.96
35585 00
Surgery
48.84
48.84
3516.48
3516.48
35587 00
Surgery
39.05
39.05
2811.60
2811.60
35600 00
Surgery
5.44
5.44
391.68
391.68
35601 00
Surgery
41.00
41.00
2952.00
2952.00
35606 00
Surgery
34.45
34.45
2480.40
2480.40
35612 00
Surgery
30.68
30.68
2208.96
2208.96
35616 00
Surgery
32.28
32.28
2324.16
2324.16
35621 00
Surgery
32.10
32.10
2311.20
2311.20
35623 00
Surgery
38.51
38.51
2772.72
2772.72
35626 00
Surgery
46.54
46.54
3350.88
3350.88
35631 00
Surgery
54.22
54.22
3903.84
3903.84
35632 00
Surgery
52.88
52.88
3807.36
3807.36
35633 00
Surgery
58.00
58.00
4176.00
4176.00
35634 00
Surgery
51.75
51.75
3726.00
3726.00
35636 00
Surgery
46.70
46.70
3362.40
3362.40
35637 00
Surgery
48.55
48.55
3495.60
3495.60
35638 00
Surgery
50.75
50.75
3654.00
3654.00
35642 00
Surgery
29.02
29.02
2089.44
2089.44
35645 00
Surgery
27.80
27.80
2001.60
2001.60
35646 00
Surgery
49.88
49.88
3591.36
3591.36
35647 00
Surgery
45.37
45.37
3266.64
3266.64
35650 00
Surgery
29.94
29.94
2155.68
2155.68
35654 00
Surgery
39.91
39.91
2873.52
2873.52
35656 00
Surgery
31.40
31.40
2260.80
2260.80
35661 00
Surgery
31.71
31.71
2283.12
2283.12
35663 00
Surgery
35.73
35.73
2572.56
2572.56
35665 00
Surgery
34.38
34.38
2475.36
2475.36
35666 00
Surgery
37.71
37.71
2715.12
2715.12
35671 00
Surgery
33.20
33.20
2390.40
2390.40
35681 00
Surgery
2.33
2.33
167.76
167.76
35682 00
Surgery
10.29
10.29
740.88
740.88
35683 00
Surgery
11.92
11.92
858.24
858.24
35685 00
Surgery
5.77
5.77
415.44
415.44
35686 00
Surgery
4.68
4.68
336.96
336.96
35691 00
Surgery
27.76
27.76
1998.72
1998.72
35693 00
Surgery
24.62
24.62
1772.64
1772.64
35694 00
Surgery
28.99
28.99
2087.28
2087.28
35695 00
Surgery
30.08
30.08
2165.76
2165.76
35697 00
Surgery
4.27
4.27
307.44
307.44
35700 00
Surgery
4.42
4.42
318.24
318.24
35701 00
Surgery
13.01
13.01
936.72
936.72
35702 00
Surgery
12.10
12.10
871.20
871.20
35703 00
Surgery
12.24
12.24
881.28
881.28
35800 00
Surgery
21.86
21.86
1573.92
1573.92
35820 00
Surgery
59.21
59.21
4263.12
4263.12
35840 00
Surgery
36.20
36.20
2606.40
2606.40
35860 00
Surgery
24.80
24.80
1785.60
1785.60
35870 00
Surgery
36.58
36.58
2633.76
2633.76
35875 00
Surgery
17.37
17.37
1250.64
1250.64
35876 00
Surgery
27.61
27.61
1987.92
1987.92
35879 00
Surgery
26.99
26.99
1943.28
1943.28
35881 00
Surgery
30.17
30.17
2172.24
2172.24
35883 00
Surgery
35.00
35.00
2520.00
2520.00
35884 00
Surgery
36.29
36.29
2612.88
2612.88
35901 00
Surgery
14.07
14.07
1013.04
1013.04
35903 00
Surgery
16.64
16.64
1198.08
1198.08
35905 00
Surgery
49.19
49.19
3541.68
3541.68
35907 00
Surgery
55.88
55.88
4023.36
4023.36
36000 00
Surgery
0.00
0.00
Bundled Code
Bundled Code
36002 00
Surgery
4.59
3.06
330.48
220.32
36005 00
Surgery
7.48
1.39
538.56
100.08
36010 00
Surgery
15.90
3.17
1144.80
228.24
36011 00
Surgery
23.52
4.55
1693.44
327.60
36012 00
Surgery
24.56
5.07
1768.32
365.04
36013 00
Surgery
22.99
3.67
1655.28
264.24
36014 00
Surgery
23.10
4.41
1663.20
317.52
36015 00
Surgery
24.81
4.99
1786.32
359.28
36100 00
Surgery
15.81
4.45
1138.32
320.40
36140 00
Surgery
15.09
2.60
1086.48
187.20
36160 00
Surgery
16.28
3.59
1172.16
258.48
36200 00
Surgery
17.47
4.07
1257.84
293.04
36215 00
Surgery
30.53
6.21
2198.16
447.12
36216 00
Surgery
31.46
7.97
2265.12
573.84
36217 00
Surgery
53.47
9.78
3849.84
704.16
36218 00
Surgery
6.22
1.54
447.84
110.88
36221 00
Surgery
29.12
5.85
2096.64
421.20
36222 00
Surgery
36.52
8.42
2629.44
606.24
36223 00
Surgery
49.64
9.73
3574.08
700.56
36224 00
Surgery
61.29
10.93
4412.88
786.96
36225 00
Surgery
47.14
9.65
3394.08
694.80
36226 00
Surgery
59.72
10.86
4299.84
781.92
36227 00
Surgery
7.28
3.58
524.16
257.76
36228 00
Surgery
38.52
7.38
2773.44
531.36
36245 00
Surgery
36.50
6.88
2628.00
495.36
36246 00
Surgery
24.58
7.38
1769.76
531.36
36247 00
Surgery
41.76
8.69
3006.72
625.68
36248 00
Surgery
3.43
1.40
246.96
100.80
36251 00
Surgery
37.83
7.46
2723.76
537.12
36252 00
Surgery
41.04
10.43
2954.88
750.96
36253 00
Surgery
59.02
10.29
4249.44
740.88
36254 00
Surgery
58.18
12.16
4188.96
875.52
36260 00
Surgery
19.79
19.79
1424.88
1424.88
36261 00
Surgery
12.47
12.47
897.84
897.84
36262 00
Surgery
9.54
9.54
686.88
686.88
36299 00
Surgery
0.00
0.00
BR
BR
36400 00
Surgery
0.82
0.55
59.04
39.60
36405 00
Surgery
0.72
0.44
51.84
31.68
36406 00
Surgery
0.53
0.26
38.16
18.72
36410 00
Surgery
0.53
0.27
38.16
19.44
36415 00
Surgery
0.27
0.27
19.42
19.42
36416 00
Surgery
0.00
0.00
Bundled Code
Bundled Code
36420 00
Surgery
1.41
1.41
101.52
101.52
36425 00
Surgery
1.17
1.17
84.24
84.24
36430 00
Surgery
1.27
1.27
91.44
91.44
36440 00
Surgery
1.48
1.48
106.56
106.56
36450 00
Surgery
5.03
5.03
362.16
362.16
36455 00
Surgery
3.69
3.69
265.68
265.68
36456 00
Surgery
2.87
2.87
206.64
206.64
36460 00
Surgery
10.24
10.24
737.28
737.28
36465 00
Surgery
38.22
3.49
2751.84
251.28
36466 00
Surgery
40.36
4.45
2905.92
320.40
36468 00
Surgery
-
-
243.36
208.80
36470 00
Surgery
3.46
1.12
249.12
80.64
36471 00
Surgery
5.99
2.23
431.28
160.56
36473 00
Surgery
35.64
5.32
2566.08
383.04
36474 00
Surgery
7.47
2.60
537.84
187.20
36475 00
Surgery
31.71
8.15
2283.12
586.80
36476 00
Surgery
8.35
3.90
601.20
280.80
36478 00
Surgery
28.96
8.15
2085.12
586.80
36479 00
Surgery
8.98
3.98
646.56
286.56
36481 00
Surgery
50.76
9.47
3654.72
681.84
36482 00
Surgery
49.27
5.26
3547.44
378.72
36483 00
Surgery
4.09
2.59
294.48
186.48
36500 00
Surgery
5.33
5.33
383.76
383.76
36510 00
Surgery
2.58
1.57
185.76
113.04
36511 00
Surgery
3.28
3.28
236.16
236.16
36512 00
Surgery
3.12
3.12
224.64
224.64
36513 00
Surgery
3.13
3.13
225.36
225.36
36514 00
Surgery
19.94
2.75
1435.68
198.00
36516 00
Surgery
53.26
2.54
3834.72
182.88
36522 00
Surgery
39.91
2.82
2873.52
203.04
36555 00
Surgery
5.60
2.48
403.20
178.56
36556 00
Surgery
6.35
2.49
457.20
179.28
36557 00
Surgery
34.14
9.60
2458.08
691.20
36558 00
Surgery
24.30
7.63
1749.60
549.36
36560 00
Surgery
36.43
11.47
2622.96
825.84
36561 00
Surgery
28.74
9.81
2069.28
706.32
36563 00
Surgery
32.31
10.72
2326.32
771.84
36565 00
Surgery
24.49
9.98
1763.28
718.56
36566 00
Surgery
123.98
10.55
8926.56
759.60
36568 00
Surgery
2.70
2.70
194.40
194.40
36569 00
Surgery
2.79
2.79
200.88
200.88
36570 00
Surgery
42.84
9.96
3084.48
717.12
36571 00
Surgery
36.92
9.29
2658.24
668.88
36572 00
Surgery
11.02
2.38
793.44
171.36
36573 00
Surgery
11.26
2.44
810.72
175.68
36575 00
Surgery
4.28
0.98
308.16
70.56
36576 00
Surgery
10.22
5.43
735.84
390.96
36578 00
Surgery
12.74
6.04
917.28
434.88
36580 00
Surgery
5.58
1.91
401.76
137.52
36581 00
Surgery
22.79
5.38
1640.88
387.36
36582 00
Surgery
25.73
8.48
1852.56
610.56
36583 00
Surgery
33.88
9.84
2439.36
708.48
36584 00
Surgery
9.57
1.71
689.04
123.12
36585 00
Surgery
33.54
8.25
2414.88
594.00
36589 00
Surgery
4.91
4.03
353.52
290.16
36590 00
Surgery
6.64
5.62
478.08
404.64
36591 00
Surgery
0.83
0.83
59.76
59.76
36592 00
Surgery
0.90
0.90
64.80
64.80
36593 00
Surgery
1.04
1.04
74.88
74.88
36595 00
Surgery
17.48
5.29
1258.56
380.88
36596 00
Surgery
3.44
1.33
247.68
95.76
36597 00
Surgery
3.29
1.76
236.88
126.72
36598 00
Surgery
3.55
1.04
255.60
74.88
36600 00
Surgery
0.82
0.44
59.04
31.68
36620 00
Surgery
1.30
1.30
93.60
93.60
36625 00
Surgery
3.10
3.10
223.20
223.20
36640 00
Surgery
3.50
3.50
252.00
252.00
36660 00
Surgery
2.01
2.01
144.72
144.72
36680 00
Surgery
1.77
1.77
127.44
127.44
36800 00
Surgery
3.56
3.56
256.32
256.32
36810 00
Surgery
6.19
6.19
445.68
445.68
36815 00
Surgery
3.97
3.97
285.84
285.84
36818 00
Surgery
20.26
20.26
1458.72
1458.72
36819 00
Surgery
21.45
21.45
1544.40
1544.40
36820 00
Surgery
21.34
21.34
1536.48
1536.48
36821 00
Surgery
19.39
19.39
1396.08
1396.08
36823 00
Surgery
42.08
42.08
3029.76
3029.76
36825 00
Surgery
23.32
23.32
1679.04
1679.04
36830 00
Surgery
19.58
19.58
1409.76
1409.76
36831 00
Surgery
18.14
18.14
1306.08
1306.08
36832 00
Surgery
22.23
22.23
1600.56
1600.56
36833 00
Surgery
23.71
23.71
1707.12
1707.12
36835 00
Surgery
14.41
14.41
1037.52
1037.52
36836 00
Surgery
240.53
10.40
17318.16
748.80
36837 00
Surgery
286.30
13.45
20613.60
968.40
36838 00
Surgery
33.40
33.40
2404.80
2404.80
36860 00
Surgery
6.97
3.26
501.84
234.72
36861 00
Surgery
4.09
4.09
294.48
294.48
36901 00
Surgery
20.79
4.90
1496.88
352.80
36902 00
Surgery
35.53
6.99
2558.16
503.28
36903 00
Surgery
124.51
9.19
8964.72
661.68
36904 00
Surgery
53.16
10.72
3827.52
771.84
36905 00
Surgery
66.85
12.87
4813.20
926.64
36906 00
Surgery
158.48
14.86
11410.56
1069.92
36907 00
Surgery
17.33
4.25
1247.76
306.00
36908 00
Surgery
41.53
6.03
2990.16
434.16
36909 00
Surgery
55.54
5.85
3998.88
421.20
37140 00
Surgery
69.30
69.30
4989.60
4989.60
37145 00
Surgery
64.31
64.31
4630.32
4630.32
37160 00
Surgery
66.05
66.05
4755.60
4755.60
37180 00
Surgery
63.49
63.49
4571.28
4571.28
37181 00
Surgery
69.30
69.30
4989.60
4989.60
37182 00
Surgery
23.63
23.63
1701.36
1701.36
37183 00
Surgery
170.20
10.85
12254.40
781.20
37184 00
Surgery
50.25
12.55
3618.00
903.60
37185 00
Surgery
13.95
4.74
1004.40
341.28
37186 00
Surgery
34.83
7.10
2507.76
511.20
37187 00
Surgery
49.67
11.45
3576.24
824.40
37188 00
Surgery
42.55
8.19
3063.60
589.68
37191 00
Surgery
59.20
6.42
4262.40
462.24
37192 00
Surgery
37.71
10.05
2715.12
723.60
37193 00
Surgery
44.00
10.09
3168.00
726.48
37195 00
Surgery
-
-
1504.80
1293.84
37197 00
Surgery
45.94
8.76
3307.68
630.72
37200 00
Surgery
6.23
6.23
448.56
448.56
37211 00
Surgery
11.28
11.28
812.16
812.16
37212 00
Surgery
9.83
9.83
707.76
707.76
37213 00
Surgery
6.72
6.72
483.84
483.84
37214 00
Surgery
3.55
3.55
255.60
255.60
37215 00
Surgery
29.04
29.04
2090.88
2090.88
37216 00
Surgery
29.18
29.18
2100.96
2100.96
37217 00
Surgery
31.58
31.58
2273.76
2273.76
37218 00
Surgery
24.30
24.30
1749.60
1749.60
37220 00
Surgery
73.65
11.64
5302.80
838.08
37221 00
Surgery
90.41
14.34
6509.52
1032.48
37222 00
Surgery
18.18
5.38
1308.96
387.36
37223 00
Surgery
37.29
6.16
2684.88
443.52
37224 00
Surgery
85.63
12.94
6165.36
931.68
37225 00
Surgery
256.71
17.41
18483.12
1253.52
37226 00
Surgery
237.79
15.09
17120.88
1086.48
37227 00
Surgery
327.81
20.83
23602.32
1499.76
37228 00
Surgery
121.34
15.73
8736.48
1132.56
37229 00
Surgery
261.20
20.15
18806.40
1450.80
37230 00
Surgery
261.62
20.16
18836.64
1451.52
37231 00
Surgery
345.41
21.35
24869.52
1537.20
37232 00
Surgery
24.14
5.79
1738.08
416.88
37233 00
Surgery
31.01
9.36
2232.72
673.92
37234 00
Surgery
106.68
8.18
7680.96
588.96
37235 00
Surgery
115.88
10.69
8343.36
769.68
37236 00
Surgery
80.69
12.84
5809.68
924.48
37237 00
Surgery
37.94
6.15
2731.68
442.80
37238 00
Surgery
101.29
8.94
7292.88
643.68
37239 00
Surgery
50.62
4.38
3644.64
315.36
37241 00
Surgery
135.66
12.43
9767.52
894.96
37242 00
Surgery
207.36
13.84
14929.92
996.48
37243 00
Surgery
251.28
16.26
18092.16
1170.72
37244 00
Surgery
191.96
19.17
13821.12
1380.24
37246 00
Surgery
53.33
10.14
3839.76
730.08
37247 00
Surgery
17.34
5.05
1248.48
363.60
37248 00
Surgery
39.77
8.65
2863.44
622.80
37249 00
Surgery
13.01
4.24
936.72
305.28
37252 00
Surgery
27.85
2.59
2005.20
186.48
37253 00
Surgery
5.12
2.06
368.64
148.32
37500 00
Surgery
18.57
18.57
1337.04
1337.04
37501 00
Surgery
0.00
0.00
BR
BR
37565 00
Surgery
21.73
21.73
1564.56
1564.56
37600 00
Surgery
22.35
22.35
1609.20
1609.20
37605 00
Surgery
21.71
21.71
1563.12
1563.12
37606 00
Surgery
22.38
22.38
1611.36
1611.36
37607 00
Surgery
11.07
11.07
797.04
797.04
37609 00
Surgery
9.34
6.11
672.48
439.92
37615 00
Surgery
15.45
15.45
1112.40
1112.40
37616 00
Surgery
33.50
33.50
2412.00
2412.00
37617 00
Surgery
39.31
39.31
2830.32
2830.32
37618 00
Surgery
11.73
11.73
844.56
844.56
37619 00
Surgery
51.51
51.51
3708.72
3708.72
37650 00
Surgery
13.56
13.56
976.32
976.32
37660 00
Surgery
39.32
39.32
2831.04
2831.04
37700 00
Surgery
7.26
7.26
522.72
522.72
37718 00
Surgery
11.61
11.61
835.92
835.92
37722 00
Surgery
13.63
13.63
981.36
981.36
37735 00
Surgery
17.17
17.17
1236.24
1236.24
37760 00
Surgery
17.00
17.00
1224.00
1224.00
37761 00
Surgery
15.90
15.90
1144.80
1144.80
37765 00
Surgery
12.55
7.98
903.60
574.56
37766 00
Surgery
14.76
9.78
1062.72
704.16
37780 00
Surgery
7.01
7.01
504.72
504.72
37785 00
Surgery
10.45
7.58
752.40
545.76
37788 00
Surgery
37.50
37.50
2700.00
2700.00
37790 00
Surgery
14.54
14.54
1046.88
1046.88
37799 00
Surgery
0.00
0.00
BR
BR
38100 00
Surgery
34.45
34.45
2480.40
2480.40
38101 00
Surgery
34.89
34.89
2512.08
2512.08
38102 00
Surgery
7.79
7.79
560.88
560.88
38115 00
Surgery
38.69
38.69
2785.68
2785.68
38120 00
Surgery
31.84
31.84
2292.48
2292.48
38129 00
Surgery
0.00
0.00
BR
BR
38200 00
Surgery
3.82
3.82
275.04
275.04
38204 00
Surgery
0.00
0.00
Bundled Code
Bundled Code
38205 00
Surgery
2.49
2.49
179.28
179.28
38206 00
Surgery
2.44
2.44
175.68
175.68
38207 00
Surgery
1.33
1.33
95.76
95.76
38208 00
Surgery
0.84
0.84
60.48
60.48
38209 00
Surgery
0.35
0.35
25.20
25.20
38210 00
Surgery
2.34
2.34
168.48
168.48
38211 00
Surgery
2.12
2.12
152.64
152.64
38212 00
Surgery
1.40
1.40
100.80
100.80
38213 00
Surgery
0.35
0.35
25.20
25.20
38214 00
Surgery
1.20
1.20
86.40
86.40
38215 00
Surgery
1.40
1.40
100.80
100.80
38220 00
Surgery
4.72
1.99
339.84
143.28
38221 00
Surgery
4.88
2.08
351.36
149.76
38222 00
Surgery
5.26
2.22
378.72
159.84
38230 00
Surgery
6.04
6.04
434.88
434.88
38232 00
Surgery
5.61
5.61
403.92
403.92
38240 00
Surgery
7.16
7.16
515.52
515.52
38241 00
Surgery
5.29
5.29
380.88
380.88
38242 00
Surgery
3.74
3.74
269.28
269.28
38243 00
Surgery
3.67
3.67
264.24
264.24
38300 00
Surgery
10.19
6.36
733.68
457.92
38305 00
Surgery
15.00
15.00
1080.00
1080.00
38308 00
Surgery
14.20
14.20
1022.40
1022.40
38380 00
Surgery
17.45
17.45
1256.40
1256.40
38381 00
Surgery
23.98
23.98
1726.56
1726.56
38382 00
Surgery
20.44
20.44
1471.68
1471.68
38500 00
Surgery
10.15
7.70
730.80
554.40
38505 00
Surgery
5.21
2.53
375.12
182.16
38510 00
Surgery
15.91
12.58
1145.52
905.76
38520 00
Surgery
14.11
14.11
1015.92
1015.92
38525 00
Surgery
13.34
13.34
960.48
960.48
38530 00
Surgery
17.07
17.07
1229.04
1229.04
38531 00
Surgery
13.52
13.52
973.44
973.44
38542 00
Surgery
15.81
15.81
1138.32
1138.32
38550 00
Surgery
15.83
15.83
1139.76
1139.76
38555 00
Surgery
30.91
30.91
2225.52
2225.52
38562 00
Surgery
21.28
21.28
1532.16
1532.16
38564 00
Surgery
21.06
21.06
1516.32
1516.32
38570 00
Surgery
15.53
15.53
1118.16
1118.16
38571 00
Surgery
19.77
19.77
1423.44
1423.44
38572 00
Surgery
26.92
26.92
1938.24
1938.24
38573 00
Surgery
35.32
35.32
2543.04
2543.04
38589 00
Surgery
0.00
0.00
BR
BR
38700 00
Surgery
24.27
24.27
1747.44
1747.44
38720 00
Surgery
40.40
40.40
2908.80
2908.80
38724 00
Surgery
43.60
43.60
3139.20
3139.20
38740 00
Surgery
21.20
21.20
1526.40
1526.40
38745 00
Surgery
26.62
26.62
1916.64
1916.64
38746 00
Surgery
6.29
6.29
452.88
452.88
38747 00
Surgery
7.92
7.92
570.24
570.24
38760 00
Surgery
25.17
25.17
1812.24
1812.24
38765 00
Surgery
39.25
39.25
2826.00
2826.00
38770 00
Surgery
24.18
24.18
1740.96
1740.96
38780 00
Surgery
31.55
31.55
2271.60
2271.60
38790 00
Surgery
2.44
2.44
175.68
175.68
38792 00
Surgery
2.47
0.95
177.84
68.40
38794 00
Surgery
8.36
8.36
601.92
601.92
38900 00
Surgery
4.09
4.09
294.48
294.48
38999 00
Surgery
0.00
0.00
BR
BR
39000 00
Surgery
15.15
15.15
1090.80
1090.80
39010 00
Surgery
23.47
23.47
1689.84
1689.84
39200 00
Surgery
25.80
25.80
1857.60
1857.60
39220 00
Surgery
33.71
33.71
2427.12
2427.12
39401 00
Surgery
9.11
9.11
655.92
655.92
39402 00
Surgery
11.89
11.89
856.08
856.08
39499 00
Surgery
0.00
0.00
BR
BR
39501 00
Surgery
25.55
25.55
1839.60
1839.60
39503 00
Surgery
171.00
171.00
12312.00
12312.00
39540 00
Surgery
25.95
25.95
1868.40
1868.40
39541 00
Surgery
27.88
27.88
2007.36
2007.36
39545 00
Surgery
26.67
26.67
1920.24
1920.24
39560 00
Surgery
24.05
24.05
1731.60
1731.60
39561 00
Surgery
37.54
37.54
2702.88
2702.88
39599 00
Surgery
0.00
0.00
BR
BR
40490 00
Surgery
3.68
2.06
264.96
148.32
40500 00
Surgery
16.00
11.23
1152.00
808.56
40510 00
Surgery
14.79
10.57
1064.88
761.04
40520 00
Surgery
15.19
10.81
1093.68
778.32
40525 00
Surgery
16.68
16.68
1200.96
1200.96
40527 00
Surgery
19.00
19.00
1368.00
1368.00
40530 00
Surgery
16.85
12.28
1213.20
884.16
40650 00
Surgery
14.58
9.62
1049.76
692.64
40652 00
Surgery
15.66
10.96
1127.52
789.12
40654 00
Surgery
17.74
12.92
1277.28
930.24
40700 00
Surgery
30.29
30.29
2180.88
2180.88
40701 00
Surgery
35.71
35.71
2571.12
2571.12
40702 00
Surgery
30.02
30.02
2161.44
2161.44
40720 00
Surgery
30.80
30.80
2217.60
2217.60
40761 00
Surgery
32.33
32.33
2327.76
2327.76
40799 00
Surgery
0.00
0.00
BR
BR
40800 00
Surgery
6.08
3.58
437.76
257.76
40801 00
Surgery
8.77
5.98
631.44
430.56
40804 00
Surgery
5.70
3.44
410.40
247.68
40805 00
Surgery
8.55
5.94
615.60
427.68
40806 00
Surgery
3.00
0.89
216.00
64.08
40808 00
Surgery
5.10
2.69
367.20
193.68
40810 00
Surgery
6.53
3.70
470.16
266.40
40812 00
Surgery
8.33
5.48
599.76
394.56
40814 00
Surgery
11.17
8.52
804.24
613.44
40816 00
Surgery
12.16
9.17
875.52
660.24
40818 00
Surgery
10.94
7.99
787.68
575.28
40819 00
Surgery
8.12
6.01
584.64
432.72
40820 00
Surgery
7.79
5.01
560.88
360.72
40830 00
Surgery
6.73
4.37
484.56
314.64
40831 00
Surgery
8.85
6.03
637.20
434.16
40840 00
Surgery
26.07
19.08
1877.04
1373.76
40842 00
Surgery
28.06
20.42
2020.32
1470.24
40843 00
Surgery
36.11
26.16
2599.92
1883.52
40844 00
Surgery
45.33
35.40
3263.76
2548.80
40845 00
Surgery
44.52
36.23
3205.44
2608.56
40899 00
Surgery
0.00
0.00
BR
BR
41000 00
Surgery
4.37
3.14
314.64
226.08
41005 00
Surgery
6.85
3.50
493.20
252.00
41006 00
Surgery
10.18
6.95
732.96
500.40
41007 00
Surgery
9.87
6.66
710.64
479.52
41008 00
Surgery
11.82
7.77
851.04
559.44
41009 00
Surgery
12.75
8.61
918.00
619.92
41010 00
Surgery
6.52
3.33
469.44
239.76
41015 00
Surgery
11.99
8.99
863.28
647.28
41016 00
Surgery
13.98
10.36
1006.56
745.92
41017 00
Surgery
13.97
10.30
1005.84
741.60
41018 00
Surgery
15.75
12.01
1134.00
864.72
41019 00
Surgery
14.56
14.56
1048.32
1048.32
41100 00
Surgery
5.65
3.24
406.80
233.28
41105 00
Surgery
5.67
3.33
408.24
239.76
41108 00
Surgery
5.07
2.76
365.04
198.72
41110 00
Surgery
6.93
3.93
498.96
282.96
41112 00
Surgery
10.21
7.33
735.12
527.76
41113 00
Surgery
10.89
7.95
784.08
572.40
41114 00
Surgery
18.73
18.73
1348.56
1348.56
41115 00
Surgery
7.87
4.42
566.64
318.24
41116 00
Surgery
10.07
6.54
725.04
470.88
41120 00
Surgery
31.70
31.70
2282.40
2282.40
41130 00
Surgery
39.21
39.21
2823.12
2823.12
41135 00
Surgery
64.62
64.62
4652.64
4652.64
41140 00
Surgery
65.08
65.08
4685.76
4685.76
41145 00
Surgery
81.94
81.94
5899.68
5899.68
41150 00
Surgery
65.57
65.57
4721.04
4721.04
41153 00
Surgery
71.33
71.33
5135.76
5135.76
41155 00
Surgery
88.88
88.88
6399.36
6399.36
41250 00
Surgery
8.53
4.64
614.16
334.08
41251 00
Surgery
9.43
5.54
678.96
398.88
41252 00
Surgery
9.82
6.29
707.04
452.88
41510 00
Surgery
13.68
13.68
984.96
984.96
41512 00
Surgery
20.02
20.02
1441.44
1441.44
41520 00
Surgery
11.06
7.61
796.32
547.92
41530 00
Surgery
27.32
11.34
1967.04
816.48
41599 00
Surgery
0.00
0.00
BR
BR
41800 00
Surgery
8.76
4.66
630.72
335.52
41805 00
Surgery
9.22
5.86
663.84
421.92
41806 00
Surgery
12.24
8.29
881.28
596.88
41820 00
Surgery
-
-
882.00
740.88
41821 00
Surgery
-
-
223.92
187.92
41822 00
Surgery
10.68
6.08
768.96
437.76
41823 00
Surgery
15.97
11.12
1149.84
800.64
41825 00
Surgery
6.64
3.67
478.08
264.24
41826 00
Surgery
8.96
5.86
645.12
421.92
41827 00
Surgery
12.99
8.68
935.28
624.96
41828 00
Surgery
10.62
6.68
764.64
480.96
41830 00
Surgery
14.11
9.45
1015.92
680.40
41850 00
Surgery
-
-
396.72
333.36
41870 00
Surgery
-
-
731.52
614.88
41872 00
Surgery
14.21
9.22
1023.12
663.84
41874 00
Surgery
11.53
7.34
830.16
528.48
41899 00
Surgery
0.00
0.00
BR
BR
42000 00
Surgery
4.86
3.31
349.92
238.32
42100 00
Surgery
4.41
3.33
317.52
239.76
42104 00
Surgery
6.56
4.08
472.32
293.76
42106 00
Surgery
7.54
4.83
542.88
347.76
42107 00
Surgery
13.36
9.74
961.92
701.28
42120 00
Surgery
30.07
30.07
2165.04
2165.04
42140 00
Surgery
9.38
4.95
675.36
356.40
42145 00
Surgery
20.79
20.79
1496.88
1496.88
42160 00
Surgery
6.82
4.25
491.04
306.00
42180 00
Surgery
7.70
5.67
554.40
408.24
42182 00
Surgery
9.96
7.80
717.12
561.60
42200 00
Surgery
27.84
27.84
2004.48
2004.48
42205 00
Surgery
28.95
28.95
2084.40
2084.40
42210 00
Surgery
32.31
32.31
2326.32
2326.32
42215 00
Surgery
21.15
21.15
1522.80
1522.80
42220 00
Surgery
17.44
17.44
1255.68
1255.68
42225 00
Surgery
29.48
29.48
2122.56
2122.56
42226 00
Surgery
27.27
27.27
1963.44
1963.44
42227 00
Surgery
25.41
25.41
1829.52
1829.52
42235 00
Surgery
22.37
22.37
1610.64
1610.64
42260 00
Surgery
26.03
20.26
1874.16
1458.72
42280 00
Surgery
5.30
3.26
381.60
234.72
42281 00
Surgery
6.74
4.84
485.28
348.48
42299 00
Surgery
0.00
0.00
BR
BR
42300 00
Surgery
6.51
4.74
468.72
341.28
42305 00
Surgery
13.13
13.13
945.36
945.36
42310 00
Surgery
5.15
4.07
370.80
293.04
42320 00
Surgery
7.89
5.43
568.08
390.96
42330 00
Surgery
7.08
5.01
509.76
360.72
42335 00
Surgery
13.09
7.99
942.48
575.28
42340 00
Surgery
16.12
10.47
1160.64
753.84
42400 00
Surgery
2.87
1.58
206.64
113.76
42405 00
Surgery
9.21
6.86
663.12
493.92
42408 00
Surgery
16.28
10.49
1172.16
755.28
42409 00
Surgery
11.95
7.06
860.40
508.32
42410 00
Surgery
19.05
19.05
1371.60
1371.60
42415 00
Surgery
31.90
31.90
2296.80
2296.80
42420 00
Surgery
35.67
35.67
2568.24
2568.24
42425 00
Surgery
25.31
25.31
1822.32
1822.32
42426 00
Surgery
40.54
40.54
2918.88
2918.88
42440 00
Surgery
12.61
12.61
907.92
907.92
42450 00
Surgery
14.32
11.05
1031.04
795.60
42500 00
Surgery
13.60
10.47
979.20
753.84
42505 00
Surgery
17.43
13.90
1254.96
1000.80
42507 00
Surgery
14.98
14.98
1078.56
1078.56
42509 00
Surgery
24.66
24.66
1775.52
1775.52
42510 00
Surgery
18.37
18.37
1322.64
1322.64
42550 00
Surgery
4.59
1.80
330.48
129.60
42600 00
Surgery
16.51
10.82
1188.72
779.04
42650 00
Surgery
2.25
1.78
162.00
128.16
42660 00
Surgery
3.37
2.60
242.64
187.20
42665 00
Surgery
11.38
6.62
819.36
476.64
42699 00
Surgery
0.00
0.00
BR
BR
42700 00
Surgery
5.82
4.12
419.04
296.64
42720 00
Surgery
13.49
11.60
971.28
835.20
42725 00
Surgery
24.08
24.08
1733.76
1733.76
42800 00
Surgery
4.80
3.55
345.60
255.60
42804 00
Surgery
6.53
3.74
470.16
269.28
42806 00
Surgery
7.29
4.30
524.88
309.60
42808 00
Surgery
7.04
5.03
506.88
362.16
42809 00
Surgery
6.26
3.84
450.72
276.48
42810 00
Surgery
11.82
8.60
851.04
619.20
42815 00
Surgery
16.29
16.29
1172.88
1172.88
42820 00
Surgery
8.85
8.85
637.20
637.20
42821 00
Surgery
9.24
9.24
665.28
665.28
42825 00
Surgery
8.17
8.17
588.24
588.24
42826 00
Surgery
7.78
7.78
560.16
560.16
42830 00
Surgery
6.49
6.49
467.28
467.28
42831 00
Surgery
7.05
7.05
507.60
507.60
42835 00
Surgery
6.06
6.06
436.32
436.32
42836 00
Surgery
7.47
7.47
537.84
537.84
42842 00
Surgery
30.35
30.35
2185.20
2185.20
42844 00
Surgery
41.27
41.27
2971.44
2971.44
42845 00
Surgery
65.83
65.83
4739.76
4739.76
42860 00
Surgery
5.93
5.93
426.96
426.96
42870 00
Surgery
17.73
17.73
1276.56
1276.56
42890 00
Surgery
42.44
42.44
3055.68
3055.68
42892 00
Surgery
55.74
55.74
4013.28
4013.28
42894 00
Surgery
70.67
70.67
5088.24
5088.24
42900 00
Surgery
10.00
10.00
720.00
720.00
42950 00
Surgery
23.96
23.96
1725.12
1725.12
42953 00
Surgery
28.72
28.72
2067.84
2067.84
42955 00
Surgery
22.82
22.82
1643.04
1643.04
42960 00
Surgery
4.87
4.87
350.64
350.64
42961 00
Surgery
12.73
12.73
916.56
916.56
42962 00
Surgery
15.66
15.66
1127.52
1127.52
42970 00
Surgery
12.47
12.47
897.84
897.84
42971 00
Surgery
13.73
13.73
988.56
988.56
42972 00
Surgery
15.34
15.34
1104.48
1104.48
42975 00
Surgery
2.91
2.91
209.52
209.52
42999 00
Surgery
0.00
0.00
BR
BR
43020 00
Surgery
17.11
17.11
1231.92
1231.92
43030 00
Surgery
15.85
15.85
1141.20
1141.20
43045 00
Surgery
38.80
38.80
2793.60
2793.60
43100 00
Surgery
19.25
19.25
1386.00
1386.00
43101 00
Surgery
29.92
29.92
2154.24
2154.24
43107 00
Surgery
88.17
88.17
6348.24
6348.24
43108 00
Surgery
130.75
130.75
9414.00
9414.00
43112 00
Surgery
102.16
102.16
7355.52
7355.52
43113 00
Surgery
127.96
127.96
9213.12
9213.12
43116 00
Surgery
146.15
146.15
10522.80
10522.80
43117 00
Surgery
96.33
96.33
6935.76
6935.76
43118 00
Surgery
106.72
106.72
7683.84
7683.84
43121 00
Surgery
84.39
84.39
6076.08
6076.08
43122 00
Surgery
76.43
76.43
5502.96
5502.96
43123 00
Surgery
132.61
132.61
9547.92
9547.92
43124 00
Surgery
112.29
112.29
8084.88
8084.88
43130 00
Surgery
23.91
23.91
1721.52
1721.52
43135 00
Surgery
43.50
43.50
3132.00
3132.00
43180 00
Surgery
16.45
16.45
1184.40
1184.40
43191 00
Surgery
4.66
4.66
335.52
335.52
43192 00
Surgery
5.09
5.09
366.48
366.48
43193 00
Surgery
5.07
5.07
365.04
365.04
43194 00
Surgery
5.68
5.68
408.96
408.96
43195 00
Surgery
5.54
5.54
398.88
398.88
43196 00
Surgery
5.86
5.86
421.92
421.92
43197 00
Surgery
5.72
2.44
411.84
175.68
43198 00
Surgery
6.34
2.91
456.48
209.52
43200 00
Surgery
7.90
2.62
568.80
188.64
43201 00
Surgery
7.79
3.08
560.88
221.76
43202 00
Surgery
10.66
3.06
767.52
220.32
43204 00
Surgery
3.99
3.99
287.28
287.28
43205 00
Surgery
4.17
4.17
300.24
300.24
43206 00
Surgery
9.09
3.92
654.48
282.24
43210 00
Surgery
12.72
12.72
915.84
915.84
43211 00
Surgery
6.92
6.92
498.24
498.24
43212 00
Surgery
5.58
5.58
401.76
401.76
43213 00
Surgery
36.37
7.68
2618.64
552.96
43214 00
Surgery
5.75
5.75
414.00
414.00
43215 00
Surgery
11.75
4.19
846.00
301.68
43216 00
Surgery
12.22
3.95
879.84
284.40
43217 00
Surgery
12.59
4.73
906.48
340.56
43220 00
Surgery
26.70
3.50
1922.40
252.00
43226 00
Surgery
11.55
3.87
831.60
278.64
43227 00
Surgery
17.74
4.88
1277.28
351.36
43229 00
Surgery
21.16
5.81
1523.52
418.32
43231 00
Surgery
4.64
4.64
334.08
334.08
43232 00
Surgery
5.87
5.87
422.64
422.64
43233 00
Surgery
6.77
6.77
487.44
487.44
43235 00
Surgery
8.63
3.63
621.36
261.36
43236 00
Surgery
12.02
4.10
865.44
295.20
43237 00
Surgery
5.77
5.77
415.44
415.44
43238 00
Surgery
6.84
6.84
492.48
492.48
43239 00
Surgery
11.28
4.10
812.16
295.20
43240 00
Surgery
11.54
11.54
830.88
830.88
43241 00
Surgery
4.21
4.21
303.12
303.12
43242 00
Surgery
7.74
7.74
557.28
557.28
43243 00
Surgery
7.01
7.01
504.72
504.72
43244 00
Surgery
7.22
7.22
519.84
519.84
43245 00
Surgery
17.72
5.19
1275.84
373.68
43246 00
Surgery
5.92
5.92
426.24
426.24
43247 00
Surgery
11.49
5.22
827.28
375.84
43248 00
Surgery
12.38
4.91
891.36
353.52
43249 00
Surgery
32.04
4.54
2306.88
326.88
43250 00
Surgery
13.45
5.03
968.40
362.16
43251 00
Surgery
14.79
5.78
1064.88
416.16
43252 00
Surgery
10.18
4.97
732.96
357.84
43253 00
Surgery
7.73
7.73
556.56
556.56
43254 00
Surgery
7.95
7.95
572.40
572.40
43255 00
Surgery
18.68
5.90
1344.96
424.80
43257 00
Surgery
6.91
6.91
497.52
497.52
43259 00
Surgery
6.65
6.65
478.80
478.80
43260 00
Surgery
9.50
9.50
684.00
684.00
43261 00
Surgery
9.97
9.97
717.84
717.84
43262 00
Surgery
10.50
10.50
756.00
756.00
43263 00
Surgery
10.52
10.52
757.44
757.44
43264 00
Surgery
10.71
10.71
771.12
771.12
43265 00
Surgery
12.74
12.74
917.28
917.28
43266 00
Surgery
6.42
6.42
462.24
462.24
43270 00
Surgery
21.77
6.61
1567.44
475.92
43273 00
Surgery
3.50
3.50
252.00
252.00
43274 00
Surgery
13.61
13.61
979.92
979.92
43275 00
Surgery
11.07
11.07
797.04
797.04
43276 00
Surgery
14.17
14.17
1020.24
1020.24
43277 00
Surgery
11.13
11.13
801.36
801.36
43278 00
Surgery
12.74
12.74
917.28
917.28
43279 00
Surgery
38.38
38.38
2763.36
2763.36
43280 00
Surgery
32.32
32.32
2327.04
2327.04
43281 00
Surgery
45.94
45.94
3307.68
3307.68
43282 00
Surgery
51.74
51.74
3725.28
3725.28
43283 00
Surgery
4.67
4.67
336.24
336.24
43284 00
Surgery
19.68
19.68
1416.96
1416.96
43285 00
Surgery
20.23
20.23
1456.56
1456.56
43286 00
Surgery
94.05
94.05
6771.60
6771.60
43287 00
Surgery
105.10
105.10
7567.20
7567.20
43288 00
Surgery
110.84
110.84
7980.48
7980.48
43289 00
Surgery
0.00
0.00
BR
BR
43290 00
Surgery
78.00
5.38
5616.00
387.36
43291 00
Surgery
13.76
4.74
990.72
341.28
43300 00
Surgery
18.95
18.95
1364.40
1364.40
43305 00
Surgery
32.94
32.94
2371.68
2371.68
43310 00
Surgery
43.89
43.89
3160.08
3160.08
43312 00
Surgery
46.86
46.86
3373.92
3373.92
43313 00
Surgery
86.92
86.92
6258.24
6258.24
43314 00
Surgery
92.99
92.99
6695.28
6695.28
43320 00
Surgery
41.93
41.93
3018.96
3018.96
43325 00
Surgery
40.76
40.76
2934.72
2934.72
43327 00
Surgery
24.50
24.50
1764.00
1764.00
43328 00
Surgery
33.23
33.23
2392.56
2392.56
43330 00
Surgery
40.11
40.11
2887.92
2887.92
43331 00
Surgery
39.77
39.77
2863.44
2863.44
43332 00
Surgery
34.37
34.37
2474.64
2474.64
43333 00
Surgery
37.65
37.65
2710.80
2710.80
43334 00
Surgery
36.72
36.72
2643.84
2643.84
43335 00
Surgery
39.44
39.44
2839.68
2839.68
43336 00
Surgery
42.84
42.84
3084.48
3084.48
43337 00
Surgery
45.63
45.63
3285.36
3285.36
43338 00
Surgery
3.36
3.36
241.92
241.92
43340 00
Surgery
41.42
41.42
2982.24
2982.24
43341 00
Surgery
41.58
41.58
2993.76
2993.76
43351 00
Surgery
39.27
39.27
2827.44
2827.44
43352 00
Surgery
31.78
31.78
2288.16
2288.16
43360 00
Surgery
66.57
66.57
4793.04
4793.04
43361 00
Surgery
80.75
80.75
5814.00
5814.00
43400 00
Surgery
45.66
45.66
3287.52
3287.52
43405 00
Surgery
43.34
43.34
3120.48
3120.48
43410 00
Surgery
31.15
31.15
2242.80
2242.80
43415 00
Surgery
76.54
76.54
5510.88
5510.88
43420 00
Surgery
30.62
30.62
2204.64
2204.64
43425 00
Surgery
42.79
42.79
3080.88
3080.88
43450 00
Surgery
5.62
2.37
404.64
170.64
43453 00
Surgery
23.73
2.58
1708.56
185.76
43460 00
Surgery
6.26
6.26
450.72
450.72
43496 00
Surgery
0.00
0.00
BR
BR
43497 00
Surgery
23.49
23.49
1691.28
1691.28
43499 00
Surgery
0.00
0.00
BR
BR
43500 00
Surgery
23.68
23.68
1704.96
1704.96
43501 00
Surgery
40.58
40.58
2921.76
2921.76
43502 00
Surgery
45.77
45.77
3295.44
3295.44
43510 00
Surgery
28.62
28.62
2060.64
2060.64
43520 00
Surgery
20.80
20.80
1497.60
1497.60
43605 00
Surgery
25.14
25.14
1810.08
1810.08
43610 00
Surgery
29.36
29.36
2113.92
2113.92
43611 00
Surgery
36.89
36.89
2656.08
2656.08
43620 00
Surgery
59.33
59.33
4271.76
4271.76
43621 00
Surgery
67.98
67.98
4894.56
4894.56
43622 00
Surgery
69.08
69.08
4973.76
4973.76
43631 00
Surgery
43.47
43.47
3129.84
3129.84
43632 00
Surgery
60.90
60.90
4384.80
4384.80
43633 00
Surgery
57.62
57.62
4148.64
4148.64
43634 00
Surgery
63.57
63.57
4577.04
4577.04
43635 00
Surgery
3.34
3.34
240.48
240.48
43640 00
Surgery
35.81
35.81
2578.32
2578.32
43641 00
Surgery
36.22
36.22
2607.84
2607.84
43644 00
Surgery
52.09
52.09
3750.48
3750.48
43645 00
Surgery
55.34
55.34
3984.48
3984.48
43647 00
Surgery
-
-
1288.08
1082.16
43648 00
Surgery
-
-
1215.36
1020.96
43651 00
Surgery
19.86
19.86
1429.92
1429.92
43652 00
Surgery
23.11
23.11
1663.92
1663.92
43653 00
Surgery
17.48
17.48
1258.56
1258.56
43659 00
Surgery
0.00
0.00
BR
BR
43752 00
Surgery
1.18
1.18
84.96
84.96
43753 00
Surgery
0.64
0.64
46.08
46.08
43754 00
Surgery
7.03
1.14
506.16
82.08
43755 00
Surgery
6.09
1.78
438.48
128.16
43756 00
Surgery
8.26
1.52
594.72
109.44
43757 00
Surgery
11.09
2.29
798.48
164.88
43761 00
Surgery
3.70
3.09
266.40
222.48
43762 00
Surgery
6.76
1.11
486.72
79.92
43763 00
Surgery
10.00
2.61
720.00
187.92
43770 00
Surgery
33.88
33.88
2439.36
2439.36
43771 00
Surgery
38.42
38.42
2766.24
2766.24
43772 00
Surgery
28.57
28.57
2057.04
2057.04
43773 00
Surgery
38.42
38.42
2766.24
2766.24
43774 00
Surgery
28.90
28.90
2080.80
2080.80
43775 00
Surgery
33.03
33.03
2378.16
2378.16
43800 00
Surgery
27.95
27.95
2012.40
2012.40
43810 00
Surgery
30.56
30.56
2200.32
2200.32
43820 00
Surgery
40.38
40.38
2907.36
2907.36
43825 00
Surgery
39.39
39.39
2836.08
2836.08
43830 00
Surgery
21.19
21.19
1525.68
1525.68
43831 00
Surgery
18.45
18.45
1328.40
1328.40
43832 00
Surgery
31.46
31.46
2265.12
2265.12
43840 00
Surgery
40.80
40.80
2937.60
2937.60
43842 00
Surgery
34.50
34.50
2484.00
2484.00
43843 00
Surgery
38.59
38.59
2778.48
2778.48
43845 00
Surgery
58.74
58.74
4229.28
4229.28
43846 00
Surgery
49.59
49.59
3570.48
3570.48
43847 00
Surgery
54.24
54.24
3905.28
3905.28
43848 00
Surgery
58.07
58.07
4181.04
4181.04
43860 00
Surgery
49.01
49.01
3528.72
3528.72
43865 00
Surgery
51.24
51.24
3689.28
3689.28
43870 00
Surgery
21.34
21.34
1536.48
1536.48
43880 00
Surgery
48.17
48.17
3468.24
3468.24
43881 00
Surgery
-
-
2037.60
1711.44
43882 00
Surgery
0.00
0.00
BR
BR
43886 00
Surgery
11.20
11.20
806.40
806.40
43887 00
Surgery
10.12
10.12
728.64
728.64
43888 00
Surgery
14.10
14.10
1015.20
1015.20
43999 00
Surgery
0.00
0.00
BR
BR
44005 00
Surgery
32.71
32.71
2355.12
2355.12
44010 00
Surgery
25.46
25.46
1833.12
1833.12
44015 00
Surgery
4.19
4.19
301.68
301.68
44020 00
Surgery
29.20
29.20
2102.40
2102.40
44021 00
Surgery
29.12
29.12
2096.64
2096.64
44025 00
Surgery
29.44
29.44
2119.68
2119.68
44050 00
Surgery
28.12
28.12
2024.64
2024.64
44055 00
Surgery
44.58
44.58
3209.76
3209.76
44100 00
Surgery
3.15
3.15
226.80
226.80
44110 00
Surgery
25.53
25.53
1838.16
1838.16
44111 00
Surgery
29.31
29.31
2110.32
2110.32
44120 00
Surgery
36.59
36.59
2634.48
2634.48
44121 00
Surgery
7.15
7.15
514.80
514.80
44125 00
Surgery
35.20
35.20
2534.40
2534.40
44126 00
Surgery
73.86
73.86
5317.92
5317.92
44127 00
Surgery
85.25
85.25
6138.00
6138.00
44128 00
Surgery
7.22
7.22
519.84
519.84
44130 00
Surgery
39.42
39.42
2838.24
2838.24
44132 00
Surgery
0.00
0.00
BR
BR
44133 00
Surgery
0.00
0.00
BR
BR
44135 00
Surgery
0.00
0.00
BR
BR
44136 00
Surgery
0.00
0.00
BR
BR
44137 00
Surgery
0.00
0.00
BR
BR
44139 00
Surgery
3.56
3.56
256.32
256.32
44140 00
Surgery
40.18
40.18
2892.96
2892.96
44141 00
Surgery
54.17
54.17
3900.24
3900.24
44143 00
Surgery
49.34
49.34
3552.48
3552.48
44144 00
Surgery
52.66
52.66
3791.52
3791.52
44145 00
Surgery
49.22
49.22
3543.84
3543.84
44146 00
Surgery
62.57
62.57
4505.04
4505.04
44147 00
Surgery
57.64
57.64
4150.08
4150.08
44150 00
Surgery
55.28
55.28
3980.16
3980.16
44151 00
Surgery
64.29
64.29
4628.88
4628.88
44155 00
Surgery
61.61
61.61
4435.92
4435.92
44156 00
Surgery
68.72
68.72
4947.84
4947.84
44157 00
Surgery
65.35
65.35
4705.20
4705.20
44158 00
Surgery
66.98
66.98
4822.56
4822.56
44160 00
Surgery
37.17
37.17
2676.24
2676.24
44180 00
Surgery
27.62
27.62
1988.64
1988.64
44186 00
Surgery
19.62
19.62
1412.64
1412.64
44187 00
Surgery
32.58
32.58
2345.76
2345.76
44188 00
Surgery
36.28
36.28
2612.16
2612.16
44202 00
Surgery
41.50
41.50
2988.00
2988.00
44203 00
Surgery
7.12
7.12
512.64
512.64
44204 00
Surgery
45.80
45.80
3297.60
3297.60
44205 00
Surgery
39.76
39.76
2862.72
2862.72
44206 00
Surgery
51.88
51.88
3735.36
3735.36
44207 00
Surgery
53.84
53.84
3876.48
3876.48
44208 00
Surgery
58.62
58.62
4220.64
4220.64
44210 00
Surgery
52.66
52.66
3791.52
3791.52
44211 00
Surgery
62.70
62.70
4514.40
4514.40
44212 00
Surgery
60.13
60.13
4329.36
4329.36
44213 00
Surgery
5.51
5.51
396.72
396.72
44227 00
Surgery
49.37
49.37
3554.64
3554.64
44238 00
Surgery
0.00
0.00
BR
BR
44300 00
Surgery
25.30
25.30
1821.60
1821.60
44310 00
Surgery
31.10
31.10
2239.20
2239.20
44312 00
Surgery
17.98
17.98
1294.56
1294.56
44314 00
Surgery
30.08
30.08
2165.76
2165.76
44316 00
Surgery
42.46
42.46
3057.12
3057.12
44320 00
Surgery
35.95
35.95
2588.40
2588.40
44322 00
Surgery
30.22
30.22
2175.84
2175.84
44340 00
Surgery
19.00
19.00
1368.00
1368.00
44345 00
Surgery
31.48
31.48
2266.56
2266.56
44346 00
Surgery
35.40
35.40
2548.80
2548.80
44360 00
Surgery
4.25
4.25
306.00
306.00
44361 00
Surgery
4.68
4.68
336.96
336.96
44363 00
Surgery
5.65
5.65
406.80
406.80
44364 00
Surgery
6.02
6.02
433.44
433.44
44365 00
Surgery
5.38
5.38
387.36
387.36
44366 00
Surgery
7.06
7.06
508.32
508.32
44369 00
Surgery
7.23
7.23
520.56
520.56
44370 00
Surgery
7.87
7.87
566.64
566.64
44372 00
Surgery
7.06
7.06
508.32
508.32
44373 00
Surgery
5.64
5.64
406.08
406.08
44376 00
Surgery
8.35
8.35
601.20
601.20
44377 00
Surgery
8.81
8.81
634.32
634.32
44378 00
Surgery
11.31
11.31
814.32
814.32
44379 00
Surgery
12.06
12.06
868.32
868.32
44380 00
Surgery
5.91
1.71
425.52
123.12
44381 00
Surgery
29.13
2.52
2097.36
181.44
44382 00
Surgery
8.93
2.20
642.96
158.40
44384 00
Surgery
4.50
4.50
324.00
324.00
44385 00
Surgery
6.49
2.17
467.28
156.24
44386 00
Surgery
9.30
2.65
669.60
190.80
44388 00
Surgery
9.48
4.62
682.56
332.64
44389 00
Surgery
12.33
5.07
887.76
365.04
44390 00
Surgery
12.12
6.20
872.64
446.40
44391 00
Surgery
19.08
6.80
1373.76
489.60
44392 00
Surgery
11.68
5.91
840.96
425.52
44394 00
Surgery
13.13
6.65
945.36
478.80
44401 00
Surgery
70.18
7.14
5052.96
514.08
44402 00
Surgery
7.70
7.70
554.40
554.40
44403 00
Surgery
8.96
8.96
645.12
645.12
44404 00
Surgery
12.60
5.07
907.20
365.04
44405 00
Surgery
16.59
5.41
1194.48
389.52
44406 00
Surgery
6.76
6.76
486.72
486.72
44407 00
Surgery
8.10
8.10
583.20
583.20
44408 00
Surgery
6.82
6.82
491.04
491.04
44500 00
Surgery
0.56
0.56
40.32
40.32
44602 00
Surgery
42.01
42.01
3024.72
3024.72
44603 00
Surgery
48.27
48.27
3475.44
3475.44
44604 00
Surgery
31.53
31.53
2270.16
2270.16
44605 00
Surgery
38.47
38.47
2769.84
2769.84
44615 00
Surgery
31.94
31.94
2299.68
2299.68
44620 00
Surgery
25.86
25.86
1861.92
1861.92
44625 00
Surgery
30.18
30.18
2172.96
2172.96
44626 00
Surgery
47.40
47.40
3412.80
3412.80
44640 00
Surgery
41.65
41.65
2998.80
2998.80
44650 00
Surgery
42.94
42.94
3091.68
3091.68
44660 00
Surgery
40.02
40.02
2881.44
2881.44
44661 00
Surgery
45.92
45.92
3306.24
3306.24
44680 00
Surgery
32.31
32.31
2326.32
2326.32
44700 00
Surgery
29.92
29.92
2154.24
2154.24
44701 00
Surgery
5.03
5.03
362.16
362.16
44705 00
Surgery
3.37
2.12
242.64
152.64
44715 00
Surgery
0.00
0.00
BR
BR
44720 00
Surgery
8.11
8.11
583.92
583.92
44721 00
Surgery
11.35
11.35
817.20
817.20
44799 00
Surgery
0.00
0.00
BR
BR
44800 00
Surgery
23.42
23.42
1686.24
1686.24
44820 00
Surgery
25.64
25.64
1846.08
1846.08
44850 00
Surgery
22.51
22.51
1620.72
1620.72
44899 00
Surgery
0.00
0.00
BR
BR
44900 00
Surgery
23.61
23.61
1699.92
1699.92
44950 00
Surgery
19.32
19.32
1391.04
1391.04
44955 00
Surgery
2.48
2.48
178.56
178.56
44960 00
Surgery
26.35
26.35
1897.20
1897.20
44970 00
Surgery
18.18
18.18
1308.96
1308.96
44979 00
Surgery
0.00
0.00
BR
BR
45000 00
Surgery
12.95
12.95
932.40
932.40
45005 00
Surgery
9.48
5.00
682.56
360.00
45020 00
Surgery
17.13
17.13
1233.36
1233.36
45100 00
Surgery
9.18
9.18
660.96
660.96
45108 00
Surgery
11.36
11.36
817.92
817.92
45110 00
Surgery
54.09
54.09
3894.48
3894.48
45111 00
Surgery
32.55
32.55
2343.60
2343.60
45112 00
Surgery
53.83
53.83
3875.76
3875.76
45113 00
Surgery
55.34
55.34
3984.48
3984.48
45114 00
Surgery
54.40
54.40
3916.80
3916.80
45116 00
Surgery
45.91
45.91
3305.52
3305.52
45119 00
Surgery
55.75
55.75
4014.00
4014.00
45120 00
Surgery
48.01
48.01
3456.72
3456.72
45121 00
Surgery
52.39
52.39
3772.08
3772.08
45123 00
Surgery
33.22
33.22
2391.84
2391.84
45126 00
Surgery
81.59
81.59
5874.48
5874.48
45130 00
Surgery
32.36
32.36
2329.92
2329.92
45135 00
Surgery
38.65
38.65
2782.80
2782.80
45136 00
Surgery
53.02
53.02
3817.44
3817.44
45150 00
Surgery
12.85
12.85
925.20
925.20
45160 00
Surgery
30.90
30.90
2224.80
2224.80
45171 00
Surgery
18.60
18.60
1339.20
1339.20
45172 00
Surgery
24.75
24.75
1782.00
1782.00
45190 00
Surgery
20.97
20.97
1509.84
1509.84
45300 00
Surgery
3.85
1.44
277.20
103.68
45303 00
Surgery
28.07
2.56
2021.04
184.32
45305 00
Surgery
5.44
2.18
391.68
156.96
45307 00
Surgery
6.41
3.01
461.52
216.72
45308 00
Surgery
6.14
2.54
442.08
182.88
45309 00
Surgery
6.33
2.69
455.76
193.68
45315 00
Surgery
6.83
3.17
491.76
228.24
45317 00
Surgery
6.63
3.31
477.36
238.32
45320 00
Surgery
6.68
3.14
480.96
226.08
45321 00
Surgery
3.10
3.10
223.20
223.20
45327 00
Surgery
3.50
3.50
252.00
252.00
45330 00
Surgery
5.59
1.69
402.48
121.68
45331 00
Surgery
8.58
2.15
617.76
154.80
45332 00
Surgery
8.32
3.13
599.04
225.36
45333 00
Surgery
9.83
2.80
707.76
201.60
45334 00
Surgery
14.68
3.48
1056.96
250.56
45335 00
Surgery
8.71
1.99
627.12
143.28
45337 00
Surgery
3.38
3.38
243.36
243.36
45338 00
Surgery
8.97
3.56
645.84
256.32
45340 00
Surgery
13.61
2.33
979.92
167.76
45341 00
Surgery
3.67
3.67
264.24
264.24
45342 00
Surgery
5.04
5.04
362.88
362.88
45346 00
Surgery
67.85
4.74
4885.20
341.28
45347 00
Surgery
4.55
4.55
327.60
327.60
45349 00
Surgery
5.84
5.84
420.48
420.48
45350 00
Surgery
19.98
3.00
1438.56
216.00
45378 00
Surgery
10.19
5.45
733.68
392.40
45379 00
Surgery
13.01
7.03
936.72
506.16
45380 00
Surgery
12.99
5.92
935.28
426.24
45381 00
Surgery
13.26
5.91
954.72
425.52
45382 00
Surgery
19.87
7.62
1430.64
548.64
45384 00
Surgery
14.62
6.74
1052.64
485.28
45385 00
Surgery
13.60
7.49
979.20
539.28
45386 00
Surgery
18.20
6.25
1310.40
450.00
45388 00
Surgery
72.50
7.97
5220.00
573.84
45389 00
Surgery
8.53
8.53
614.16
614.16
45390 00
Surgery
9.79
9.79
704.88
704.88
45391 00
Surgery
7.59
7.59
546.48
546.48
45392 00
Surgery
8.96
8.96
645.12
645.12
45393 00
Surgery
7.41
7.41
533.52
533.52
45395 00
Surgery
58.20
58.20
4190.40
4190.40
45397 00
Surgery
62.97
62.97
4533.84
4533.84
45398 00
Surgery
24.52
6.95
1765.44
500.40
45399 00
Surgery
0.00
0.00
BR
BR
45400 00
Surgery
33.77
33.77
2431.44
2431.44
45402 00
Surgery
45.15
45.15
3250.80
3250.80
45499 00
Surgery
0.00
0.00
BR
BR
45500 00
Surgery
17.22
17.22
1239.84
1239.84
45505 00
Surgery
18.15
18.15
1306.80
1306.80
45520 00
Surgery
4.86
1.22
349.92
87.84
45540 00
Surgery
31.33
31.33
2255.76
2255.76
45541 00
Surgery
28.11
28.11
2023.92
2023.92
45550 00
Surgery
43.29
43.29
3116.88
3116.88
45560 00
Surgery
20.77
20.77
1495.44
1495.44
45562 00
Surgery
35.12
35.12
2528.64
2528.64
45563 00
Surgery
49.68
49.68
3576.96
3576.96
45800 00
Surgery
38.15
38.15
2746.80
2746.80
45805 00
Surgery
44.01
44.01
3168.72
3168.72
45820 00
Surgery
38.25
38.25
2754.00
2754.00
45825 00
Surgery
46.09
46.09
3318.48
3318.48
45900 00
Surgery
6.42
6.42
462.24
462.24
45905 00
Surgery
5.14
5.14
370.08
370.08
45910 00
Surgery
5.82
5.82
419.04
419.04
45915 00
Surgery
10.63
6.89
765.36
496.08
45990 00
Surgery
3.16
3.16
227.52
227.52
45999 00
Surgery
0.00
0.00
BR
BR
46020 00
Surgery
3.50
3.50
252.00
252.00
46030 00
Surgery
7.61
2.59
547.92
186.48
46040 00
Surgery
16.75
12.90
1206.00
928.80
46045 00
Surgery
13.31
13.31
958.32
958.32
46050 00
Surgery
7.12
3.07
512.64
221.04
46060 00
Surgery
14.72
14.72
1059.84
1059.84
46070 00
Surgery
8.22
8.22
591.84
591.84
46080 00
Surgery
8.65
4.75
622.80
342.00
46083 00
Surgery
6.27
3.33
451.44
239.76
46200 00
Surgery
14.33
10.26
1031.76
738.72
46220 00
Surgery
7.56
3.68
544.32
264.96
46221 00
Surgery
8.53
5.80
614.16
417.60
46230 00
Surgery
9.43
5.24
678.96
377.28
46250 00
Surgery
14.41
9.63
1037.52
693.36
46255 00
Surgery
15.65
10.72
1126.80
771.84
46257 00
Surgery
12.58
12.58
905.76
905.76
46258 00
Surgery
14.63
14.63
1053.36
1053.36
46260 00
Surgery
14.56
14.56
1048.32
1048.32
46261 00
Surgery
16.11
16.11
1159.92
1159.92
46262 00
Surgery
17.73
17.73
1276.56
1276.56
46270 00
Surgery
16.10
12.15
1159.20
874.80
46275 00
Surgery
17.01
12.79
1224.72
920.88
46280 00
Surgery
14.53
14.53
1046.16
1046.16
46285 00
Surgery
17.00
12.83
1224.00
923.76
46288 00
Surgery
16.88
16.88
1215.36
1215.36
46320 00
Surgery
6.44
3.43
463.68
246.96
46500 00
Surgery
9.38
5.54
675.36
398.88
46505 00
Surgery
9.48
7.55
682.56
543.60
46600 00
Surgery
3.54
1.24
254.88
89.28
46601 00
Surgery
4.50
2.80
324.00
201.60
46604 00
Surgery
19.21
1.98
1383.12
142.56
46606 00
Surgery
8.40
2.26
604.80
162.72
46607 00
Surgery
6.23
3.72
448.56
267.84
46608 00
Surgery
8.69
2.54
625.68
182.88
46610 00
Surgery
8.22
2.40
591.84
172.80
46611 00
Surgery
6.69
2.41
481.68
173.52
46612 00
Surgery
9.92
2.86
714.24
205.92
46614 00
Surgery
5.05
1.93
363.60
138.96
46615 00
Surgery
5.32
2.71
383.04
195.12
46700 00
Surgery
19.66
19.66
1415.52
1415.52
46705 00
Surgery
17.29
17.29
1244.88
1244.88
46706 00
Surgery
5.45
5.45
392.40
392.40
46707 00
Surgery
15.26
15.26
1098.72
1098.72
46710 00
Surgery
33.38
33.38
2403.36
2403.36
46712 00
Surgery
66.32
66.32
4775.04
4775.04
46715 00
Surgery
16.78
16.78
1208.16
1208.16
46716 00
Surgery
37.26
37.26
2682.72
2682.72
46730 00
Surgery
59.79
59.79
4304.88
4304.88
46735 00
Surgery
68.72
68.72
4947.84
4947.84
46740 00
Surgery
65.19
65.19
4693.68
4693.68
46742 00
Surgery
75.23
75.23
5416.56
5416.56
46744 00
Surgery
105.87
105.87
7622.64
7622.64
46746 00
Surgery
116.56
116.56
8392.32
8392.32
46748 00
Surgery
126.27
126.27
9091.44
9091.44
46750 00
Surgery
22.49
22.49
1619.28
1619.28
46751 00
Surgery
20.22
20.22
1455.84
1455.84
46753 00
Surgery
18.71
18.71
1347.12
1347.12
46754 00
Surgery
10.53
7.33
758.16
527.76
46760 00
Surgery
33.05
33.05
2379.60
2379.60
46761 00
Surgery
27.37
27.37
1970.64
1970.64
46900 00
Surgery
7.25
4.15
522.00
298.80
46910 00
Surgery
7.97
4.09
573.84
294.48
46916 00
Surgery
7.86
4.28
565.92
308.16
46917 00
Surgery
13.32
3.90
959.04
280.80
46922 00
Surgery
9.45
4.17
680.40
300.24
46924 00
Surgery
16.70
5.46
1202.40
393.12
46930 00
Surgery
6.52
4.58
469.44
329.76
46940 00
Surgery
8.04
4.36
578.88
313.92
46942 00
Surgery
7.66
3.92
551.52
282.24
46945 00
Surgery
10.28
10.28
740.16
740.16
46946 00
Surgery
11.48
11.48
826.56
826.56
46947 00
Surgery
11.78
11.78
848.16
848.16
46948 00
Surgery
13.40
13.40
964.80
964.80
46999 00
Surgery
0.00
0.00
BR
BR
47000 00
Surgery
8.93
2.58
642.96
185.76
47001 00
Surgery
3.07
3.07
221.04
221.04
47010 00
Surgery
36.42
36.42
2622.24
2622.24
47015 00
Surgery
34.99
34.99
2519.28
2519.28
47100 00
Surgery
25.59
25.59
1842.48
1842.48
47120 00
Surgery
69.91
69.91
5033.52
5033.52
47122 00
Surgery
102.01
102.01
7344.72
7344.72
47125 00
Surgery
91.90
91.90
6616.80
6616.80
47130 00
Surgery
98.60
98.60
7099.20
7099.20
47133 00
Surgery
-
-
11963.52
10049.76
47135 00
Surgery
161.52
161.52
11629.44
11629.44
47140 00
Surgery
107.03
107.03
7706.16
7706.16
47141 00
Surgery
127.84
127.84
9204.48
9204.48
47142 00
Surgery
140.71
140.71
10131.12
10131.12
47143 00
Surgery
-
-
1620.72
1361.52
47144 00
Surgery
0.00
0.00
BR
BR
47145 00
Surgery
0.00
0.00
BR
BR
47146 00
Surgery
9.71
9.71
699.12
699.12
47147 00
Surgery
11.34
11.34
816.48
816.48
47300 00
Surgery
34.15
34.15
2458.80
2458.80
47350 00
Surgery
40.86
40.86
2941.92
2941.92
47360 00
Surgery
56.10
56.10
4039.20
4039.20
47361 00
Surgery
89.71
89.71
6459.12
6459.12
47362 00
Surgery
43.49
43.49
3131.28
3131.28
47370 00
Surgery
37.66
37.66
2711.52
2711.52
47371 00
Surgery
37.82
37.82
2723.04
2723.04
47379 00
Surgery
0.00
0.00
BR
BR
47380 00
Surgery
43.38
43.38
3123.36
3123.36
47381 00
Surgery
44.43
44.43
3198.96
3198.96
47382 00
Surgery
107.26
21.51
7722.72
1548.72
47383 00
Surgery
172.75
13.11
12438.00
943.92
47399 00
Surgery
0.00
0.00
BR
BR
47400 00
Surgery
64.32
64.32
4631.04
4631.04
47420 00
Surgery
40.17
40.17
2892.24
2892.24
47425 00
Surgery
41.02
41.02
2953.44
2953.44
47460 00
Surgery
38.11
38.11
2743.92
2743.92
47480 00
Surgery
26.36
26.36
1897.92
1897.92
47490 00
Surgery
9.79
9.79
704.88
704.88
47531 00
Surgery
12.48
2.06
898.56
148.32
47532 00
Surgery
24.76
6.14
1782.72
442.08
47533 00
Surgery
34.25
7.64
2466.00
550.08
47534 00
Surgery
37.62
10.69
2708.64
769.68
47535 00
Surgery
26.08
5.68
1877.76
408.96
47536 00
Surgery
18.68
3.83
1344.96
275.76
47537 00
Surgery
14.46
2.81
1041.12
202.32
47538 00
Surgery
109.95
6.80
7916.40
489.60
47539 00
Surgery
123.64
12.35
8902.08
889.20
47540 00
Surgery
123.38
12.72
8883.36
915.84
47541 00
Surgery
34.28
9.74
2468.16
701.28
47542 00
Surgery
14.65
3.93
1054.80
282.96
47543 00
Surgery
11.55
4.15
831.60
298.80
47544 00
Surgery
24.56
4.53
1768.32
326.16
47550 00
Surgery
4.85
4.85
349.20
349.20
47552 00
Surgery
8.14
8.14
586.08
586.08
47553 00
Surgery
8.15
8.15
586.80
586.80
47554 00
Surgery
13.14
13.14
946.08
946.08
47555 00
Surgery
9.71
9.71
699.12
699.12
47556 00
Surgery
11.00
11.00
792.00
792.00
47562 00
Surgery
19.92
19.92
1434.24
1434.24
47563 00
Surgery
21.65
21.65
1558.80
1558.80
47564 00
Surgery
33.65
33.65
2422.80
2422.80
47570 00
Surgery
23.37
23.37
1682.64
1682.64
47579 00
Surgery
0.00
0.00
BR
BR
47600 00
Surgery
32.18
32.18
2316.96
2316.96
47605 00
Surgery
33.87
33.87
2438.64
2438.64
47610 00
Surgery
37.47
37.47
2697.84
2697.84
47612 00
Surgery
38.20
38.20
2750.40
2750.40
47620 00
Surgery
41.23
41.23
2968.56
2968.56
47700 00
Surgery
31.88
31.88
2295.36
2295.36
47701 00
Surgery
52.04
52.04
3746.88
3746.88
47711 00
Surgery
46.73
46.73
3364.56
3364.56
47712 00
Surgery
59.73
59.73
4300.56
4300.56
47715 00
Surgery
39.96
39.96
2877.12
2877.12
47720 00
Surgery
34.73
34.73
2500.56
2500.56
47721 00
Surgery
40.68
40.68
2928.96
2928.96
47740 00
Surgery
39.45
39.45
2840.40
2840.40
47741 00
Surgery
44.28
44.28
3188.16
3188.16
47760 00
Surgery
67.41
67.41
4853.52
4853.52
47765 00
Surgery
90.54
90.54
6518.88
6518.88
47780 00
Surgery
74.07
74.07
5333.04
5333.04
47785 00
Surgery
96.70
96.70
6962.40
6962.40
47800 00
Surgery
46.59
46.59
3354.48
3354.48
47801 00
Surgery
33.54
33.54
2414.88
2414.88
47802 00
Surgery
45.74
45.74
3293.28
3293.28
47900 00
Surgery
41.40
41.40
2980.80
2980.80
47999 00
Surgery
0.00
0.00
BR
BR
48000 00
Surgery
56.35
56.35
4057.20
4057.20
48001 00
Surgery
68.94
68.94
4963.68
4963.68
48020 00
Surgery
35.47
35.47
2553.84
2553.84
48100 00
Surgery
26.83
26.83
1931.76
1931.76
48102 00
Surgery
15.19
6.91
1093.68
497.52
48105 00
Surgery
84.12
84.12
6056.64
6056.64
48120 00
Surgery
33.45
33.45
2408.40
2408.40
48140 00
Surgery
46.98
46.98
3382.56
3382.56
48145 00
Surgery
48.96
48.96
3525.12
3525.12
48146 00
Surgery
56.47
56.47
4065.84
4065.84
48148 00
Surgery
37.57
37.57
2705.04
2705.04
48150 00
Surgery
93.20
93.20
6710.40
6710.40
48152 00
Surgery
86.27
86.27
6211.44
6211.44
48153 00
Surgery
92.81
92.81
6682.32
6682.32
48154 00
Surgery
86.65
86.65
6238.80
6238.80
48155 00
Surgery
54.53
54.53
3926.16
3926.16
48160 00
Surgery
-
-
7514.64
6312.24
48400 00
Surgery
3.16
3.16
227.52
227.52
48500 00
Surgery
34.56
34.56
2488.32
2488.32
48510 00
Surgery
32.98
32.98
2374.56
2374.56
48520 00
Surgery
33.03
33.03
2378.16
2378.16
48540 00
Surgery
39.20
39.20
2822.40
2822.40
48545 00
Surgery
40.43
40.43
2910.96
2910.96
48547 00
Surgery
53.66
53.66
3863.52
3863.52
48548 00
Surgery
50.10
50.10
3607.20
3607.20
48550 00
Surgery
0.00
0.00
BR
BR
48551 00
Surgery
-
-
1364.40
1146.24
48552 00
Surgery
6.99
6.99
503.28
503.28
48554 00
Surgery
79.11
79.11
5695.92
5695.92
48556 00
Surgery
38.86
38.86
2797.92
2797.92
48999 00
Surgery
0.00
0.00
BR
BR
49000 00
Surgery
23.10
23.10
1663.20
1663.20
49002 00
Surgery
31.24
31.24
2249.28
2249.28
49010 00
Surgery
27.61
27.61
1987.92
1987.92
49013 00
Surgery
13.56
13.56
976.32
976.32
49014 00
Surgery
11.29
11.29
812.88
812.88
49020 00
Surgery
47.79
47.79
3440.88
3440.88
49040 00
Surgery
30.11
30.11
2167.92
2167.92
49060 00
Surgery
32.81
32.81
2362.32
2362.32
49062 00
Surgery
23.18
23.18
1668.96
1668.96
49082 00
Surgery
6.35
2.18
457.20
156.96
49083 00
Surgery
8.71
3.12
627.12
224.64
49084 00
Surgery
3.17
3.17
228.24
228.24
49180 00
Surgery
5.19
2.42
373.68
174.24
49185 00
Surgery
37.11
3.49
2671.92
251.28
49203 00
Surgery
35.85
35.85
2581.20
2581.20
49204 00
Surgery
45.67
45.67
3288.24
3288.24
49205 00
Surgery
52.39
52.39
3772.08
3772.08
49215 00
Surgery
66.43
66.43
4782.96
4782.96
49250 00
Surgery
17.96
17.96
1293.12
1293.12
49255 00
Surgery
23.88
23.88
1719.36
1719.36
49320 00
Surgery
9.94
9.94
715.68
715.68
49321 00
Surgery
10.39
10.39
748.08
748.08
49322 00
Surgery
11.30
11.30
813.60
813.60
49323 00
Surgery
19.25
19.25
1386.00
1386.00
49324 00
Surgery
11.63
11.63
837.36
837.36
49325 00
Surgery
12.40
12.40
892.80
892.80
49326 00
Surgery
5.59
5.59
402.48
402.48
49327 00
Surgery
3.86
3.86
277.92
277.92
49329 00
Surgery
0.00
0.00
BR
BR
49400 00
Surgery
4.45
2.64
320.40
190.08
49402 00
Surgery
25.68
25.68
1848.96
1848.96
49405 00
Surgery
26.10
5.67
1879.20
408.24
49406 00
Surgery
26.11
5.67
1879.92
408.24
49407 00
Surgery
22.28
6.01
1604.16
432.72
49411 00
Surgery
14.33
5.44
1031.76
391.68
49412 00
Surgery
2.44
2.44
175.68
175.68
49418 00
Surgery
28.92
5.85
2082.24
421.20
49419 00
Surgery
12.48
12.48
898.56
898.56
49421 00
Surgery
6.73
6.73
484.56
484.56
49422 00
Surgery
6.58
6.58
473.76
473.76
49423 00
Surgery
17.24
2.06
1241.28
148.32
49424 00
Surgery
5.35
1.09
385.20
78.48
49425 00
Surgery
23.54
23.54
1694.88
1694.88
49426 00
Surgery
20.23
20.23
1456.56
1456.56
49427 00
Surgery
1.14
1.14
82.08
82.08
49428 00
Surgery
12.97
12.97
933.84
933.84
49429 00
Surgery
13.75
13.75
990.00
990.00
49435 00
Surgery
3.49
3.49
251.28
251.28
49436 00
Surgery
16.08
5.61
1157.76
403.92
49440 00
Surgery
24.48
5.93
1762.56
426.96
49441 00
Surgery
28.33
7.07
2039.76
509.04
49442 00
Surgery
23.38
6.06
1683.36
436.32
49446 00
Surgery
23.51
4.26
1692.72
306.72
49450 00
Surgery
17.52
1.91
1261.44
137.52
49451 00
Surgery
18.73
2.58
1348.56
185.76
49452 00
Surgery
22.74
3.97
1637.28
285.84
49460 00
Surgery
21.57
1.49
1553.04
107.28
49465 00
Surgery
4.07
0.89
293.04
64.08
49491 00
Surgery
24.10
24.10
1735.20
1735.20
49492 00
Surgery
28.93
28.93
2082.96
2082.96
49495 00
Surgery
12.38
12.38
891.36
891.36
49496 00
Surgery
18.63
18.63
1341.36
1341.36
49500 00
Surgery
12.64
12.64
910.08
910.08
49501 00
Surgery
18.35
18.35
1321.20
1321.20
49505 00
Surgery
15.82
15.82
1139.04
1139.04
49507 00
Surgery
17.77
17.77
1279.44
1279.44
49520 00
Surgery
19.14
19.14
1378.08
1378.08
49521 00
Surgery
21.62
21.62
1556.64
1556.64
49525 00
Surgery
17.34
17.34
1248.48
1248.48
49540 00
Surgery
20.26
20.26
1458.72
1458.72
49550 00
Surgery
17.47
17.47
1257.84
1257.84
49553 00
Surgery
19.10
19.10
1375.20
1375.20
49555 00
Surgery
18.28
18.28
1316.16
1316.16
49557 00
Surgery
21.80
21.80
1569.60
1569.60
49591 00
Surgery
10.25
10.25
738.00
738.00
49592 00
Surgery
14.24
14.24
1025.28
1025.28
49593 00
Surgery
17.15
17.15
1234.80
1234.80
49594 00
Surgery
22.32
22.32
1607.04
1607.04
49595 00
Surgery
23.07
23.07
1661.04
1661.04
49596 00
Surgery
30.60
30.60
2203.20
2203.20
49600 00
Surgery
22.18
22.18
1596.96
1596.96
49605 00
Surgery
146.66
146.66
10559.52
10559.52
49606 00
Surgery
34.10
34.10
2455.20
2455.20
49610 00
Surgery
20.96
20.96
1509.12
1509.12
49611 00
Surgery
18.49
18.49
1331.28
1331.28
49613 00
Surgery
12.63
12.63
909.36
909.36
49614 00
Surgery
17.10
17.10
1231.20
1231.20
49615 00
Surgery
19.12
19.12
1376.64
1376.64
49616 00
Surgery
25.69
25.69
1849.68
1849.68
49617 00
Surgery
26.47
26.47
1905.84
1905.84
49618 00
Surgery
37.08
37.08
2669.76
2669.76
49621 00
Surgery
22.19
22.19
1597.68
1597.68
49622 00
Surgery
27.36
27.36
1969.92
1969.92
49623 00
Surgery
5.88
5.88
423.36
423.36
49650 00
Surgery
13.12
13.12
944.64
944.64
49651 00
Surgery
17.12
17.12
1232.64
1232.64
49659 00
Surgery
0.00
0.00
BR
BR
49900 00
Surgery
24.85
24.85
1789.20
1789.20
49904 00
Surgery
41.70
41.70
3002.40
3002.40
49905 00
Surgery
10.47
10.47
753.84
753.84
49906 00
Surgery
-
-
11741.76
9863.28
49999 00
Surgery
0.00
0.00
BR
BR
50010 00
Surgery
21.11
21.11
1519.92
1519.92
50020 00
Surgery
30.29
30.29
2180.88
2180.88
50040 00
Surgery
27.59
27.59
1986.48
1986.48
50045 00
Surgery
27.80
27.80
2001.60
2001.60
50060 00
Surgery
33.88
33.88
2439.36
2439.36
50065 00
Surgery
35.89
35.89
2584.08
2584.08
50070 00
Surgery
35.21
35.21
2535.12
2535.12
50075 00
Surgery
43.25
43.25
3114.00
3114.00
50080 00
Surgery
20.79
20.79
1496.88
1496.88
50081 00
Surgery
33.44
33.44
2407.68
2407.68
50100 00
Surgery
32.54
32.54
2342.88
2342.88
50120 00
Surgery
28.29
28.29
2036.88
2036.88
50125 00
Surgery
29.27
29.27
2107.44
2107.44
50130 00
Surgery
30.73
30.73
2212.56
2212.56
50135 00
Surgery
33.33
33.33
2399.76
2399.76
50200 00
Surgery
15.20
3.72
1094.40
267.84
50205 00
Surgery
22.71
22.71
1635.12
1635.12
50220 00
Surgery
31.41
31.41
2261.52
2261.52
50225 00
Surgery
36.08
36.08
2597.76
2597.76
50230 00
Surgery
38.02
38.02
2737.44
2737.44
50234 00
Surgery
38.65
38.65
2782.80
2782.80
50236 00
Surgery
43.47
43.47
3129.84
3129.84
50240 00
Surgery
39.53
39.53
2846.16
2846.16
50250 00
Surgery
36.18
36.18
2604.96
2604.96
50280 00
Surgery
28.19
28.19
2029.68
2029.68
50290 00
Surgery
26.82
26.82
1931.04
1931.04
50300 00
Surgery
0.00
0.00
BR
BR
50320 00
Surgery
45.95
45.95
3308.40
3308.40
50323 00
Surgery
-
-
1042.56
897.12
50325 00
Surgery
-
-
809.28
696.24
50327 00
Surgery
6.42
6.42
462.24
462.24
50328 00
Surgery
5.63
5.63
405.36
405.36
50329 00
Surgery
5.33
5.33
383.76
383.76
50340 00
Surgery
29.01
29.01
2088.72
2088.72
50360 00
Surgery
73.11
73.11
5263.92
5263.92
50365 00
Surgery
87.30
87.30
6285.60
6285.60
50370 00
Surgery
36.66
36.66
2639.52
2639.52
50380 00
Surgery
61.53
61.53
4430.16
4430.16
50382 00
Surgery
29.46
7.32
2121.12
527.04
50384 00
Surgery
25.26
6.61
1818.72
475.92
50385 00
Surgery
29.92
6.31
2154.24
454.32
50386 00
Surgery
22.34
4.79
1608.48
344.88
50387 00
Surgery
16.25
2.42
1170.00
174.24
50389 00
Surgery
12.22
1.56
879.84
112.32
50390 00
Surgery
2.76
2.76
198.72
198.72
50391 00
Surgery
3.75
2.90
270.00
208.80
50396 00
Surgery
3.41
3.41
245.52
245.52
50400 00
Surgery
34.35
34.35
2473.20
2473.20
50405 00
Surgery
41.43
41.43
2982.96
2982.96
50430 00
Surgery
18.73
4.50
1348.56
324.00
50431 00
Surgery
9.53
1.95
686.16
140.40
50432 00
Surgery
26.73
5.96
1924.56
429.12
50433 00
Surgery
33.28
7.40
2396.16
532.80
50434 00
Surgery
26.72
5.56
1923.84
400.32
50435 00
Surgery
17.60
2.92
1267.20
210.24
50436 00
Surgery
4.38
4.38
315.36
315.36
50437 00
Surgery
7.25
7.25
522.00
522.00
50500 00
Surgery
38.69
38.69
2785.68
2785.68
50520 00
Surgery
34.87
34.87
2510.64
2510.64
50525 00
Surgery
44.16
44.16
3179.52
3179.52
50526 00
Surgery
47.28
47.28
3404.16
3404.16
50540 00
Surgery
34.10
34.10
2455.20
2455.20
50541 00
Surgery
27.29
27.29
1964.88
1964.88
50542 00
Surgery
34.52
34.52
2485.44
2485.44
50543 00
Surgery
44.27
44.27
3187.44
3187.44
50544 00
Surgery
36.81
36.81
2650.32
2650.32
50545 00
Surgery
39.61
39.61
2851.92
2851.92
50546 00
Surgery
35.81
35.81
2578.32
2578.32
50547 00
Surgery
48.70
48.70
3506.40
3506.40
50548 00
Surgery
39.82
39.82
2867.04
2867.04
50549 00
Surgery
0.00
0.00
BR
BR
50551 00
Surgery
10.80
8.66
777.60
623.52
50553 00
Surgery
11.59
9.26
834.48
666.72
50555 00
Surgery
12.35
10.05
889.20
723.60
50557 00
Surgery
12.56
10.18
904.32
732.96
50561 00
Surgery
14.27
11.63
1027.44
837.36
50562 00
Surgery
17.08
17.08
1229.76
1229.76
50570 00
Surgery
14.47
14.47
1041.84
1041.84
50572 00
Surgery
15.63
15.63
1125.36
1125.36
50574 00
Surgery
16.61
16.61
1195.92
1195.92
50575 00
Surgery
20.97
20.97
1509.84
1509.84
50576 00
Surgery
16.56
16.56
1192.32
1192.32
50580 00
Surgery
17.85
17.85
1285.20
1285.20
50590 00
Surgery
22.26
17.15
1602.72
1234.80
50592 00
Surgery
82.56
10.04
5944.32
722.88
50593 00
Surgery
110.40
13.39
7948.80
964.08
50600 00
Surgery
27.91
27.91
2009.52
2009.52
50605 00
Surgery
30.22
30.22
2175.84
2175.84
50606 00
Surgery
14.27
4.06
1027.44
292.32
50610 00
Surgery
28.11
28.11
2023.92
2023.92
50620 00
Surgery
26.90
26.90
1936.80
1936.80
50630 00
Surgery
26.59
26.59
1914.48
1914.48
50650 00
Surgery
30.95
30.95
2228.40
2228.40
50660 00
Surgery
33.99
33.99
2447.28
2447.28
50684 00
Surgery
3.82
1.52
275.04
109.44
50686 00
Surgery
4.31
2.64
310.32
190.08
50688 00
Surgery
2.31
2.31
166.32
166.32
50690 00
Surgery
3.55
2.07
255.60
149.04
50693 00
Surgery
29.27
5.93
2107.44
426.96
50694 00
Surgery
32.82
7.74
2363.04
557.28
50695 00
Surgery
39.42
9.93
2838.24
714.96
50700 00
Surgery
27.61
27.61
1987.92
1987.92
50705 00
Surgery
53.71
5.17
3867.12
372.24
50706 00
Surgery
24.65
5.25
1774.80
378.00
50715 00
Surgery
36.16
36.16
2603.52
2603.52
50722 00
Surgery
30.63
30.63
2205.36
2205.36
50725 00
Surgery
32.77
32.77
2359.44
2359.44
50727 00
Surgery
15.40
15.40
1108.80
1108.80
50728 00
Surgery
20.96
20.96
1509.12
1509.12
50740 00
Surgery
36.83
36.83
2651.76
2651.76
50750 00
Surgery
34.28
34.28
2468.16
2468.16
50760 00
Surgery
33.72
33.72
2427.84
2427.84
50770 00
Surgery
34.28
34.28
2468.16
2468.16
50780 00
Surgery
33.18
33.18
2388.96
2388.96
50782 00
Surgery
31.97
31.97
2301.84
2301.84
50783 00
Surgery
33.51
33.51
2412.72
2412.72
50785 00
Surgery
36.06
36.06
2596.32
2596.32
50800 00
Surgery
27.51
27.51
1980.72
1980.72
50810 00
Surgery
42.28
42.28
3044.16
3044.16
50815 00
Surgery
36.44
36.44
2623.68
2623.68
50820 00
Surgery
39.03
39.03
2810.16
2810.16
50825 00
Surgery
48.85
48.85
3517.20
3517.20
50830 00
Surgery
53.40
53.40
3844.80
3844.80
50840 00
Surgery
36.63
36.63
2637.36
2637.36
50845 00
Surgery
37.37
37.37
2690.64
2690.64
50860 00
Surgery
28.18
28.18
2028.96
2028.96
50900 00
Surgery
25.16
25.16
1811.52
1811.52
50920 00
Surgery
26.30
26.30
1893.60
1893.60
50930 00
Surgery
32.74
32.74
2357.28
2357.28
50940 00
Surgery
26.47
26.47
1905.84
1905.84
50945 00
Surgery
28.85
28.85
2077.20
2077.20
50947 00
Surgery
41.10
41.10
2959.20
2959.20
50948 00
Surgery
37.69
37.69
2713.68
2713.68
50949 00
Surgery
0.00
0.00
BR
BR
50951 00
Surgery
11.34
9.05
816.48
651.60
50953 00
Surgery
11.98
9.62
862.56
692.64
50955 00
Surgery
12.78
10.38
920.16
747.36
50957 00
Surgery
12.90
10.43
928.80
750.96
50961 00
Surgery
11.65
9.35
838.80
673.20
50970 00
Surgery
10.91
10.91
785.52
785.52
50972 00
Surgery
10.53
10.53
758.16
758.16
50974 00
Surgery
13.92
13.92
1002.24
1002.24
50976 00
Surgery
13.73
13.73
988.56
988.56
50980 00
Surgery
10.48
10.48
754.56
754.56
51020 00
Surgery
14.16
14.16
1019.52
1019.52
51030 00
Surgery
14.26
14.26
1026.72
1026.72
51040 00
Surgery
8.80
8.80
633.60
633.60
51045 00
Surgery
14.98
14.98
1078.56
1078.56
51050 00
Surgery
14.18
14.18
1020.96
1020.96
51060 00
Surgery
17.49
17.49
1259.28
1259.28
51065 00
Surgery
17.41
17.41
1253.52
1253.52
51080 00
Surgery
12.31
12.31
886.32
886.32
51100 00
Surgery
2.22
1.16
159.84
83.52
51101 00
Surgery
4.62
1.51
332.64
108.72
51102 00
Surgery
7.16
4.22
515.52
303.84
51500 00
Surgery
19.09
19.09
1374.48
1374.48
51520 00
Surgery
17.86
17.86
1285.92
1285.92
51525 00
Surgery
25.58
25.58
1841.76
1841.76
51530 00
Surgery
23.00
23.00
1656.00
1656.00
51535 00
Surgery
23.28
23.28
1676.16
1676.16
51550 00
Surgery
28.75
28.75
2070.00
2070.00
51555 00
Surgery
37.51
37.51
2700.72
2700.72
51565 00
Surgery
38.29
38.29
2756.88
2756.88
51570 00
Surgery
43.72
43.72
3147.84
3147.84
51575 00
Surgery
53.82
53.82
3875.04
3875.04
51580 00
Surgery
56.22
56.22
4047.84
4047.84
51585 00
Surgery
62.49
62.49
4499.28
4499.28
51590 00
Surgery
57.18
57.18
4116.96
4116.96
51595 00
Surgery
64.73
64.73
4660.56
4660.56
51596 00
Surgery
69.76
69.76
5022.72
5022.72
51597 00
Surgery
68.16
68.16
4907.52
4907.52
51600 00
Surgery
6.29
1.28
452.88
92.16
51605 00
Surgery
1.15
1.15
82.80
82.80
51610 00
Surgery
3.86
1.91
277.92
137.52
51700 00
Surgery
2.30
0.89
165.60
64.08
51701 00
Surgery
1.34
0.76
96.48
54.72
51702 00
Surgery
1.87
0.75
134.64
54.00
51703 00
Surgery
4.49
2.26
323.28
162.72
51705 00
Surgery
2.93
1.54
210.96
110.88
51710 00
Surgery
4.09
2.39
294.48
172.08
51715 00
Surgery
11.10
5.92
799.20
426.24
51720 00
Surgery
2.66
1.29
191.52
92.88
51725 00
Surgery
6.83
6.83
491.76
491.76
51725 26
Surgery
2.24
2.24
161.28
161.28
51725 TC
Surgery
4.59
4.59
330.48
330.48
51726 00
Surgery
9.01
9.01
648.72
648.72
51726 26
Surgery
2.48
2.48
178.56
178.56
51726 TC
Surgery
6.53
6.53
470.16
470.16
51727 00
Surgery
10.98
10.98
790.56
790.56
51727 26
Surgery
3.13
3.13
225.36
225.36
51727 TC
Surgery
7.85
7.85
565.20
565.20
51728 00
Surgery
10.91
10.91
785.52
785.52
51728 26
Surgery
3.05
3.05
219.60
219.60
51728 TC
Surgery
7.86
7.86
565.92
565.92
51729 00
Surgery
11.51
11.51
828.72
828.72
51729 26
Surgery
3.70
3.70
266.40
266.40
51729 TC
Surgery
7.81
7.81
562.32
562.32
51736 00
Surgery
0.41
0.41
29.52
29.52
51736 26
Surgery
0.24
0.24
17.28
17.28
51736 TC
Surgery
0.17
0.17
12.24
12.24
51741 00
Surgery
0.43
0.43
30.96
30.96
51741 26
Surgery
0.25
0.25
18.00
18.00
51741 TC
Surgery
0.18
0.18
12.96
12.96
51784 00
Surgery
1.93
1.93
138.96
138.96
51784 26
Surgery
1.09
1.09
78.48
78.48
51784 TC
Surgery
0.84
0.84
60.48
60.48
51785 00
Surgery
13.12
13.12
944.64
944.64
51785 26
Surgery
2.75
2.75
198.00
198.00
51785 TC
Surgery
10.37
10.37
746.64
746.64
51792 00
Surgery
8.22
8.22
591.84
591.84
51792 26
Surgery
1.64
1.64
118.08
118.08
51792 TC
Surgery
6.58
6.58
473.76
473.76
51797 00
Surgery
5.67
5.67
408.24
408.24
51797 26
Surgery
1.17
1.17
84.24
84.24
51797 TC
Surgery
4.50
4.50
324.00
324.00
51798 00
Surgery
0.34
0.34
24.48
24.48
51800 00
Surgery
30.90
30.90
2224.80
2224.80
51820 00
Surgery
32.32
32.32
2327.04
2327.04
51840 00
Surgery
20.87
20.87
1502.64
1502.64
51841 00
Surgery
24.09
24.09
1734.48
1734.48
51845 00
Surgery
17.45
17.45
1256.40
1256.40
51860 00
Surgery
22.34
22.34
1608.48
1608.48
51865 00
Surgery
26.75
26.75
1926.00
1926.00
51880 00
Surgery
14.00
14.00
1008.00
1008.00
51900 00
Surgery
24.61
24.61
1771.92
1771.92
51920 00
Surgery
22.83
22.83
1643.76
1643.76
51925 00
Surgery
32.42
32.42
2334.24
2334.24
51940 00
Surgery
48.66
48.66
3503.52
3503.52
51960 00
Surgery
41.15
41.15
2962.80
2962.80
51980 00
Surgery
21.34
21.34
1536.48
1536.48
51990 00
Surgery
22.22
22.22
1599.84
1599.84
51992 00
Surgery
25.06
25.06
1804.32
1804.32
51999 00
Surgery
0.00
0.00
BR
BR
52000 00
Surgery
7.19
2.38
517.68
171.36
52001 00
Surgery
13.15
8.47
946.80
609.84
52005 00
Surgery
9.10
3.95
655.20
284.40
52007 00
Surgery
13.47
4.92
969.84
354.24
52010 00
Surgery
11.45
4.89
824.40
352.08
52204 00
Surgery
11.31
4.19
814.32
301.68
52214 00
Surgery
22.31
5.15
1606.32
370.80
52224 00
Surgery
23.31
5.96
1678.32
429.12
52234 00
Surgery
7.25
7.25
522.00
522.00
52235 00
Surgery
8.51
8.51
612.72
612.72
52240 00
Surgery
11.55
11.55
831.60
831.60
52250 00
Surgery
7.05
7.05
507.60
507.60
52260 00
Surgery
6.22
6.22
447.84
447.84
52265 00
Surgery
11.17
4.81
804.24
346.32
52270 00
Surgery
12.58
5.36
905.76
385.92
52275 00
Surgery
16.14
7.32
1162.08
527.04
52276 00
Surgery
7.79
7.79
560.88
560.88
52277 00
Surgery
9.52
9.52
685.44
685.44
52281 00
Surgery
9.79
4.50
704.88
324.00
52282 00
Surgery
9.94
9.94
715.68
715.68
52283 00
Surgery
10.61
5.95
763.92
428.40
52284 00
Surgery
80.28
4.86
5780.16
349.92
52285 00
Surgery
10.51
5.80
756.72
417.60
52287 00
Surgery
11.62
4.99
836.64
359.28
52290 00
Surgery
7.18
7.18
516.96
516.96
52300 00
Surgery
8.25
8.25
594.00
594.00
52301 00
Surgery
8.55
8.55
615.60
615.60
52305 00
Surgery
8.19
8.19
589.68
589.68
52310 00
Surgery
9.58
4.48
689.76
322.56
52315 00
Surgery
14.08
8.09
1013.76
582.48
52317 00
Surgery
26.43
10.20
1902.96
734.40
52318 00
Surgery
13.94
13.94
1003.68
1003.68
52320 00
Surgery
7.25
7.25
522.00
522.00
52325 00
Surgery
9.42
9.42
678.24
678.24
52327 00
Surgery
7.62
7.62
548.64
548.64
52330 00
Surgery
18.04
7.76
1298.88
558.72
52332 00
Surgery
11.99
4.60
863.28
331.20
52334 00
Surgery
5.39
5.39
388.08
388.08
52341 00
Surgery
8.38
8.38
603.36
603.36
52342 00
Surgery
9.12
9.12
656.64
656.64
52343 00
Surgery
10.13
10.13
729.36
729.36
52344 00
Surgery
10.89
10.89
784.08
784.08
52345 00
Surgery
11.62
11.62
836.64
836.64
52346 00
Surgery
13.14
13.14
946.08
946.08
52351 00
Surgery
8.93
8.93
642.96
642.96
52352 00
Surgery
10.43
10.43
750.96
750.96
52353 00
Surgery
11.54
11.54
830.88
830.88
52354 00
Surgery
12.28
12.28
884.16
884.16
52355 00
Surgery
13.76
13.76
990.72
990.72
52356 00
Surgery
12.24
12.24
881.28
881.28
52400 00
Surgery
14.23
14.23
1024.56
1024.56
52402 00
Surgery
7.81
7.81
562.32
562.32
52441 00
Surgery
37.72
6.18
2715.84
444.96
52442 00
Surgery
25.64
1.49
1846.08
107.28
52450 00
Surgery
14.28
14.28
1028.16
1028.16
52500 00
Surgery
14.82
14.82
1067.04
1067.04
52601 00
Surgery
21.73
21.73
1564.56
1564.56
52630 00
Surgery
12.20
12.20
878.40
878.40
52640 00
Surgery
9.74
9.74
701.28
701.28
52647 00
Surgery
46.75
19.45
3366.00
1400.40
52648 00
Surgery
48.21
20.72
3471.12
1491.84
52649 00
Surgery
24.64
24.64
1774.08
1774.08
52700 00
Surgery
13.29
13.29
956.88
956.88
53000 00
Surgery
4.47
4.47
321.84
321.84
53010 00
Surgery
8.98
8.98
646.56
646.56
53020 00
Surgery
2.87
2.87
206.64
206.64
53025 00
Surgery
2.05
2.05
147.60
147.60
53040 00
Surgery
11.79
11.79
848.88
848.88
53060 00
Surgery
5.72
5.00
411.84
360.00
53080 00
Surgery
12.66
12.66
911.52
911.52
53085 00
Surgery
19.41
19.41
1397.52
1397.52
53200 00
Surgery
4.78
4.23
344.16
304.56
53210 00
Surgery
23.20
23.20
1670.40
1670.40
53215 00
Surgery
27.60
27.60
1987.20
1987.20
53220 00
Surgery
13.58
13.58
977.76
977.76
53230 00
Surgery
18.30
18.30
1317.60
1317.60
53235 00
Surgery
19.00
19.00
1368.00
1368.00
53240 00
Surgery
12.78
12.78
920.16
920.16
53250 00
Surgery
11.92
11.92
858.24
858.24
53260 00
Surgery
6.25
5.45
450.00
392.40
53265 00
Surgery
6.92
5.67
498.24
408.24
53270 00
Surgery
6.39
5.55
460.08
399.60
53275 00
Surgery
7.87
7.87
566.64
566.64
53400 00
Surgery
23.90
23.90
1720.80
1720.80
53405 00
Surgery
26.05
26.05
1875.60
1875.60
53410 00
Surgery
29.20
29.20
2102.40
2102.40
53415 00
Surgery
33.61
33.61
2419.92
2419.92
53420 00
Surgery
25.07
25.07
1805.04
1805.04
53425 00
Surgery
27.88
27.88
2007.36
2007.36
53430 00
Surgery
29.08
29.08
2093.76
2093.76
53431 00
Surgery
34.28
34.28
2468.16
2468.16
53440 00
Surgery
22.50
22.50
1620.00
1620.00
53442 00
Surgery
23.53
23.53
1694.16
1694.16
53444 00
Surgery
23.69
23.69
1705.68
1705.68
53445 00
Surgery
22.66
22.66
1631.52
1631.52
53446 00
Surgery
19.26
19.26
1386.72
1386.72
53447 00
Surgery
24.08
24.08
1733.76
1733.76
53448 00
Surgery
37.93
37.93
2730.96
2730.96
53449 00
Surgery
18.36
18.36
1321.92
1321.92
53450 00
Surgery
12.30
12.30
885.60
885.60
53451 00
Surgery
0.00
0.00
BR
BR
53452 00
Surgery
0.00
0.00
BR
BR
53453 00
Surgery
0.00
0.00
BR
BR
53454 00
Surgery
-
-
154.08
132.48
53460 00
Surgery
13.76
13.76
990.72
990.72
53500 00
Surgery
22.42
22.42
1614.24
1614.24
53502 00
Surgery
14.61
14.61
1051.92
1051.92
53505 00
Surgery
14.60
14.60
1051.20
1051.20
53510 00
Surgery
18.95
18.95
1364.40
1364.40
53515 00
Surgery
23.74
23.74
1709.28
1709.28
53520 00
Surgery
16.79
16.79
1208.88
1208.88
53600 00
Surgery
2.66
1.88
191.52
135.36
53601 00
Surgery
2.58
1.58
185.76
113.76
53605 00
Surgery
1.89
1.89
136.08
136.08
53620 00
Surgery
5.10
2.58
367.20
185.76
53621 00
Surgery
4.89
2.13
352.08
153.36
53660 00
Surgery
2.29
1.24
164.88
89.28
53661 00
Surgery
2.25
1.20
162.00
86.40
53665 00
Surgery
1.12
1.12
80.64
80.64
53850 00
Surgery
42.19
10.72
3037.68
771.84
53852 00
Surgery
41.19
11.48
2965.68
826.56
53854 00
Surgery
49.70
11.48
3578.40
826.56
53855 00
Surgery
19.40
2.42
1396.80
174.24
53860 00
Surgery
70.89
6.66
5104.08
479.52
53899 00
Surgery
0.00
0.00
BR
BR
54000 00
Surgery
4.94
3.35
355.68
241.20
54001 00
Surgery
6.00
4.23
432.00
304.56
54015 00
Surgery
9.12
9.12
656.64
656.64
54050 00
Surgery
4.37
3.23
314.64
232.56
54055 00
Surgery
4.17
2.90
300.24
208.80
54056 00
Surgery
4.38
3.38
315.36
243.36
54057 00
Surgery
4.31
2.96
310.32
213.12
54060 00
Surgery
5.93
3.97
426.96
285.84
54065 00
Surgery
6.72
5.17
483.84
372.24
54100 00
Surgery
6.10
3.63
439.20
261.36
54105 00
Surgery
8.34
6.39
600.48
460.08
54110 00
Surgery
18.70
18.70
1346.40
1346.40
54111 00
Surgery
23.85
23.85
1717.20
1717.20
54112 00
Surgery
27.95
27.95
2012.40
2012.40
54115 00
Surgery
13.81
12.85
994.32
925.20
54120 00
Surgery
18.96
18.96
1365.12
1365.12
54125 00
Surgery
24.58
24.58
1769.76
1769.76
54130 00
Surgery
35.52
35.52
2557.44
2557.44
54135 00
Surgery
44.84
44.84
3228.48
3228.48
54150 00
Surgery
4.46
2.85
321.12
205.20
54160 00
Surgery
6.66
4.36
479.52
313.92
54161 00
Surgery
5.92
5.92
426.24
426.24
54162 00
Surgery
7.74
6.02
557.28
433.44
54163 00
Surgery
6.61
6.61
475.92
475.92
54164 00
Surgery
5.87
5.87
422.64
422.64
54200 00
Surgery
3.53
2.64
254.16
190.08
54205 00
Surgery
15.99
15.99
1151.28
1151.28
54220 00
Surgery
6.71
4.02
483.12
289.44
54230 00
Surgery
3.21
2.38
231.12
171.36
54231 00
Surgery
4.32
3.45
311.04
248.40
54235 00
Surgery
2.72
2.21
195.84
159.12
54240 00
Surgery
3.22
3.22
231.84
231.84
54240 26
Surgery
1.90
1.90
136.80
136.80
54240 TC
Surgery
1.32
1.32
95.04
95.04
54250 00
Surgery
3.63
3.63
261.36
261.36
54250 26
Surgery
3.19
3.19
229.68
229.68
54250 TC
Surgery
0.44
0.44
31.68
31.68
54300 00
Surgery
19.32
19.32
1391.04
1391.04
54304 00
Surgery
22.34
22.34
1608.48
1608.48
54308 00
Surgery
21.42
21.42
1542.24
1542.24
54312 00
Surgery
24.45
24.45
1760.40
1760.40
54316 00
Surgery
29.63
29.63
2133.36
2133.36
54318 00
Surgery
21.31
21.31
1534.32
1534.32
54322 00
Surgery
23.32
23.32
1679.04
1679.04
54324 00
Surgery
28.86
28.86
2077.92
2077.92
54326 00
Surgery
28.11
28.11
2023.92
2023.92
54328 00
Surgery
27.92
27.92
2010.24
2010.24
54332 00
Surgery
30.09
30.09
2166.48
2166.48
54336 00
Surgery
35.37
35.37
2546.64
2546.64
54340 00
Surgery
17.09
17.09
1230.48
1230.48
54344 00
Surgery
28.16
28.16
2027.52
2027.52
54348 00
Surgery
30.10
30.10
2167.20
2167.20
54352 00
Surgery
42.01
42.01
3024.72
3024.72
54360 00
Surgery
21.56
21.56
1552.32
1552.32
54380 00
Surgery
23.88
23.88
1719.36
1719.36
54385 00
Surgery
27.79
27.79
2000.88
2000.88
54390 00
Surgery
36.93
36.93
2658.96
2658.96
54400 00
Surgery
15.96
15.96
1149.12
1149.12
54401 00
Surgery
20.01
20.01
1440.72
1440.72
54405 00
Surgery
24.12
24.12
1736.64
1736.64
54406 00
Surgery
21.88
21.88
1575.36
1575.36
54408 00
Surgery
23.66
23.66
1703.52
1703.52
54410 00
Surgery
25.81
25.81
1858.32
1858.32
54411 00
Surgery
30.70
30.70
2210.40
2210.40
54415 00
Surgery
16.00
16.00
1152.00
1152.00
54416 00
Surgery
21.52
21.52
1549.44
1549.44
54417 00
Surgery
26.84
26.84
1932.48
1932.48
54420 00
Surgery
21.02
21.02
1513.44
1513.44
54430 00
Surgery
19.14
19.14
1378.08
1378.08
54435 00
Surgery
12.47
12.47
897.84
897.84
54437 00
Surgery
20.36
20.36
1465.92
1465.92
54438 00
Surgery
39.75
39.75
2862.00
2862.00
54440 00
Surgery
-
-
1899.36
1784.88
54450 00
Surgery
2.07
1.69
149.04
121.68
54500 00
Surgery
2.22
2.22
159.84
159.84
54505 00
Surgery
6.28
6.28
452.16
452.16
54512 00
Surgery
16.13
16.13
1161.36
1161.36
54520 00
Surgery
9.89
9.89
712.08
712.08
54522 00
Surgery
17.60
17.60
1267.20
1267.20
54530 00
Surgery
15.30
15.30
1101.60
1101.60
54535 00
Surgery
22.26
22.26
1602.72
1602.72
54550 00
Surgery
14.77
14.77
1063.44
1063.44
54560 00
Surgery
20.57
20.57
1481.04
1481.04
54600 00
Surgery
13.62
13.62
980.64
980.64
54620 00
Surgery
8.93
8.93
642.96
642.96
54640 00
Surgery
12.92
12.92
930.24
930.24
54650 00
Surgery
21.34
21.34
1536.48
1536.48
54660 00
Surgery
10.81
10.81
778.32
778.32
54670 00
Surgery
12.32
12.32
887.04
887.04
54680 00
Surgery
23.52
23.52
1693.44
1693.44
54690 00
Surgery
19.60
19.60
1411.20
1411.20
54692 00
Surgery
22.54
22.54
1622.88
1622.88
54699 00
Surgery
0.00
0.00
BR
BR
54700 00
Surgery
6.41
6.41
461.52
461.52
54800 00
Surgery
3.73
3.73
268.56
268.56
54830 00
Surgery
11.23
11.23
808.56
808.56
54840 00
Surgery
9.70
9.70
698.40
698.40
54860 00
Surgery
12.61
12.61
907.92
907.92
54861 00
Surgery
17.07
17.07
1229.04
1229.04
54865 00
Surgery
10.86
10.86
781.92
781.92
54900 00
Surgery
23.91
23.91
1721.52
1721.52
54901 00
Surgery
31.53
31.53
2270.16
2270.16
55000 00
Surgery
3.62
2.53
260.64
182.16
55040 00
Surgery
10.21
10.21
735.12
735.12
55041 00
Surgery
15.39
15.39
1108.08
1108.08
55060 00
Surgery
11.44
11.44
823.68
823.68
55100 00
Surgery
6.98
5.07
502.56
365.04
55110 00
Surgery
11.69
11.69
841.68
841.68
55120 00
Surgery
10.72
10.72
771.84
771.84
55150 00
Surgery
14.83
14.83
1067.76
1067.76
55175 00
Surgery
11.00
11.00
792.00
792.00
55180 00
Surgery
20.64
20.64
1486.08
1486.08
55200 00
Surgery
11.53
8.36
830.16
601.92
55250 00
Surgery
10.09
6.93
726.48
498.96
55300 00
Surgery
5.51
5.51
396.72
396.72
55400 00
Surgery
15.01
15.01
1080.72
1080.72
55500 00
Surgery
11.81
11.81
850.32
850.32
55520 00
Surgery
13.88
13.88
999.36
999.36
55530 00
Surgery
10.61
10.61
763.92
763.92
55535 00
Surgery
12.95
12.95
932.40
932.40
55540 00
Surgery
16.79
16.79
1208.88
1208.88
55550 00
Surgery
12.93
12.93
930.96
930.96
55559 00
Surgery
0.00
0.00
BR
BR
55600 00
Surgery
12.70
12.70
914.40
914.40
55605 00
Surgery
15.76
15.76
1134.72
1134.72
55650 00
Surgery
21.49
21.49
1547.28
1547.28
55680 00
Surgery
10.46
10.46
753.12
753.12
55700 00
Surgery
7.23
3.86
520.56
277.92
55705 00
Surgery
7.92
7.92
570.24
570.24
55706 00
Surgery
11.26
11.26
810.72
810.72
55720 00
Surgery
13.58
13.58
977.76
977.76
55725 00
Surgery
17.89
17.89
1288.08
1288.08
55801 00
Surgery
32.62
32.62
2348.64
2348.64
55810 00
Surgery
38.82
38.82
2795.04
2795.04
55812 00
Surgery
47.72
47.72
3435.84
3435.84
55815 00
Surgery
52.22
52.22
3759.84
3759.84
55821 00
Surgery
25.02
25.02
1801.44
1801.44
55831 00
Surgery
25.65
25.65
1846.80
1846.80
55840 00
Surgery
34.83
34.83
2507.76
2507.76
55842 00
Surgery
34.81
34.81
2506.32
2506.32
55845 00
Surgery
40.47
40.47
2913.84
2913.84
55860 00
Surgery
26.07
26.07
1877.04
1877.04
55862 00
Surgery
32.59
32.59
2346.48
2346.48
55865 00
Surgery
39.66
39.66
2855.52
2855.52
55866 00
Surgery
35.53
35.53
2558.16
2558.16
55867 00
Surgery
31.21
31.21
2247.12
2247.12
55870 00
Surgery
5.36
4.22
385.92
303.84
55873 00
Surgery
170.19
22.84
12253.68
1644.48
55874 00
Surgery
85.22
4.87
6135.84
350.64
55875 00
Surgery
23.31
23.31
1678.32
1678.32
55876 00
Surgery
4.55
3.05
327.60
219.60
55880 00
Surgery
29.21
29.21
2103.12
2103.12
55899 00
Surgery
0.00
0.00
BR
BR
55920 00
Surgery
13.72
13.72
987.84
987.84
55970 00
Surgery
0.00
0.00
BR
BR
55980 00
Surgery
0.00
0.00
BR
BR
56405 00
Surgery
4.44
3.85
319.68
277.20
56420 00
Surgery
5.63
3.35
405.36
241.20
56440 00
Surgery
5.49
5.49
395.28
395.28
56441 00
Surgery
5.56
4.71
400.32
339.12
56442 00
Surgery
1.43
1.43
102.96
102.96
56501 00
Surgery
5.82
4.05
419.04
291.60
56515 00
Surgery
8.39
6.43
604.08
462.96
56605 00
Surgery
2.91
1.77
209.52
127.44
56606 00
Surgery
1.14
0.87
82.08
62.64
56620 00
Surgery
17.81
17.81
1282.32
1282.32
56625 00
Surgery
20.26
20.26
1458.72
1458.72
56630 00
Surgery
29.08
29.08
2093.76
2093.76
56631 00
Surgery
35.88
35.88
2583.36
2583.36
56632 00
Surgery
43.39
43.39
3124.08
3124.08
56633 00
Surgery
37.46
37.46
2697.12
2697.12
56634 00
Surgery
39.18
39.18
2820.96
2820.96
56637 00
Surgery
45.87
45.87
3302.64
3302.64
56640 00
Surgery
46.11
46.11
3319.92
3319.92
56700 00
Surgery
6.15
6.15
442.80
442.80
56740 00
Surgery
9.52
9.52
685.44
685.44
56800 00
Surgery
7.66
7.66
551.52
551.52
56805 00
Surgery
35.11
35.11
2527.92
2527.92
56810 00
Surgery
8.26
8.26
594.72
594.72
56820 00
Surgery
3.79
2.52
272.88
181.44
56821 00
Surgery
5.08
3.40
365.76
244.80
57000 00
Surgery
6.11
6.11
439.92
439.92
57010 00
Surgery
13.87
13.87
998.64
998.64
57020 00
Surgery
3.77
2.37
271.44
170.64
57022 00
Surgery
5.48
5.48
394.56
394.56
57023 00
Surgery
9.67
9.67
696.24
696.24
57061 00
Surgery
5.07
3.50
365.04
252.00
57065 00
Surgery
7.47
5.63
537.84
405.36
57100 00
Surgery
3.13
1.96
225.36
141.12
57105 00
Surgery
5.37
4.45
386.64
320.40
57106 00
Surgery
16.28
16.28
1172.16
1172.16
57107 00
Surgery
43.96
43.96
3165.12
3165.12
57109 00
Surgery
52.25
52.25
3762.00
3762.00
57110 00
Surgery
27.22
27.22
1959.84
1959.84
57111 00
Surgery
52.25
52.25
3762.00
3762.00
57120 00
Surgery
16.06
16.06
1156.32
1156.32
57130 00
Surgery
6.97
5.24
501.84
377.28
57135 00
Surgery
7.49
5.69
539.28
409.68
57150 00
Surgery
1.74
0.77
125.28
55.44
57155 00
Surgery
11.97
8.48
861.84
610.56
57156 00
Surgery
6.89
4.52
496.08
325.44
57160 00
Surgery
2.24
1.37
161.28
98.64
57170 00
Surgery
2.34
1.41
168.48
101.52
57180 00
Surgery
5.99
3.66
431.28
263.52
57200 00
Surgery
10.09
10.09
726.48
726.48
57210 00
Surgery
11.92
11.92
858.24
858.24
57220 00
Surgery
10.49
10.49
755.28
755.28
57230 00
Surgery
12.70
12.70
914.40
914.40
57240 00
Surgery
18.51
18.51
1332.72
1332.72
57250 00
Surgery
18.59
18.59
1338.48
1338.48
57260 00
Surgery
23.47
23.47
1689.84
1689.84
57265 00
Surgery
26.24
26.24
1889.28
1889.28
57267 00
Surgery
7.46
7.46
537.12
537.12
57268 00
Surgery
15.33
15.33
1103.76
1103.76
57270 00
Surgery
24.52
24.52
1765.44
1765.44
57280 00
Surgery
29.04
29.04
2090.88
2090.88
57282 00
Surgery
20.92
20.92
1506.24
1506.24
57283 00
Surgery
21.07
21.07
1517.04
1517.04
57284 00
Surgery
25.06
25.06
1804.32
1804.32
57285 00
Surgery
20.87
20.87
1502.64
1502.64
57287 00
Surgery
22.41
22.41
1613.52
1613.52
57288 00
Surgery
22.42
22.42
1614.24
1614.24
57289 00
Surgery
23.97
23.97
1725.84
1725.84
57291 00
Surgery
16.64
16.64
1198.08
1198.08
57292 00
Surgery
24.97
24.97
1797.84
1797.84
57295 00
Surgery
15.16
15.16
1091.52
1091.52
57296 00
Surgery
28.86
28.86
2077.92
2077.92
57300 00
Surgery
18.55
18.55
1335.60
1335.60
57305 00
Surgery
29.46
29.46
2121.12
2121.12
57307 00
Surgery
32.45
32.45
2336.40
2336.40
57308 00
Surgery
20.01
20.01
1440.72
1440.72
57310 00
Surgery
14.88
14.88
1071.36
1071.36
57311 00
Surgery
16.75
16.75
1206.00
1206.00
57320 00
Surgery
17.09
17.09
1230.48
1230.48
57330 00
Surgery
23.01
23.01
1656.72
1656.72
57335 00
Surgery
35.47
35.47
2553.84
2553.84
57400 00
Surgery
3.91
3.91
281.52
281.52
57410 00
Surgery
3.19
3.19
229.68
229.68
57415 00
Surgery
5.32
5.32
383.04
383.04
57420 00
Surgery
4.02
2.69
289.44
193.68
57421 00
Surgery
5.38
3.65
387.36
262.80
57423 00
Surgery
27.93
27.93
2010.96
2010.96
57425 00
Surgery
29.26
29.26
2106.72
2106.72
57426 00
Surgery
26.33
26.33
1895.76
1895.76
57452 00
Surgery
3.83
2.73
275.76
196.56
57454 00
Surgery
5.10
4.01
367.20
288.72
57455 00
Surgery
4.89
3.25
352.08
234.00
57456 00
Surgery
4.61
3.03
331.92
218.16
57460 00
Surgery
9.45
4.78
680.40
344.16
57461 00
Surgery
10.53
5.47
758.16
393.84
57465 00
Surgery
1.65
1.27
118.80
91.44
57500 00
Surgery
4.63
2.26
333.36
162.72
57505 00
Surgery
4.69
3.33
337.68
239.76
57510 00
Surgery
5.06
3.41
364.32
245.52
57511 00
Surgery
6.04
4.47
434.88
321.84
57513 00
Surgery
6.23
4.45
448.56
320.40
57520 00
Surgery
10.72
9.00
771.84
648.00
57522 00
Surgery
9.19
7.74
661.68
557.28
57530 00
Surgery
11.36
11.36
817.92
817.92
57531 00
Surgery
55.23
55.23
3976.56
3976.56
57540 00
Surgery
23.87
23.87
1718.64
1718.64
57545 00
Surgery
25.14
25.14
1810.08
1810.08
57550 00
Surgery
13.10
13.10
943.20
943.20
57555 00
Surgery
18.71
18.71
1347.12
1347.12
57556 00
Surgery
17.77
17.77
1279.44
1279.44
57558 00
Surgery
4.80
3.91
345.60
281.52
57700 00
Surgery
10.84
10.84
780.48
780.48
57720 00
Surgery
10.14
10.14
730.08
730.08
57800 00
Surgery
2.35
1.45
169.20
104.40
58100 00
Surgery
3.06
1.89
220.32
136.08
58110 00
Surgery
1.51
1.20
108.72
86.40
58120 00
Surgery
9.02
7.06
649.44
508.32
58140 00
Surgery
27.78
27.78
2000.16
2000.16
58145 00
Surgery
17.22
17.22
1239.84
1239.84
58146 00
Surgery
34.75
34.75
2502.00
2502.00
58150 00
Surgery
30.62
30.62
2204.64
2204.64
58152 00
Surgery
37.24
37.24
2681.28
2681.28
58180 00
Surgery
28.96
28.96
2085.12
2085.12
58200 00
Surgery
40.60
40.60
2923.20
2923.20
58210 00
Surgery
54.83
54.83
3947.76
3947.76
58240 00
Surgery
87.85
87.85
6325.20
6325.20
58260 00
Surgery
25.31
25.31
1822.32
1822.32
58262 00
Surgery
27.96
27.96
2013.12
2013.12
58263 00
Surgery
29.96
29.96
2157.12
2157.12
58267 00
Surgery
32.23
32.23
2320.56
2320.56
58270 00
Surgery
26.95
26.95
1940.40
1940.40
58275 00
Surgery
29.86
29.86
2149.92
2149.92
58280 00
Surgery
31.94
31.94
2299.68
2299.68
58285 00
Surgery
42.91
42.91
3089.52
3089.52
58290 00
Surgery
34.64
34.64
2494.08
2494.08
58291 00
Surgery
37.41
37.41
2693.52
2693.52
58292 00
Surgery
39.42
39.42
2838.24
2838.24
58294 00
Surgery
36.61
36.61
2635.92
2635.92
58300 00
Surgery
3.31
1.50
238.32
108.00
58301 00
Surgery
3.33
1.98
239.76
142.56
58321 00
Surgery
2.48
1.44
178.56
103.68
58322 00
Surgery
2.76
1.72
198.72
123.84
58323 00
Surgery
0.45
0.36
32.40
25.92
58340 00
Surgery
7.26
1.73
522.72
124.56
58345 00
Surgery
8.73
8.73
628.56
628.56
58346 00
Surgery
14.94
14.94
1075.68
1075.68
58350 00
Surgery
4.65
2.88
334.80
207.36
58353 00
Surgery
27.64
6.97
1990.08
501.84
58356 00
Surgery
49.90
10.63
3592.80
765.36
58400 00
Surgery
14.03
14.03
1010.16
1010.16
58410 00
Surgery
24.60
24.60
1771.20
1771.20
58520 00
Surgery
24.09
24.09
1734.48
1734.48
58540 00
Surgery
27.65
27.65
1990.80
1990.80
58541 00
Surgery
22.05
22.05
1587.60
1587.60
58542 00
Surgery
25.02
25.02
1801.44
1801.44
58543 00
Surgery
25.41
25.41
1829.52
1829.52
58544 00
Surgery
27.30
27.30
1965.60
1965.60
58545 00
Surgery
27.19
27.19
1957.68
1957.68
58546 00
Surgery
33.50
33.50
2412.00
2412.00
58548 00
Surgery
56.72
56.72
4083.84
4083.84
58550 00
Surgery
26.60
26.60
1915.20
1915.20
58552 00
Surgery
29.54
29.54
2126.88
2126.88
58553 00
Surgery
33.69
33.69
2425.68
2425.68
58554 00
Surgery
39.26
39.26
2826.72
2826.72
58555 00
Surgery
10.84
4.53
780.48
326.16
58558 00
Surgery
39.55
6.92
2847.60
498.24
58559 00
Surgery
8.49
8.49
611.28
611.28
58560 00
Surgery
9.35
9.35
673.20
673.20
58561 00
Surgery
10.70
10.70
770.40
770.40
58562 00
Surgery
12.96
6.63
933.12
477.36
58563 00
Surgery
62.67
7.35
4512.24
529.20
58565 00
Surgery
49.71
13.84
3579.12
996.48
58570 00
Surgery
24.36
24.36
1753.92
1753.92
58571 00
Surgery
27.43
27.43
1974.96
1974.96
58572 00
Surgery
30.56
30.56
2200.32
2200.32
58573 00
Surgery
36.72
36.72
2643.84
2643.84
58575 00
Surgery
58.21
58.21
4191.12
4191.12
58578 00
Surgery
0.00
0.00
BR
BR
58579 00
Surgery
0.00
0.00
BR
BR
58580 00
Surgery
93.09
11.96
6702.48
861.12
58600 00
Surgery
11.23
11.23
808.56
808.56
58605 00
Surgery
10.21
10.21
735.12
735.12
58611 00
Surgery
2.25
2.25
162.00
162.00
58615 00
Surgery
7.67
7.67
552.24
552.24
58660 00
Surgery
20.65
20.65
1486.80
1486.80
58661 00
Surgery
19.65
19.65
1414.80
1414.80
58662 00
Surgery
21.51
21.51
1548.72
1548.72
58670 00
Surgery
11.25
11.25
810.00
810.00
58671 00
Surgery
11.25
11.25
810.00
810.00
58672 00
Surgery
22.00
22.00
1584.00
1584.00
58673 00
Surgery
23.87
23.87
1718.64
1718.64
58674 00
Surgery
24.49
24.49
1763.28
1763.28
58679 00
Surgery
0.00
0.00
BR
BR
58700 00
Surgery
24.18
24.18
1740.96
1740.96
58720 00
Surgery
22.96
22.96
1653.12
1653.12
58740 00
Surgery
27.20
27.20
1958.40
1958.40
58750 00
Surgery
27.42
27.42
1974.24
1974.24
58752 00
Surgery
27.35
27.35
1969.20
1969.20
58760 00
Surgery
24.75
24.75
1782.00
1782.00
58770 00
Surgery
25.98
25.98
1870.56
1870.56
58800 00
Surgery
10.98
9.57
790.56
689.04
58805 00
Surgery
12.98
12.98
934.56
934.56
58820 00
Surgery
10.29
10.29
740.88
740.88
58822 00
Surgery
21.58
21.58
1553.76
1553.76
58825 00
Surgery
21.42
21.42
1542.24
1542.24
58900 00
Surgery
13.25
13.25
954.00
954.00
58920 00
Surgery
21.56
21.56
1552.32
1552.32
58925 00
Surgery
23.16
23.16
1667.52
1667.52
58940 00
Surgery
16.80
16.80
1209.60
1209.60
58943 00
Surgery
36.23
36.23
2608.56
2608.56
58950 00
Surgery
34.73
34.73
2500.56
2500.56
58951 00
Surgery
43.47
43.47
3129.84
3129.84
58952 00
Surgery
49.67
49.67
3576.24
3576.24
58953 00
Surgery
60.28
60.28
4340.16
4340.16
58954 00
Surgery
65.23
65.23
4696.56
4696.56
58956 00
Surgery
41.03
41.03
2954.16
2954.16
58957 00
Surgery
47.95
47.95
3452.40
3452.40
58958 00
Surgery
49.81
49.81
3586.32
3586.32
58960 00
Surgery
30.12
30.12
2168.64
2168.64
58970 00
Surgery
7.25
5.87
522.00
422.64
58974 00
Surgery
-
-
1020.96
918.72
58976 00
Surgery
7.78
6.33
560.16
455.76
58999 00
Surgery
0.00
0.00
BR
BR
59000 00
Surgery
3.57
2.43
257.04
174.96
59001 00
Surgery
5.35
5.35
385.20
385.20
59012 00
Surgery
6.05
6.05
435.60
435.60
59015 00
Surgery
4.78
3.95
344.16
284.40
59020 00
Surgery
2.15
2.15
154.80
154.80
59020 26
Surgery
1.10
1.10
79.20
79.20
59020 TC
Surgery
1.05
1.05
75.60
75.60
59025 00
Surgery
1.48
1.48
106.56
106.56
59025 26
Surgery
0.87
0.87
62.64
62.64
59025 TC
Surgery
0.61
0.61
43.92
43.92
59030 00
Surgery
3.36
3.36
241.92
241.92
59050 00
Surgery
1.49
1.49
107.28
107.28
59051 00
Surgery
1.26
1.26
90.72
90.72
59070 00
Surgery
12.03
9.26
866.16
666.72
59072 00
Surgery
15.61
15.61
1123.92
1123.92
59074 00
Surgery
11.57
9.26
833.04
666.72
59076 00
Surgery
15.61
15.61
1123.92
1123.92
59100 00
Surgery
25.95
25.95
1868.40
1868.40
59120 00
Surgery
24.76
24.76
1782.72
1782.72
59121 00
Surgery
24.77
24.77
1783.44
1783.44
59130 00
Surgery
28.73
28.73
2068.56
2068.56
59136 00
Surgery
27.26
27.26
1962.72
1962.72
59140 00
Surgery
12.69
12.69
913.68
913.68
59150 00
Surgery
24.02
24.02
1729.44
1729.44
59151 00
Surgery
23.50
23.50
1692.00
1692.00
59160 00
Surgery
8.28
5.72
596.16
411.84
59200 00
Surgery
3.16
1.33
227.52
95.76
59300 00
Surgery
6.96
4.45
501.12
320.40
59320 00
Surgery
4.56
4.56
328.32
328.32
59325 00
Surgery
7.23
7.23
520.56
520.56
59350 00
Surgery
8.36
8.36
601.92
601.92
59400 00
Surgery
73.00
73.00
5256.00
5256.00
59409 00
Surgery
24.01
24.01
1728.72
1728.72
59410 00
Surgery
32.51
32.51
2340.72
2340.72
59412 00
Surgery
3.09
3.09
222.48
222.48
59414 00
Surgery
2.72
2.72
195.84
195.84
59425 00
Surgery
17.00
13.02
1224.00
937.44
59426 00
Surgery
31.10
23.91
2239.20
1721.52
59430 00
Surgery
7.99
5.39
575.28
388.08
59510 00
Surgery
81.17
81.17
5844.24
5844.24
59514 00
Surgery
27.23
27.23
1960.56
1960.56
59515 00
Surgery
40.37
40.37
2906.64
2906.64
59525 00
Surgery
14.44
14.44
1039.68
1039.68
59610 00
Surgery
76.53
76.53
5510.16
5510.16
59612 00
Surgery
27.21
27.21
1959.12
1959.12
59614 00
Surgery
35.15
35.15
2530.80
2530.80
59618 00
Surgery
82.04
82.04
5906.88
5906.88
59620 00
Surgery
28.19
28.19
2029.68
2029.68
59622 00
Surgery
41.85
41.85
3013.20
3013.20
59812 00
Surgery
11.02
9.35
793.44
673.20
59820 00
Surgery
13.37
11.77
962.64
847.44
59821 00
Surgery
13.17
11.50
948.24
828.00
59830 00
Surgery
14.11
14.11
1015.92
1015.92
59840 00
Surgery
7.61
6.76
547.92
486.72
59841 00
Surgery
12.96
11.31
933.12
814.32
59850 00
Surgery
11.90
11.90
856.80
856.80
59851 00
Surgery
13.03
13.03
938.16
938.16
59852 00
Surgery
17.90
17.90
1288.80
1288.80
59855 00
Surgery
12.92
12.92
930.24
930.24
59856 00
Surgery
15.10
15.10
1087.20
1087.20
59857 00
Surgery
17.57
17.57
1265.04
1265.04
59866 00
Surgery
7.16
7.16
515.52
515.52
59870 00
Surgery
16.32
16.32
1175.04
1175.04
59871 00
Surgery
4.02
4.02
289.44
289.44
59897 00
Surgery
0.00
0.00
BR
BR
59898 00
Surgery
0.00
0.00
BR
BR
59899 00
Surgery
0.00
0.00
BR
BR
60000 00
Surgery
5.65
4.80
406.80
345.60
60100 00
Surgery
3.29
2.26
236.88
162.72
60200 00
Surgery
20.21
20.21
1455.12
1455.12
60210 00
Surgery
21.33
21.33
1535.76
1535.76
60212 00
Surgery
30.87
30.87
2222.64
2222.64
60220 00
Surgery
21.31
21.31
1534.32
1534.32
60225 00
Surgery
28.26
28.26
2034.72
2034.72
60240 00
Surgery
27.59
27.59
1986.48
1986.48
60252 00
Surgery
39.64
39.64
2854.08
2854.08
60254 00
Surgery
50.01
50.01
3600.72
3600.72
60260 00
Surgery
32.69
32.69
2353.68
2353.68
60270 00
Surgery
40.88
40.88
2943.36
2943.36
60271 00
Surgery
31.69
31.69
2281.68
2281.68
60280 00
Surgery
13.78
13.78
992.16
992.16
60281 00
Surgery
18.03
18.03
1298.16
1298.16
60300 00
Surgery
3.21
1.43
231.12
102.96
60500 00
Surgery
29.20
29.20
2102.40
2102.40
60502 00
Surgery
39.20
39.20
2822.40
2822.40
60505 00
Surgery
42.10
42.10
3031.20
3031.20
60512 00
Surgery
7.19
7.19
517.68
517.68
60520 00
Surgery
31.52
31.52
2269.44
2269.44
60521 00
Surgery
33.43
33.43
2406.96
2406.96
60522 00
Surgery
40.46
40.46
2913.12
2913.12
60540 00
Surgery
32.37
32.37
2330.64
2330.64
60545 00
Surgery
37.51
37.51
2700.72
2700.72
60600 00
Surgery
40.65
40.65
2926.80
2926.80
60605 00
Surgery
48.32
48.32
3479.04
3479.04
60650 00
Surgery
35.68
35.68
2568.96
2568.96
60659 00
Surgery
0.00
0.00
BR
BR
60699 00
Surgery
0.00
0.00
BR
BR
61000 00
Surgery
3.45
3.45
248.40
248.40
61001 00
Surgery
3.27
3.27
235.44
235.44
61020 00
Surgery
3.24
3.24
233.28
233.28
61026 00
Surgery
3.31
3.31
238.32
238.32
61050 00
Surgery
2.37
2.37
170.64
170.64
61055 00
Surgery
3.49
3.49
251.28
251.28
61070 00
Surgery
1.68
1.68
120.96
120.96
61105 00
Surgery
14.29
14.29
1028.88
1028.88
61107 00
Surgery
9.41
9.41
677.52
677.52
61108 00
Surgery
27.74
27.74
1997.28
1997.28
61120 00
Surgery
23.03
23.03
1658.16
1658.16
61140 00
Surgery
38.92
38.92
2802.24
2802.24
61150 00
Surgery
41.23
41.23
2968.56
2968.56
61151 00
Surgery
30.41
30.41
2189.52
2189.52
61154 00
Surgery
39.11
39.11
2815.92
2815.92
61156 00
Surgery
37.85
37.85
2725.20
2725.20
61210 00
Surgery
11.03
11.03
794.16
794.16
61215 00
Surgery
15.91
15.91
1145.52
1145.52
61250 00
Surgery
26.60
26.60
1915.20
1915.20
61253 00
Surgery
30.41
30.41
2189.52
2189.52
61304 00
Surgery
49.99
49.99
3599.28
3599.28
61305 00
Surgery
61.09
61.09
4398.48
4398.48
61312 00
Surgery
62.99
62.99
4535.28
4535.28
61313 00
Surgery
60.53
60.53
4358.16
4358.16
61314 00
Surgery
55.63
55.63
4005.36
4005.36
61315 00
Surgery
63.03
63.03
4538.16
4538.16
61316 00
Surgery
2.63
2.63
189.36
189.36
61320 00
Surgery
57.64
57.64
4150.08
4150.08
61321 00
Surgery
64.68
64.68
4656.96
4656.96
61322 00
Surgery
72.54
72.54
5222.88
5222.88
61323 00
Surgery
72.70
72.70
5234.40
5234.40
61330 00
Surgery
54.72
54.72
3939.84
3939.84
61333 00
Surgery
61.37
61.37
4418.64
4418.64
61340 00
Surgery
43.97
43.97
3165.84
3165.84
61343 00
Surgery
66.69
66.69
4801.68
4801.68
61345 00
Surgery
62.22
62.22
4479.84
4479.84
61450 00
Surgery
58.47
58.47
4209.84
4209.84
61458 00
Surgery
61.24
61.24
4409.28
4409.28
61460 00
Surgery
64.14
64.14
4618.08
4618.08
61500 00
Surgery
39.44
39.44
2839.68
2839.68
61501 00
Surgery
34.32
34.32
2471.04
2471.04
61510 00
Surgery
67.11
67.11
4831.92
4831.92
61512 00
Surgery
77.60
77.60
5587.20
5587.20
61514 00
Surgery
58.32
58.32
4199.04
4199.04
61516 00
Surgery
57.14
57.14
4114.08
4114.08
61517 00
Surgery
2.62
2.62
188.64
188.64
61518 00
Surgery
84.27
84.27
6067.44
6067.44
61519 00
Surgery
89.31
89.31
6430.32
6430.32
61520 00
Surgery
112.51
112.51
8100.72
8100.72
61521 00
Surgery
96.47
96.47
6945.84
6945.84
61522 00
Surgery
66.60
66.60
4795.20
4795.20
61524 00
Surgery
63.48
63.48
4570.56
4570.56
61526 00
Surgery
100.64
100.64
7246.08
7246.08
61530 00
Surgery
93.20
93.20
6710.40
6710.40
61531 00
Surgery
37.55
37.55
2703.60
2703.60
61533 00
Surgery
46.62
46.62
3356.64
3356.64
61534 00
Surgery
50.42
50.42
3630.24
3630.24
61535 00
Surgery
30.86
30.86
2221.92
2221.92
61536 00
Surgery
78.32
78.32
5639.04
5639.04
61537 00
Surgery
74.61
74.61
5371.92
5371.92
61538 00
Surgery
80.76
80.76
5814.72
5814.72
61539 00
Surgery
71.78
71.78
5168.16
5168.16
61540 00
Surgery
66.25
66.25
4770.00
4770.00
61541 00
Surgery
65.46
65.46
4713.12
4713.12
61543 00
Surgery
66.17
66.17
4764.24
4764.24
61544 00
Surgery
57.83
57.83
4163.76
4163.76
61545 00
Surgery
96.81
96.81
6970.32
6970.32
61546 00
Surgery
70.22
70.22
5055.84
5055.84
61548 00
Surgery
47.63
47.63
3429.36
3429.36
61550 00
Surgery
36.72
36.72
2643.84
2643.84
61552 00
Surgery
45.45
45.45
3272.40
3272.40
61556 00
Surgery
52.13
52.13
3753.36
3753.36
61557 00
Surgery
51.54
51.54
3710.88
3710.88
61558 00
Surgery
57.44
57.44
4135.68
4135.68
61559 00
Surgery
73.08
73.08
5261.76
5261.76
61563 00
Surgery
60.39
60.39
4348.08
4348.08
61564 00
Surgery
73.22
73.22
5271.84
5271.84
61566 00
Surgery
68.17
68.17
4908.24
4908.24
61567 00
Surgery
77.64
77.64
5590.08
5590.08
61570 00
Surgery
57.08
57.08
4109.76
4109.76
61571 00
Surgery
60.69
60.69
4369.68
4369.68
61575 00
Surgery
76.12
76.12
5480.64
5480.64
61576 00
Surgery
126.52
126.52
9109.44
9109.44
61580 00
Surgery
74.81
74.81
5386.32
5386.32
61581 00
Surgery
81.47
81.47
5865.84
5865.84
61582 00
Surgery
90.93
90.93
6546.96
6546.96
61583 00
Surgery
88.47
88.47
6369.84
6369.84
61584 00
Surgery
87.23
87.23
6280.56
6280.56
61585 00
Surgery
99.41
99.41
7157.52
7157.52
61586 00
Surgery
76.79
76.79
5528.88
5528.88
61590 00
Surgery
90.73
90.73
6532.56
6532.56
61591 00
Surgery
92.37
92.37
6650.64
6650.64
61592 00
Surgery
96.07
96.07
6917.04
6917.04
61595 00
Surgery
72.16
72.16
5195.52
5195.52
61596 00
Surgery
73.10
73.10
5263.20
5263.20
61597 00
Surgery
89.90
89.90
6472.80
6472.80
61598 00
Surgery
86.57
86.57
6233.04
6233.04
61600 00
Surgery
63.91
63.91
4601.52
4601.52
61601 00
Surgery
73.79
73.79
5312.88
5312.88
61605 00
Surgery
65.06
65.06
4684.32
4684.32
61606 00
Surgery
87.83
87.83
6323.76
6323.76
61607 00
Surgery
92.14
92.14
6634.08
6634.08
61608 00
Surgery
99.41
99.41
7157.52
7157.52
61611 00
Surgery
14.04
14.04
1010.88
1010.88
61613 00
Surgery
99.60
99.60
7171.20
7171.20
61615 00
Surgery
85.42
85.42
6150.24
6150.24
61616 00
Surgery
101.15
101.15
7282.80
7282.80
61618 00
Surgery
39.07
39.07
2813.04
2813.04
61619 00
Surgery
43.34
43.34
3120.48
3120.48
61623 00
Surgery
17.24
17.24
1241.28
1241.28
61624 00
Surgery
34.77
34.77
2503.44
2503.44
61626 00
Surgery
26.95
26.95
1940.40
1940.40
61630 00
Surgery
40.93
40.93
2946.96
2946.96
61635 00
Surgery
44.45
44.45
3200.40
3200.40
61640 00
Surgery
14.01
14.01
1008.72
1008.72
61641 00
Surgery
4.92
4.92
354.24
354.24
61642 00
Surgery
9.84
9.84
708.48
708.48
61645 00
Surgery
25.17
25.17
1812.24
1812.24
61650 00
Surgery
17.42
17.42
1254.24
1254.24
61651 00
Surgery
7.44
7.44
535.68
535.68
61680 00
Surgery
69.09
69.09
4974.48
4974.48
61682 00
Surgery
126.19
126.19
9085.68
9085.68
61684 00
Surgery
86.31
86.31
6214.32
6214.32
61686 00
Surgery
135.88
135.88
9783.36
9783.36
61690 00
Surgery
66.43
66.43
4782.96
4782.96
61692 00
Surgery
110.50
110.50
7956.00
7956.00
61697 00
Surgery
127.86
127.86
9205.92
9205.92
61698 00
Surgery
139.91
139.91
10073.52
10073.52
61700 00
Surgery
103.44
103.44
7447.68
7447.68
61702 00
Surgery
121.71
121.71
8763.12
8763.12
61703 00
Surgery
41.57
41.57
2993.04
2993.04
61705 00
Surgery
79.04
79.04
5690.88
5690.88
61708 00
Surgery
77.36
77.36
5569.92
5569.92
61710 00
Surgery
65.27
65.27
4699.44
4699.44
61711 00
Surgery
79.20
79.20
5702.40
5702.40
61720 00
Surgery
38.89
38.89
2800.08
2800.08
61735 00
Surgery
48.73
48.73
3508.56
3508.56
61736 00
Surgery
36.47
36.47
2625.84
2625.84
61737 00
Surgery
43.94
43.94
3163.68
3163.68
61750 00
Surgery
42.96
42.96
3093.12
3093.12
61751 00
Surgery
42.44
42.44
3055.68
3055.68
61760 00
Surgery
48.10
48.10
3463.20
3463.20
61770 00
Surgery
49.46
49.46
3561.12
3561.12
61781 00
Surgery
7.08
7.08
509.76
509.76
61782 00
Surgery
5.13
5.13
369.36
369.36
61783 00
Surgery
6.93
6.93
498.96
498.96
61790 00
Surgery
27.01
27.01
1944.72
1944.72
61791 00
Surgery
34.49
34.49
2483.28
2483.28
61796 00
Surgery
31.15
31.15
2242.80
2242.80
61797 00
Surgery
6.60
6.60
475.20
475.20
61798 00
Surgery
42.10
42.10
3031.20
3031.20
61799 00
Surgery
9.12
9.12
656.64
656.64
61800 00
Surgery
4.54
4.54
326.88
326.88
61850 00
Surgery
30.21
30.21
2175.12
2175.12
61860 00
Surgery
47.68
47.68
3432.96
3432.96
61863 00
Surgery
46.01
46.01
3312.72
3312.72
61864 00
Surgery
8.49
8.49
611.28
611.28
61867 00
Surgery
69.39
69.39
4996.08
4996.08
61868 00
Surgery
15.00
15.00
1080.00
1080.00
61880 00
Surgery
18.04
18.04
1298.88
1298.88
61885 00
Surgery
16.20
16.20
1166.40
1166.40
61886 00
Surgery
27.03
27.03
1946.16
1946.16
61888 00
Surgery
12.17
12.17
876.24
876.24
61889 00
Surgery
37.92
37.92
2730.24
2730.24
61891 00
Surgery
17.99
17.99
1295.28
1295.28
61892 00
Surgery
24.82
24.82
1787.04
1787.04
62000 00
Surgery
31.69
31.69
2281.68
2281.68
62005 00
Surgery
38.92
38.92
2802.24
2802.24
62010 00
Surgery
46.97
46.97
3381.84
3381.84
62100 00
Surgery
47.81
47.81
3442.32
3442.32
62115 00
Surgery
51.57
51.57
3713.04
3713.04
62117 00
Surgery
59.82
59.82
4307.04
4307.04
62120 00
Surgery
63.21
63.21
4551.12
4551.12
62121 00
Surgery
47.10
47.10
3391.20
3391.20
62140 00
Surgery
31.15
31.15
2242.80
2242.80
62141 00
Surgery
34.88
34.88
2511.36
2511.36
62142 00
Surgery
27.32
27.32
1967.04
1967.04
62143 00
Surgery
31.92
31.92
2298.24
2298.24
62145 00
Surgery
43.36
43.36
3121.92
3121.92
62146 00
Surgery
38.24
38.24
2753.28
2753.28
62147 00
Surgery
43.14
43.14
3106.08
3106.08
62148 00
Surgery
3.78
3.78
272.16
272.16
62160 00
Surgery
5.65
5.65
406.80
406.80
62161 00
Surgery
46.59
46.59
3354.48
3354.48
62162 00
Surgery
57.62
57.62
4148.64
4148.64
62164 00
Surgery
63.88
63.88
4599.36
4599.36
62165 00
Surgery
45.95
45.95
3308.40
3308.40
62180 00
Surgery
48.83
48.83
3515.76
3515.76
62190 00
Surgery
28.54
28.54
2054.88
2054.88
62192 00
Surgery
30.45
30.45
2192.40
2192.40
62194 00
Surgery
15.21
15.21
1095.12
1095.12
62200 00
Surgery
42.05
42.05
3027.60
3027.60
62201 00
Surgery
37.20
37.20
2678.40
2678.40
62220 00
Surgery
29.74
29.74
2141.28
2141.28
62223 00
Surgery
31.56
31.56
2272.32
2272.32
62225 00
Surgery
16.50
16.50
1188.00
1188.00
62230 00
Surgery
25.72
25.72
1851.84
1851.84
62252 00
Surgery
2.59
2.59
186.48
186.48
62252 26
Surgery
1.37
1.37
98.64
98.64
62252 TC
Surgery
1.22
1.22
87.84
87.84
62256 00
Surgery
18.82
18.82
1355.04
1355.04
62258 00
Surgery
34.03
34.03
2450.16
2450.16
62263 00
Surgery
19.42
9.72
1398.24
699.84
62264 00
Surgery
13.17
7.29
948.24
524.88
62267 00
Surgery
7.89
4.55
568.08
327.60
62268 00
Surgery
9.96
9.96
717.12
717.12
62269 00
Surgery
7.65
7.65
550.80
550.80
62270 00
Surgery
4.39
1.90
316.08
136.80
62272 00
Surgery
5.56
2.75
400.32
198.00
62273 00
Surgery
5.04
3.37
362.88
242.64
62280 00
Surgery
9.86
4.78
709.92
344.16
62281 00
Surgery
7.21
4.64
519.12
334.08
62282 00
Surgery
9.33
4.24
671.76
305.28
62284 00
Surgery
5.60
2.46
403.20
177.12
62287 00
Surgery
18.09
18.09
1302.48
1302.48
62290 00
Surgery
10.28
4.63
740.16
333.36
62291 00
Surgery
9.25
4.22
666.00
303.84
62292 00
Surgery
17.46
17.46
1257.12
1257.12
62294 00
Surgery
29.21
29.21
2103.12
2103.12
62302 00
Surgery
7.59
3.51
546.48
252.72
62303 00
Surgery
7.72
3.51
555.84
252.72
62304 00
Surgery
7.55
3.47
543.60
249.84
62305 00
Surgery
8.22
3.60
591.84
259.20
62320 00
Surgery
4.92
2.98
354.24
214.56
62321 00
Surgery
7.89
3.20
568.08
230.40
62322 00
Surgery
4.06
2.36
292.32
169.92
62323 00
Surgery
7.76
2.96
558.72
213.12
62324 00
Surgery
4.11
2.64
295.92
190.08
62325 00
Surgery
7.50
3.28
540.00
236.16
62326 00
Surgery
4.12
2.53
296.64
182.16
62327 00
Surgery
8.19
3.20
589.68
230.40
62328 00
Surgery
6.64
2.52
478.08
181.44
62329 00
Surgery
7.83
3.09
563.76
222.48
62350 00
Surgery
12.04
12.04
866.88
866.88
62351 00
Surgery
27.87
27.87
2006.64
2006.64
62355 00
Surgery
8.38
8.38
603.36
603.36
62360 00
Surgery
9.41
9.41
677.52
677.52
62361 00
Surgery
13.36
13.36
961.92
961.92
62362 00
Surgery
11.68
11.68
840.96
840.96
62365 00
Surgery
9.06
9.06
652.32
652.32
62367 00
Surgery
0.96
0.74
69.12
53.28
62368 00
Surgery
1.33
1.02
95.76
73.44
62369 00
Surgery
2.77
1.04
199.44
74.88
62370 00
Surgery
2.77
1.36
199.44
97.92
62380 00
Surgery
-
-
5215.68
4693.68
63001 00
Surgery
37.44
37.44
2695.68
2695.68
63003 00
Surgery
37.58
37.58
2705.76
2705.76
63005 00
Surgery
36.60
36.60
2635.20
2635.20
63011 00
Surgery
33.01
33.01
2376.72
2376.72
63012 00
Surgery
36.31
36.31
2614.32
2614.32
63015 00
Surgery
45.13
45.13
3249.36
3249.36
63016 00
Surgery
46.40
46.40
3340.80
3340.80
63017 00
Surgery
38.59
38.59
2778.48
2778.48
63020 00
Surgery
33.40
33.40
2404.80
2404.80
63030 00
Surgery
27.85
27.85
2005.20
2005.20
63035 00
Surgery
6.98
6.98
502.56
502.56
63040 00
Surgery
41.74
41.74
3005.28
3005.28
63042 00
Surgery
39.29
39.29
2828.88
2828.88
63043 00
Surgery
-
-
1950.48
1755.36
63044 00
Surgery
-
-
1417.68
1275.84
63045 00
Surgery
39.21
39.21
2823.12
2823.12
63046 00
Surgery
37.40
37.40
2692.80
2692.80
63047 00
Surgery
33.61
33.61
2419.92
2419.92
63048 00
Surgery
6.30
6.30
453.60
453.60
63050 00
Surgery
44.38
44.38
3195.36
3195.36
63051 00
Surgery
51.16
51.16
3683.52
3683.52
63052 00
Surgery
7.72
7.72
555.84
555.84
63053 00
Surgery
6.86
6.86
493.92
493.92
63055 00
Surgery
49.38
49.38
3555.36
3555.36
63056 00
Surgery
45.18
45.18
3252.96
3252.96
63057 00
Surgery
9.62
9.62
692.64
692.64
63064 00
Surgery
53.91
53.91
3881.52
3881.52
63066 00
Surgery
6.17
6.17
444.24
444.24
63075 00
Surgery
41.04
41.04
2954.88
2954.88
63076 00
Surgery
7.22
7.22
519.84
519.84
63077 00
Surgery
43.91
43.91
3161.52
3161.52
63078 00
Surgery
6.21
6.21
447.12
447.12
63081 00
Surgery
53.41
53.41
3845.52
3845.52
63082 00
Surgery
7.96
7.96
573.12
573.12
63085 00
Surgery
58.81
58.81
4234.32
4234.32
63086 00
Surgery
5.73
5.73
412.56
412.56
63087 00
Surgery
73.11
73.11
5263.92
5263.92
63088 00
Surgery
7.75
7.75
558.00
558.00
63090 00
Surgery
58.66
58.66
4223.52
4223.52
63091 00
Surgery
5.23
5.23
376.56
376.56
63101 00
Surgery
70.51
70.51
5076.72
5076.72
63102 00
Surgery
69.17
69.17
4980.24
4980.24
63103 00
Surgery
8.78
8.78
632.16
632.16
63170 00
Surgery
48.70
48.70
3506.40
3506.40
63172 00
Surgery
43.19
43.19
3109.68
3109.68
63173 00
Surgery
52.71
52.71
3795.12
3795.12
63185 00
Surgery
37.65
37.65
2710.80
2710.80
63190 00
Surgery
37.36
37.36
2689.92
2689.92
63191 00
Surgery
42.27
42.27
3043.44
3043.44
63197 00
Surgery
52.26
52.26
3762.72
3762.72
63200 00
Surgery
46.77
46.77
3367.44
3367.44
63250 00
Surgery
89.96
89.96
6477.12
6477.12
63251 00
Surgery
91.98
91.98
6622.56
6622.56
63252 00
Surgery
91.97
91.97
6621.84
6621.84
63265 00
Surgery
50.86
50.86
3661.92
3661.92
63266 00
Surgery
52.20
52.20
3758.40
3758.40
63267 00
Surgery
41.74
41.74
3005.28
3005.28
63268 00
Surgery
44.74
44.74
3221.28
3221.28
63270 00
Surgery
63.30
63.30
4557.60
4557.60
63271 00
Surgery
63.11
63.11
4543.92
4543.92
63272 00
Surgery
56.91
56.91
4097.52
4097.52
63273 00
Surgery
57.00
57.00
4104.00
4104.00
63275 00
Surgery
54.78
54.78
3944.16
3944.16
63276 00
Surgery
54.44
54.44
3919.68
3919.68
63277 00
Surgery
47.48
47.48
3418.56
3418.56
63278 00
Surgery
48.73
48.73
3508.56
3508.56
63280 00
Surgery
64.57
64.57
4649.04
4649.04
63281 00
Surgery
64.04
64.04
4610.88
4610.88
63282 00
Surgery
60.36
60.36
4345.92
4345.92
63283 00
Surgery
58.10
58.10
4183.20
4183.20
63285 00
Surgery
79.51
79.51
5724.72
5724.72
63286 00
Surgery
78.21
78.21
5631.12
5631.12
63287 00
Surgery
83.35
83.35
6001.20
6001.20
63290 00
Surgery
84.75
84.75
6102.00
6102.00
63295 00
Surgery
9.88
9.88
711.36
711.36
63300 00
Surgery
54.95
54.95
3956.40
3956.40
63301 00
Surgery
67.22
67.22
4839.84
4839.84
63302 00
Surgery
66.42
66.42
4782.24
4782.24
63303 00
Surgery
70.42
70.42
5070.24
5070.24
63304 00
Surgery
71.52
71.52
5149.44
5149.44
63305 00
Surgery
76.07
76.07
5477.04
5477.04
63306 00
Surgery
74.75
74.75
5382.00
5382.00
63307 00
Surgery
73.18
73.18
5268.96
5268.96
63308 00
Surgery
9.61
9.61
691.92
691.92
63600 00
Surgery
33.47
33.47
2409.84
2409.84
63610 00
Surgery
17.52
17.52
1261.44
1261.44
63620 00
Surgery
34.42
34.42
2478.24
2478.24
63621 00
Surgery
7.58
7.58
545.76
545.76
63650 00
Surgery
68.30
12.42
4917.60
894.24
63655 00
Surgery
25.60
25.60
1843.20
1843.20
63661 00
Surgery
20.62
9.95
1484.64
716.40
63662 00
Surgery
25.99
25.99
1871.28
1871.28
63663 00
Surgery
27.15
13.56
1954.80
976.32
63664 00
Surgery
27.05
27.05
1947.60
1947.60
63685 00
Surgery
10.28
10.28
740.16
740.16
63688 00
Surgery
9.09
9.09
654.48
654.48
63700 00
Surgery
40.21
40.21
2895.12
2895.12
63702 00
Surgery
43.88
43.88
3159.36
3159.36
63704 00
Surgery
51.04
51.04
3674.88
3674.88
63706 00
Surgery
56.59
56.59
4074.48
4074.48
63707 00
Surgery
28.59
28.59
2058.48
2058.48
63709 00
Surgery
33.90
33.90
2440.80
2440.80
63710 00
Surgery
32.91
32.91
2369.52
2369.52
63740 00
Surgery
30.26
30.26
2178.72
2178.72
63741 00
Surgery
20.88
20.88
1503.36
1503.36
63744 00
Surgery
20.97
20.97
1509.84
1509.84
63746 00
Surgery
18.81
18.81
1354.32
1354.32
64400 00
Surgery
3.42
1.55
246.24
111.60
64405 00
Surgery
2.27
1.58
163.44
113.76
64408 00
Surgery
2.45
1.34
176.40
96.48
64415 00
Surgery
4.02
2.06
289.44
148.32
64416 00
Surgery
2.28
2.28
164.16
164.16
64417 00
Surgery
4.81
1.90
346.32
136.80
64418 00
Surgery
2.59
1.65
186.48
118.80
64420 00
Surgery
2.94
1.73
211.68
124.56
64421 00
Surgery
1.00
0.74
72.00
53.28
64425 00
Surgery
3.32
1.62
239.04
116.64
64430 00
Surgery
2.95
1.63
212.40
117.36
64435 00
Surgery
2.42
1.31
174.24
94.32
64445 00
Surgery
4.76
2.14
342.72
154.08
64446 00
Surgery
2.23
2.23
160.56
160.56
64447 00
Surgery
3.48
1.87
250.56
134.64
64448 00
Surgery
2.13
2.13
153.36
153.36
64449 00
Surgery
1.89
1.89
136.08
136.08
64450 00
Surgery
2.26
1.25
162.72
90.00
64451 00
Surgery
6.84
2.43
492.48
174.96
64454 00
Surgery
6.66
2.45
479.52
176.40
64455 00
Surgery
1.50
0.99
108.00
71.28
64461 00
Surgery
4.02
2.31
289.44
166.32
64462 00
Surgery
2.13
1.43
153.36
102.96
64463 00
Surgery
6.83
2.41
491.76
173.52
64479 00
Surgery
7.98
3.89
574.56
280.08
64480 00
Surgery
4.04
1.81
290.88
130.32
64483 00
Surgery
7.40
3.32
532.80
239.04
64484 00
Surgery
3.34
1.53
240.48
110.16
64486 00
Surgery
3.34
1.63
240.48
117.36
64487 00
Surgery
6.39
1.87
460.08
134.64
64488 00
Surgery
4.12
2.03
296.64
146.16
64489 00
Surgery
10.36
2.28
745.92
164.16
64490 00
Surgery
5.79
3.14
416.88
226.08
64491 00
Surgery
2.92
1.76
210.24
126.72
64492 00
Surgery
2.93
1.79
210.96
128.88
64493 00
Surgery
5.33
2.70
383.76
194.40
64494 00
Surgery
2.73
1.51
196.56
108.72
64495 00
Surgery
2.73
1.54
196.56
110.88
64505 00
Surgery
4.37
3.17
314.64
228.24
64510 00
Surgery
4.40
2.30
316.80
165.60
64517 00
Surgery
5.84
3.76
420.48
270.72
64520 00
Surgery
6.92
2.54
498.24
182.88
64530 00
Surgery
6.86
2.82
493.92
203.04
64553 00
Surgery
116.06
13.74
8356.32
989.28
64555 00
Surgery
63.67
9.68
4584.24
696.96
64561 00
Surgery
22.00
9.06
1584.00
652.32
64566 00
Surgery
3.50
0.90
252.00
64.80
64568 00
Surgery
18.23
18.23
1312.56
1312.56
64569 00
Surgery
23.48
23.48
1690.56
1690.56
64570 00
Surgery
22.60
22.60
1627.20
1627.20
64575 00
Surgery
9.48
9.48
682.56
682.56
64580 00
Surgery
9.54
9.54
686.88
686.88
64581 00
Surgery
19.62
19.62
1412.64
1412.64
64582 00
Surgery
25.13
25.13
1809.36
1809.36
64583 00
Surgery
25.94
25.94
1867.68
1867.68
64584 00
Surgery
21.89
21.89
1576.08
1576.08
64585 00
Surgery
7.28
4.33
524.16
311.76
64590 00
Surgery
13.27
8.83
955.44
635.76
64595 00
Surgery
10.94
6.89
787.68
496.08
64596 00
Surgery
0.00
0.00
BR
BR
64597 00
Surgery
0.00
0.00
BR
BR
64598 00
Surgery
0.00
0.00
BR
BR
64600 00
Surgery
14.38
7.15
1035.36
514.80
64605 00
Surgery
27.30
12.92
1965.60
930.24
64610 00
Surgery
23.29
14.54
1676.88
1046.88
64611 00
Surgery
4.01
3.43
288.72
246.96
64612 00
Surgery
4.16
3.60
299.52
259.20
64615 00
Surgery
4.64
3.70
334.08
266.40
64616 00
Surgery
4.19
3.31
301.68
238.32
64617 00
Surgery
4.87
3.24
350.64
233.28
64620 00
Surgery
6.32
5.32
455.04
383.04
64624 00
Surgery
11.66
4.36
839.52
313.92
64625 00
Surgery
14.19
5.84
1021.68
420.48
64628 00
Surgery
12.37
12.37
890.64
890.64
64629 00
Surgery
5.85
5.85
421.20
421.20
64630 00
Surgery
7.71
5.74
555.12
413.28
64632 00
Surgery
2.73
2.01
196.56
144.72
64633 00
Surgery
13.15
5.74
946.80
413.28
64634 00
Surgery
7.67
1.99
552.24
143.28
64635 00
Surgery
13.26
5.75
954.72
414.00
64636 00
Surgery
7.20
1.74
518.40
125.28
64640 00
Surgery
7.46
3.56
537.12
256.32
64642 00
Surgery
4.62
3.22
332.64
231.84
64643 00
Surgery
2.81
2.09
202.32
150.48
64644 00
Surgery
5.36
3.48
385.92
250.56
64645 00
Surgery
3.63
2.43
261.36
174.96
64646 00
Surgery
4.87
3.49
350.64
251.28
64647 00
Surgery
5.55
4.02
399.60
289.44
64650 00
Surgery
2.67
1.22
192.24
87.84
64653 00
Surgery
3.14
1.55
226.08
111.60
64680 00
Surgery
10.23
4.79
736.56
344.88
64681 00
Surgery
13.55
6.52
975.60
469.44
64702 00
Surgery
15.67
15.67
1128.24
1128.24
64704 00
Surgery
9.84
9.84
708.48
708.48
64708 00
Surgery
15.47
15.47
1113.84
1113.84
64712 00
Surgery
18.06
18.06
1300.32
1300.32
64713 00
Surgery
24.29
24.29
1748.88
1748.88
64714 00
Surgery
23.22
23.22
1671.84
1671.84
64716 00
Surgery
15.49
15.49
1115.28
1115.28
64718 00
Surgery
18.41
18.41
1325.52
1325.52
64719 00
Surgery
12.46
12.46
897.12
897.12
64721 00
Surgery
13.61
13.37
979.92
962.64
64722 00
Surgery
11.30
11.30
813.60
813.60
64726 00
Surgery
8.13
8.13
585.36
585.36
64727 00
Surgery
5.32
5.32
383.04
383.04
64732 00
Surgery
14.00
14.00
1008.00
1008.00
64734 00
Surgery
15.80
15.80
1137.60
1137.60
64736 00
Surgery
9.97
9.97
717.84
717.84
64738 00
Surgery
13.50
13.50
972.00
972.00
64740 00
Surgery
13.78
13.78
992.16
992.16
64742 00
Surgery
14.83
14.83
1067.76
1067.76
64744 00
Surgery
15.57
15.57
1121.04
1121.04
64746 00
Surgery
12.98
12.98
934.56
934.56
64755 00
Surgery
27.71
27.71
1995.12
1995.12
64760 00
Surgery
15.77
15.77
1135.44
1135.44
64763 00
Surgery
15.60
15.60
1123.20
1123.20
64766 00
Surgery
19.24
19.24
1385.28
1385.28
64771 00
Surgery
17.51
17.51
1260.72
1260.72
64772 00
Surgery
16.93
16.93
1218.96
1218.96
64774 00
Surgery
13.01
13.01
936.72
936.72
64776 00
Surgery
12.31
12.31
886.32
886.32
64778 00
Surgery
5.35
5.35
385.20
385.20
64782 00
Surgery
13.79
13.79
992.88
992.88
64783 00
Surgery
6.38
6.38
459.36
459.36
64784 00
Surgery
21.89
21.89
1576.08
1576.08
64786 00
Surgery
30.25
30.25
2178.00
2178.00
64787 00
Surgery
6.94
6.94
499.68
499.68
64788 00
Surgery
12.44
12.44
895.68
895.68
64790 00
Surgery
25.76
25.76
1854.72
1854.72
64792 00
Surgery
32.54
32.54
2342.88
2342.88
64795 00
Surgery
5.86
5.86
421.92
421.92
64802 00
Surgery
25.99
25.99
1871.28
1871.28
64804 00
Surgery
36.50
36.50
2628.00
2628.00
64809 00
Surgery
33.36
33.36
2401.92
2401.92
64818 00
Surgery
23.52
23.52
1693.44
1693.44
64820 00
Surgery
23.23
23.23
1672.56
1672.56
64821 00
Surgery
21.24
21.24
1529.28
1529.28
64822 00
Surgery
21.24
21.24
1529.28
1529.28
64823 00
Surgery
24.02
24.02
1729.44
1729.44
64831 00
Surgery
21.05
21.05
1515.60
1515.60
64832 00
Surgery
9.87
9.87
710.64
710.64
64834 00
Surgery
22.51
22.51
1620.72
1620.72
64835 00
Surgery
24.69
24.69
1777.68
1777.68
64836 00
Surgery
24.69
24.69
1777.68
1777.68
64837 00
Surgery
10.77
10.77
775.44
775.44
64840 00
Surgery
29.04
29.04
2090.88
2090.88
64856 00
Surgery
30.30
30.30
2181.60
2181.60
64857 00
Surgery
31.67
31.67
2280.24
2280.24
64858 00
Surgery
35.34
35.34
2544.48
2544.48
64859 00
Surgery
7.32
7.32
527.04
527.04
64861 00
Surgery
46.49
46.49
3347.28
3347.28
64862 00
Surgery
41.23
41.23
2968.56
2968.56
64864 00
Surgery
25.79
25.79
1856.88
1856.88
64865 00
Surgery
32.60
32.60
2347.20
2347.20
64866 00
Surgery
37.27
37.27
2683.44
2683.44
64868 00
Surgery
29.90
29.90
2152.80
2152.80
64872 00
Surgery
3.42
3.42
246.24
246.24
64874 00
Surgery
5.13
5.13
369.36
369.36
64876 00
Surgery
5.81
5.81
418.32
418.32
64885 00
Surgery
32.25
32.25
2322.00
2322.00
64886 00
Surgery
38.60
38.60
2779.20
2779.20
64890 00
Surgery
32.47
32.47
2337.84
2337.84
64891 00
Surgery
34.52
34.52
2485.44
2485.44
64892 00
Surgery
31.62
31.62
2276.64
2276.64
64893 00
Surgery
33.69
33.69
2425.68
2425.68
64895 00
Surgery
39.74
39.74
2861.28
2861.28
64896 00
Surgery
42.87
42.87
3086.64
3086.64
64897 00
Surgery
38.02
38.02
2737.44
2737.44
64898 00
Surgery
41.16
41.16
2963.52
2963.52
64901 00
Surgery
17.58
17.58
1265.76
1265.76
64902 00
Surgery
20.34
20.34
1464.48
1464.48
64905 00
Surgery
30.11
30.11
2167.92
2167.92
64907 00
Surgery
39.00
39.00
2808.00
2808.00
64910 00
Surgery
22.98
22.98
1654.56
1654.56
64911 00
Surgery
30.83
30.83
2219.76
2219.76
64912 00
Surgery
26.96
26.96
1941.12
1941.12
64913 00
Surgery
5.12
5.12
368.64
368.64
64999 00
Surgery
0.00
0.00
BR
BR
65091 00
Surgery
22.23
22.23
1600.56
1600.56
65093 00
Surgery
22.05
22.05
1587.60
1587.60
65101 00
Surgery
25.45
25.45
1832.40
1832.40
65103 00
Surgery
26.27
26.27
1891.44
1891.44
65105 00
Surgery
28.56
28.56
2056.32
2056.32
65110 00
Surgery
39.37
39.37
2834.64
2834.64
65112 00
Surgery
45.09
45.09
3246.48
3246.48
65114 00
Surgery
47.04
47.04
3386.88
3386.88
65125 00
Surgery
13.61
8.79
979.92
632.88
65130 00
Surgery
25.54
25.54
1838.88
1838.88
65135 00
Surgery
25.85
25.85
1861.20
1861.20
65140 00
Surgery
27.76
27.76
1998.72
1998.72
65150 00
Surgery
20.99
20.99
1511.28
1511.28
65155 00
Surgery
28.86
28.86
2077.92
2077.92
65175 00
Surgery
23.33
23.33
1679.76
1679.76
65205 00
Surgery
0.85
0.86
61.20
61.92
65210 00
Surgery
1.14
1.06
82.08
76.32
65220 00
Surgery
1.82
1.23
131.04
88.56
65222 00
Surgery
2.03
1.49
146.16
107.28
65235 00
Surgery
21.81
21.81
1570.32
1570.32
65260 00
Surgery
29.17
29.17
2100.24
2100.24
65265 00
Surgery
32.83
32.83
2363.76
2363.76
65270 00
Surgery
8.50
4.17
612.00
300.24
65272 00
Surgery
15.78
10.49
1136.16
755.28
65273 00
Surgery
11.27
11.27
811.44
811.44
65275 00
Surgery
17.60
13.67
1267.20
984.24
65280 00
Surgery
19.90
19.90
1432.80
1432.80
65285 00
Surgery
32.78
32.78
2360.16
2360.16
65286 00
Surgery
20.82
14.71
1499.04
1059.12
65290 00
Surgery
14.55
14.55
1047.60
1047.60
65400 00
Surgery
20.70
17.94
1490.40
1291.68
65410 00
Surgery
4.28
3.04
308.16
218.88
65420 00
Surgery
16.12
11.35
1160.64
817.20
65426 00
Surgery
20.00
14.24
1440.00
1025.28
65430 00
Surgery
3.43
3.00
246.96
216.00
65435 00
Surgery
2.46
2.07
177.12
149.04
65436 00
Surgery
11.57
11.00
833.04
792.00
65450 00
Surgery
9.87
9.66
710.64
695.52
65600 00
Surgery
13.08
10.16
941.76
731.52
65710 00
Surgery
33.85
33.85
2437.20
2437.20
65730 00
Surgery
37.19
37.19
2677.68
2677.68
65750 00
Surgery
37.40
37.40
2692.80
2692.80
65755 00
Surgery
37.29
37.29
2684.88
2684.88
65756 00
Surgery
35.01
35.01
2520.72
2520.72
65757 00
Surgery
-
-
567.36
498.96
65760 00
Surgery
-
-
2025.36
1782.72
65765 00
Surgery
0.00
0.00
BR
BR
65767 00
Surgery
0.00
0.00
BR
BR
65770 00
Surgery
41.72
41.72
3003.84
3003.84
65771 00
Surgery
0.00
0.00
BR
BR
65772 00
Surgery
13.63
12.07
981.36
869.04
65775 00
Surgery
17.10
17.10
1231.20
1231.20
65778 00
Surgery
32.64
1.30
2350.08
93.60
65779 00
Surgery
34.67
3.49
2496.24
251.28
65780 00
Surgery
17.61
17.61
1267.92
1267.92
65781 00
Surgery
39.33
39.33
2831.76
2831.76
65782 00
Surgery
33.98
33.98
2446.56
2446.56
65785 00
Surgery
63.55
13.21
4575.60
951.12
65800 00
Surgery
3.56
2.63
256.32
189.36
65810 00
Surgery
13.82
13.82
995.04
995.04
65815 00
Surgery
19.17
14.18
1380.24
1020.96
65820 00
Surgery
24.54
24.54
1766.88
1766.88
65850 00
Surgery
25.04
25.04
1802.88
1802.88
65855 00
Surgery
7.31
6.09
526.32
438.48
65860 00
Surgery
9.18
7.38
660.96
531.36
65865 00
Surgery
14.25
14.25
1026.00
1026.00
65870 00
Surgery
17.69
17.69
1273.68
1273.68
65875 00
Surgery
18.89
18.89
1360.08
1360.08
65880 00
Surgery
19.84
19.84
1428.48
1428.48
65900 00
Surgery
29.46
29.46
2121.12
2121.12
65920 00
Surgery
23.55
23.55
1695.60
1695.60
65930 00
Surgery
19.09
19.09
1374.48
1374.48
66020 00
Surgery
5.90
3.91
424.80
281.52
66030 00
Surgery
5.32
3.32
383.04
239.04
66130 00
Surgery
21.02
16.76
1513.44
1206.72
66150 00
Surgery
26.14
26.14
1882.08
1882.08
66155 00
Surgery
26.12
26.12
1880.64
1880.64
66160 00
Surgery
29.34
29.34
2112.48
2112.48
66170 00
Surgery
32.54
32.54
2342.88
2342.88
66172 00
Surgery
35.54
35.54
2558.88
2558.88
66174 00
Surgery
18.57
18.57
1337.04
1337.04
66175 00
Surgery
21.56
21.56
1552.32
1552.32
66179 00
Surgery
32.13
32.13
2313.36
2313.36
66180 00
Surgery
33.84
33.84
2436.48
2436.48
66183 00
Surgery
30.62
30.62
2204.64
2204.64
66184 00
Surgery
23.58
23.58
1697.76
1697.76
66185 00
Surgery
25.31
25.31
1822.32
1822.32
66225 00
Surgery
27.79
27.79
2000.88
2000.88
66250 00
Surgery
22.44
16.55
1615.68
1191.60
66500 00
Surgery
11.79
11.79
848.88
848.88
66505 00
Surgery
12.82
12.82
923.04
923.04
66600 00
Surgery
26.96
26.96
1941.12
1941.12
66605 00
Surgery
32.35
32.35
2329.20
2329.20
66625 00
Surgery
12.77
12.77
919.44
919.44
66630 00
Surgery
16.87
16.87
1214.64
1214.64
66635 00
Surgery
17.02
17.02
1225.44
1225.44
66680 00
Surgery
15.52
15.52
1117.44
1117.44
66682 00
Surgery
21.24
21.24
1529.28
1529.28
66700 00
Surgery
13.52
11.65
973.44
838.80
66710 00
Surgery
13.21
11.64
951.12
838.08
66711 00
Surgery
15.10
15.10
1087.20
1087.20
66720 00
Surgery
14.01
12.27
1008.72
883.44
66740 00
Surgery
13.13
11.65
945.36
838.80
66761 00
Surgery
8.93
7.03
642.96
506.16
66762 00
Surgery
14.25
12.63
1026.00
909.36
66770 00
Surgery
15.81
14.32
1138.32
1031.04
66820 00
Surgery
14.01
14.01
1008.72
1008.72
66821 00
Surgery
9.98
9.29
718.56
668.88
66825 00
Surgery
24.82
24.82
1787.04
1787.04
66830 00
Surgery
21.08
21.08
1517.76
1517.76
66840 00
Surgery
20.58
20.58
1481.76
1481.76
66850 00
Surgery
23.40
23.40
1684.80
1684.80
66852 00
Surgery
24.89
24.89
1792.08
1792.08
66920 00
Surgery
22.22
22.22
1599.84
1599.84
66930 00
Surgery
25.44
25.44
1831.68
1831.68
66940 00
Surgery
23.30
23.30
1677.60
1677.60
66982 00
Surgery
22.11
22.11
1591.92
1591.92
66983 00
Surgery
-
-
1215.36
1069.20
66984 00
Surgery
16.14
16.14
1162.08
1162.08
66985 00
Surgery
22.85
22.85
1645.20
1645.20
66986 00
Surgery
26.77
26.77
1927.44
1927.44
66987 00
Surgery
-
-
2228.40
1960.56
66988 00
Surgery
-
-
2268.72
1996.56
66989 00
Surgery
25.37
25.37
1826.64
1826.64
66990 00
Surgery
2.60
2.60
187.20
187.20
66991 00
Surgery
20.28
20.28
1460.16
1460.16
66999 00
Surgery
0.00
0.00
BR
BR
67005 00
Surgery
14.21
14.21
1023.12
1023.12
67010 00
Surgery
16.24
16.24
1169.28
1169.28
67015 00
Surgery
18.00
18.00
1296.00
1296.00
67025 00
Surgery
22.08
18.74
1589.76
1349.28
67027 00
Surgery
25.13
25.13
1809.36
1809.36
67028 00
Surgery
3.37
2.71
242.64
195.12
67030 00
Surgery
16.63
16.63
1197.36
1197.36
67031 00
Surgery
11.58
10.51
833.76
756.72
67036 00
Surgery
26.59
26.59
1914.48
1914.48
67039 00
Surgery
28.44
28.44
2047.68
2047.68
67040 00
Surgery
30.68
30.68
2208.96
2208.96
67041 00
Surgery
33.81
33.81
2434.32
2434.32
67042 00
Surgery
33.81
33.81
2434.32
2434.32
67043 00
Surgery
35.65
35.65
2566.80
2566.80
67101 00
Surgery
10.00
8.47
720.00
609.84
67105 00
Surgery
8.84
8.17
636.48
588.24
67107 00
Surgery
33.24
33.24
2393.28
2393.28
67108 00
Surgery
35.18
35.18
2532.96
2532.96
67110 00
Surgery
26.51
24.17
1908.72
1740.24
67113 00
Surgery
39.33
39.33
2831.76
2831.76
67115 00
Surgery
14.85
14.85
1069.20
1069.20
67120 00
Surgery
19.99
16.50
1439.28
1188.00
67121 00
Surgery
26.80
26.80
1929.60
1929.60
67141 00
Surgery
8.07
6.45
581.04
464.40
67145 00
Surgery
7.27
6.45
523.44
464.40
67208 00
Surgery
17.92
17.13
1290.24
1233.36
67210 00
Surgery
15.34
14.81
1104.48
1066.32
67218 00
Surgery
41.14
41.14
2962.08
2962.08
67220 00
Surgery
15.79
14.81
1136.88
1066.32
67221 00
Surgery
8.08
6.14
581.76
442.08
67225 00
Surgery
0.86
0.81
61.92
58.32
67227 00
Surgery
8.80
7.55
633.60
543.60
67228 00
Surgery
10.11
8.98
727.92
646.56
67229 00
Surgery
34.28
34.28
2468.16
2468.16
67250 00
Surgery
26.98
26.98
1942.56
1942.56
67255 00
Surgery
20.51
20.51
1476.72
1476.72
67299 00
Surgery
0.00
0.00
BR
BR
67311 00
Surgery
13.55
13.55
975.60
975.60
67312 00
Surgery
19.71
19.71
1419.12
1419.12
67314 00
Surgery
13.55
13.55
975.60
975.60
67316 00
Surgery
21.13
21.13
1521.36
1521.36
67318 00
Surgery
20.44
20.44
1471.68
1471.68
67320 00
Surgery
5.14
5.14
370.08
370.08
67331 00
Surgery
4.61
4.61
331.92
331.92
67332 00
Surgery
5.99
5.99
431.28
431.28
67334 00
Surgery
4.54
4.54
326.88
326.88
67335 00
Surgery
5.50
5.50
396.00
396.00
67340 00
Surgery
8.60
8.60
619.20
619.20
67343 00
Surgery
20.04
20.04
1442.88
1442.88
67345 00
Surgery
7.26
6.44
522.72
463.68
67346 00
Surgery
5.70
5.70
410.40
410.40
67399 00
Surgery
0.00
0.00
BR
BR
67400 00
Surgery
30.94
30.94
2227.68
2227.68
67405 00
Surgery
27.05
27.05
1947.60
1947.60
67412 00
Surgery
29.52
29.52
2125.44
2125.44
67413 00
Surgery
28.76
28.76
2070.72
2070.72
67414 00
Surgery
43.29
43.29
3116.88
3116.88
67415 00
Surgery
3.03
3.03
218.16
218.16
67420 00
Surgery
51.72
51.72
3723.84
3723.84
67430 00
Surgery
41.34
41.34
2976.48
2976.48
67440 00
Surgery
40.11
40.11
2887.92
2887.92
67445 00
Surgery
45.50
45.50
3276.00
3276.00
67450 00
Surgery
41.54
41.54
2990.88
2990.88
67500 00
Surgery
2.31
1.91
166.32
137.52
67505 00
Surgery
2.56
2.13
184.32
153.36
67515 00
Surgery
1.53
1.39
110.16
100.08
67516 00
Surgery
3.58
2.87
257.76
206.64
67550 00
Surgery
32.36
32.36
2329.92
2329.92
67560 00
Surgery
33.09
33.09
2382.48
2382.48
67570 00
Surgery
37.95
37.95
2732.40
2732.40
67599 00
Surgery
0.00
0.00
BR
BR
67700 00
Surgery
8.48
3.47
610.56
249.84
67710 00
Surgery
7.25
2.93
522.00
210.96
67715 00
Surgery
7.80
3.21
561.60
231.12
67800 00
Surgery
3.86
3.04
277.92
218.88
67801 00
Surgery
4.88
3.90
351.36
280.80
67805 00
Surgery
6.10
4.85
439.20
349.20
67808 00
Surgery
10.96
10.96
789.12
789.12
67810 00
Surgery
5.51
2.01
396.72
144.72
67820 00
Surgery
0.56
0.66
40.32
47.52
67825 00
Surgery
4.03
3.64
290.16
262.08
67830 00
Surgery
8.06
4.09
580.32
294.48
67835 00
Surgery
13.12
13.12
944.64
944.64
67840 00
Surgery
8.37
4.67
602.64
336.24
67850 00
Surgery
6.47
3.91
465.84
281.52
67875 00
Surgery
5.44
2.84
391.68
204.48
67880 00
Surgery
13.99
10.96
1007.28
789.12
67882 00
Surgery
17.08
14.00
1229.76
1008.00
67900 00
Surgery
19.47
15.02
1401.84
1081.44
67901 00
Surgery
23.75
17.52
1710.00
1261.44
67902 00
Surgery
21.54
21.54
1550.88
1550.88
67903 00
Surgery
18.03
14.26
1298.16
1026.72
67904 00
Surgery
22.12
17.69
1592.64
1273.68
67906 00
Surgery
14.98
14.98
1078.56
1078.56
67908 00
Surgery
16.20
12.86
1166.40
925.92
67909 00
Surgery
16.40
13.01
1180.80
936.72
67911 00
Surgery
16.62
16.62
1196.64
1196.64
67912 00
Surgery
26.87
14.46
1934.64
1041.12
67914 00
Surgery
14.63
9.83
1053.36
707.76
67915 00
Surgery
9.47
5.98
681.84
430.56
67916 00
Surgery
18.22
12.78
1311.84
920.16
67917 00
Surgery
18.64
13.56
1342.08
976.32
67921 00
Surgery
14.30
9.33
1029.60
671.76
67922 00
Surgery
9.20
5.98
662.40
430.56
67923 00
Surgery
18.23
12.79
1312.56
920.88
67924 00
Surgery
19.40
13.56
1396.80
976.32
67930 00
Surgery
11.10
6.99
799.20
503.28
67935 00
Surgery
17.92
13.00
1290.24
936.00
67938 00
Surgery
8.08
3.51
581.76
252.72
67950 00
Surgery
17.49
13.74
1259.28
989.28
67961 00
Surgery
17.60
13.50
1267.20
972.00
67966 00
Surgery
23.21
19.40
1671.12
1396.80
67971 00
Surgery
21.31
21.31
1534.32
1534.32
67973 00
Surgery
27.41
27.41
1973.52
1973.52
67974 00
Surgery
27.34
27.34
1968.48
1968.48
67975 00
Surgery
20.19
20.19
1453.68
1453.68
67999 00
Surgery
0.00
0.00
BR
BR
68020 00
Surgery
3.63
3.28
261.36
236.16
68040 00
Surgery
1.86
1.41
133.92
101.52
68100 00
Surgery
5.37
2.83
386.64
203.76
68110 00
Surgery
7.07
4.42
509.04
318.24
68115 00
Surgery
9.93
5.44
714.96
391.68
68130 00
Surgery
16.52
12.30
1189.44
885.60
68135 00
Surgery
4.71
4.45
339.12
320.40
68200 00
Surgery
1.24
1.01
89.28
72.72
68320 00
Surgery
22.21
16.07
1599.12
1157.04
68325 00
Surgery
19.48
19.48
1402.56
1402.56
68326 00
Surgery
19.14
19.14
1378.08
1378.08
68328 00
Surgery
20.89
20.89
1504.08
1504.08
68330 00
Surgery
18.62
13.69
1340.64
985.68
68335 00
Surgery
19.19
19.19
1381.68
1381.68
68340 00
Surgery
18.02
11.84
1297.44
852.48
68360 00
Surgery
16.22
12.21
1167.84
879.12
68362 00
Surgery
19.45
19.45
1400.40
1400.40
68371 00
Surgery
12.27
12.27
883.44
883.44
68399 00
Surgery
0.00
0.00
BR
BR
68400 00
Surgery
8.88
3.91
639.36
281.52
68420 00
Surgery
9.91
4.95
713.52
356.40
68440 00
Surgery
3.14
3.00
226.08
216.00
68500 00
Surgery
31.65
31.65
2278.80
2278.80
68505 00
Surgery
31.51
31.51
2268.72
2268.72
68510 00
Surgery
13.45
8.48
968.40
610.56
68520 00
Surgery
22.01
22.01
1584.72
1584.72
68525 00
Surgery
7.60
7.60
547.20
547.20
68530 00
Surgery
12.96
7.53
933.12
542.16
68540 00
Surgery
29.29
29.29
2108.88
2108.88
68550 00
Surgery
36.47
36.47
2625.84
2625.84
68700 00
Surgery
17.90
17.90
1288.80
1288.80
68705 00
Surgery
7.81
4.93
562.32
354.96
68720 00
Surgery
24.14
24.14
1738.08
1738.08
68745 00
Surgery
24.27
24.27
1747.44
1747.44
68750 00
Surgery
25.65
25.65
1846.80
1846.80
68760 00
Surgery
6.56
4.35
472.32
313.20
68761 00
Surgery
4.36
3.49
313.92
251.28
68770 00
Surgery
18.61
18.61
1339.92
1339.92
68801 00
Surgery
2.89
2.38
208.08
171.36
68810 00
Surgery
4.82
3.81
347.04
274.32
68811 00
Surgery
4.02
4.02
289.44
289.44
68815 00
Surgery
11.21
6.62
807.12
476.64
68816 00
Surgery
25.30
4.67
1821.60
336.24
68840 00
Surgery
3.99
3.50
287.28
252.00
68841 00
Surgery
1.14
0.96
82.08
69.12
68850 00
Surgery
1.74
1.53
125.28
110.16
68899 00
Surgery
0.00
0.00
BR
BR
69000 00
Surgery
5.62
3.80
404.64
273.60
69005 00
Surgery
6.63
4.89
477.36
352.08
69020 00
Surgery
7.01
4.36
504.72
313.92
69090 00
Surgery
-
-
54.00
48.96
69100 00
Surgery
2.87
1.38
206.64
99.36
69105 00
Surgery
4.35
1.92
313.20
138.24
69110 00
Surgery
14.17
9.91
1020.24
713.52
69120 00
Surgery
11.71
11.71
843.12
843.12
69140 00
Surgery
27.21
27.21
1959.12
1959.12
69145 00
Surgery
12.41
7.81
893.52
562.32
69150 00
Surgery
30.32
30.32
2183.04
2183.04
69155 00
Surgery
48.99
48.99
3527.28
3527.28
69200 00
Surgery
2.42
1.42
174.24
102.24
69205 00
Surgery
2.88
2.88
207.36
207.36
69209 00
Surgery
0.48
0.48
34.56
34.56
69210 00
Surgery
1.44
0.97
103.68
69.84
69220 00
Surgery
2.36
1.54
169.92
110.88
69222 00
Surgery
6.53
4.14
470.16
298.08
69300 00
Surgery
19.66
14.22
1415.52
1023.84
69310 00
Surgery
33.64
33.64
2422.08
2422.08
69320 00
Surgery
46.93
46.93
3378.96
3378.96
69399 00
Surgery
0.00
0.00
BR
BR
69420 00
Surgery
5.77
3.66
415.44
263.52
69421 00
Surgery
4.60
4.60
331.20
331.20
69424 00
Surgery
3.84
1.82
276.48
131.04
69433 00
Surgery
6.11
4.02
439.92
289.44
69436 00
Surgery
4.84
4.84
348.48
348.48
69440 00
Surgery
20.94
20.94
1507.68
1507.68
69450 00
Surgery
16.59
16.59
1194.48
1194.48
69501 00
Surgery
21.46
21.46
1545.12
1545.12
69502 00
Surgery
28.49
28.49
2051.28
2051.28
69505 00
Surgery
36.99
36.99
2663.28
2663.28
69511 00
Surgery
37.86
37.86
2725.92
2725.92
69530 00
Surgery
50.37
50.37
3626.64
3626.64
69535 00
Surgery
79.94
79.94
5755.68
5755.68
69540 00
Surgery
6.38
3.95
459.36
284.40
69550 00
Surgery
32.02
32.02
2305.44
2305.44
69552 00
Surgery
47.70
47.70
3434.40
3434.40
69554 00
Surgery
76.01
76.01
5472.72
5472.72
69601 00
Surgery
30.70
30.70
2210.40
2210.40
69602 00
Surgery
32.85
32.85
2365.20
2365.20
69603 00
Surgery
38.66
38.66
2783.52
2783.52
69604 00
Surgery
33.55
33.55
2415.60
2415.60
69610 00
Surgery
11.58
8.67
833.76
624.24
69620 00
Surgery
22.39
14.97
1612.08
1077.84
69631 00
Surgery
26.89
26.89
1936.08
1936.08
69632 00
Surgery
32.62
32.62
2348.64
2348.64
69633 00
Surgery
31.77
31.77
2287.44
2287.44
69635 00
Surgery
38.57
38.57
2777.04
2777.04
69636 00
Surgery
42.39
42.39
3052.08
3052.08
69637 00
Surgery
42.21
42.21
3039.12
3039.12
69641 00
Surgery
31.43
31.43
2262.96
2262.96
69642 00
Surgery
40.34
40.34
2904.48
2904.48
69643 00
Surgery
36.86
36.86
2653.92
2653.92
69644 00
Surgery
45.30
45.30
3261.60
3261.60
69645 00
Surgery
44.45
44.45
3200.40
3200.40
69646 00
Surgery
47.29
47.29
3404.88
3404.88
69650 00
Surgery
24.27
24.27
1747.44
1747.44
69660 00
Surgery
27.88
27.88
2007.36
2007.36
69661 00
Surgery
36.31
36.31
2614.32
2614.32
69662 00
Surgery
34.88
34.88
2511.36
2511.36
69666 00
Surgery
24.42
24.42
1758.24
1758.24
69667 00
Surgery
24.50
24.50
1764.00
1764.00
69670 00
Surgery
28.48
28.48
2050.56
2050.56
69676 00
Surgery
25.20
25.20
1814.40
1814.40
69700 00
Surgery
20.12
20.12
1448.64
1448.64
69705 00
Surgery
80.55
5.19
5799.60
373.68
69706 00
Surgery
83.22
7.25
5991.84
522.00
69710 00
Surgery
0.00
0.00
BR
BR
69711 00
Surgery
25.31
25.31
1822.32
1822.32
69714 00
Surgery
14.93
14.93
1074.96
1074.96
69716 00
Surgery
18.68
18.68
1344.96
1344.96
69717 00
Surgery
16.91
16.91
1217.52
1217.52
69719 00
Surgery
19.40
19.40
1396.80
1396.80
69720 00
Surgery
35.48
35.48
2554.56
2554.56
69725 00
Surgery
56.16
56.16
4043.52
4043.52
69726 00
Surgery
14.39
14.39
1036.08
1036.08
69727 00
Surgery
16.05
16.05
1155.60
1155.60
69728 00
Surgery
18.15
18.15
1306.80
1306.80
69729 00
Surgery
20.26
20.26
1458.72
1458.72
69730 00
Surgery
21.01
21.01
1512.72
1512.72
69740 00
Surgery
34.94
34.94
2515.68
2515.68
69745 00
Surgery
37.25
37.25
2682.00
2682.00
69799 00
Surgery
0.00
0.00
BR
BR
69801 00
Surgery
6.87
3.73
494.64
268.56
69805 00
Surgery
31.00
31.00
2232.00
2232.00
69806 00
Surgery
27.77
27.77
1999.44
1999.44
69905 00
Surgery
27.73
27.73
1996.56
1996.56
69910 00
Surgery
29.85
29.85
2149.20
2149.20
69915 00
Surgery
45.17
45.17
3252.24
3252.24
69930 00
Surgery
36.57
36.57
2633.04
2633.04
69949 00
Surgery
0.00
0.00
BR
BR
69950 00
Surgery
52.40
52.40
3772.80
3772.80
69955 00
Surgery
59.06
59.06
4252.32
4252.32
69960 00
Surgery
56.57
56.57
4073.04
4073.04
69970 00
Surgery
63.84
63.84
4596.48
4596.48
69979 00
Surgery
0.00
0.00
BR
BR
69990 00
Surgery
6.52
6.52
469.44
469.44
RADIOLOGY GUIDELINES
Information regarding publications incorporated by reference
				  is found in the Introduction Section of the Fee Schedule.
The following Commission guidelines are in addition to CMS
				  and CPT® guidelines and represent additional
				  guidance from the Commission relative to unit values for these services. To the
				  extent that a conflict may exist between an incorporated portion of the
				  CPT® and a code, guideline, identifier, or
				  modifier unique to Arizona, then the Arizona code, guideline, identifier or
				  modifier shall control. Codes that are unique to Arizona are preceded by an AZ
				  identifier and numbered in the following format: AZxxx.
A. GENERAL GUIDELINES
1. Values include usual contrast media, equipment, and
				  materials. An additional charge may be warranted when special surgical trays
				  and materials are provided by the healthcare provider.
2. Values include consultation and written reports to the
				  referring healthcare provider.
3. X-ray findings and attending healthcare provider's written
				  orders for x-rays must be included with the statement for x-ray services. Bills
				  unsupported by findings will not be paid.
4. X-rays should be taken, reported, and be properly marked
				  for identification and orientation in accordance with the accepted standard of
				  radiologic practice in the State of Arizona.
B. MODIFIERS
Modifiers identify circumstances that alter or enhance the
				  description of the service. For radiology codes, two modifiers affect the
				  assigned unit value and are listed in
The Essential RBRVS.
However, other modifiers may be required for correct reporting of service. See
				  CMS and the 2024 CPT® publication for additional
				  information on modifiers. Listed radiology modifiers affect the unit values as
				  follows:
1. Total: When no modifier is listed, the unit value
				  represents the global value of the procedure. The five-digit code is used to
				  represent a global service inclusive of the professional and technical value of
				  providing that service. The following sections provide additional definitions
				  for each component.
2. Professional: Modifier 26 is used to designate
				  professional services. The professional component includes examination of the
				  patient, when indicated, performance and/or supervision of the procedure,
				  interpretation and written report of the examination, and consultation with
				  referring healthcare providers.
3. Technical: Modifier TC is used to designate the technical
				  value of providing the service. The technical component includes personnel,
				  materials, space, equipment, and other allocated facility overhead normally
				  included in providing the service.
C. REFERENCE TO RELATIVE VALUES
Two patterns of billing currently prevail in radiology. The
				  first pattern occurs when a total charge for the radiology service, including
				  both the professional component ("PC") and technical component ("TC"), is
				  billed by appropriately licensed health care providers working in offices,
				  clinics, and, independent diagnostic testing facilities. The second pattern
				  occurs when services are performed in settings such as a hospital or ambulatory
				  surgery center radiology department. The radiologist submits a separate
				  statement to the payer for services that compose the professional component.
				  The hospital or ambulatory surgery center charges for use of the department
				  facilities and the services of its employees as the technical component.
The Radiology Relative Values scales have been devised for
				  use in radiology and are not coordinated with scales for services in other
				  branches of medicine such as surgery, medicine or pathology. The two scales are
				  compatible only within themselves. Some procedures are noted as a "BR" value or
				  "By Report". This usage is intended to indicate that circumstances involving a
				  given patient procedure may require much more than the average amount of time
				  and effort to perform and thus a value would be unique and could not be
				  anticipated or established. When such added involvement is claimed, a written
				  explanation will usually be required as an addendum to the bill.
The PC values do not include TC charges made by the hospital
				  in which the procedure was accomplished. Such charges by the hospital or
				  ambulatory surgery center cover the services of technologists and other
				  helpers, the films, contrast media, radioactive agents, chemical and other
				  materials, the use of the space and facilities of the x-ray department plus any
				  other hospital or ambulatory surgery center costs. Most hospitals or ambulatory
				  surgery centers have derived their own schedule of charges for these items.
				  Establishment of hospital or ambulatory surgery center charges is not the
				  subject of the Fee Schedule.
The separation of billing in no way implies a division of
				  responsibility, but only a division of the charge. The radiologist is a
				  physician performing a needed medical service for a patient, and must retain
				  full responsibility for his or her own activity and full responsibility for the
				  potential supervision of technologists, the selection and maintenance of
				  equipment, the control of radiation hazards, and the general administration of
				  the radiology department.
D. REVIEW OF DIAGNOSTIC STUDIES
No separate charge is warranted for prior studies reviewed in
				  conjunction with a visit, consultation, record review, or other evaluation by a
				  healthcare provider; neither the professional component value modifier 26 nor
				  the radiological consultation CPT® code 76140 is
				  reimbursable. The review of diagnostic tests is included in the evaluation and
				  management codes.
ARIZONA PHYSICIANS' FEE
							 SCHEDULE
Radiology Codes
							 2024
Radiology Conversion Factor
							 $70.00
Code
Category
FY24 NF
							 RVU
FY24 FAC RVU
FY24 NF RBRVS Rate
FY24 FAC RBRVS
							 Rate
70010 00
Radiology
1.72
1.72
120.40
120.40
70015 00
Radiology
4.98
4.98
348.60
348.60
70015 26
Radiology
1.67
1.67
116.90
116.90
70015 TC
Radiology
3.31
3.31
231.70
231.70
70030 00
Radiology
0.98
0.98
68.60
68.60
70030 26
Radiology
0.25
0.25
17.50
17.50
70030 TC
Radiology
0.73
0.73
51.10
51.10
70100 00
Radiology
1.17
1.17
81.90
81.90
70100 26
Radiology
0.26
0.26
18.20
18.20
70100 TC
Radiology
0.91
0.91
63.70
63.70
70110 00
Radiology
1.31
1.31
91.70
91.70
70110 26
Radiology
0.35
0.35
24.50
24.50
70110 TC
Radiology
0.96
0.96
67.20
67.20
70120 00
Radiology
1.15
1.15
80.50
80.50
70120 26
Radiology
0.26
0.26
18.20
18.20
70120 TC
Radiology
0.89
0.89
62.30
62.30
70130 00
Radiology
1.86
1.86
130.20
130.20
70130 26
Radiology
0.48
0.48
33.60
33.60
70130 TC
Radiology
1.38
1.38
96.60
96.60
70134 00
Radiology
1.86
1.86
130.20
130.20
70134 26
Radiology
0.51
0.51
35.70
35.70
70134 TC
Radiology
1.35
1.35
94.50
94.50
70140 00
Radiology
0.96
0.96
67.20
67.20
70140 26
Radiology
0.28
0.28
19.60
19.60
70140 TC
Radiology
0.68
0.68
47.60
47.60
70150 00
Radiology
1.42
1.42
99.40
99.40
70150 26
Radiology
0.37
0.37
25.90
25.90
70150 TC
Radiology
1.05
1.05
73.50
73.50
70160 00
Radiology
1.13
1.13
79.10
79.10
70160 26
Radiology
0.24
0.24
16.80
16.80
70160 TC
Radiology
0.89
0.89
62.30
62.30
70170 00
Radiology
-
-
103.60
103.60
70170 26
Radiology
0.43
0.43
30.10
30.10
70170 TC
Radiology
-
-
73.50
73.50
70190 00
Radiology
1.13
1.13
79.10
79.10
70190 26
Radiology
0.32
0.32
22.40
22.40
70190 TC
Radiology
0.81
0.81
56.70
56.70
70200 00
Radiology
1.44
1.44
100.80
100.80
70200 26
Radiology
0.40
0.40
28.00
28.00
70200 TC
Radiology
1.04
1.04
72.80
72.80
70210 00
Radiology
0.97
0.97
67.90
67.90
70210 26
Radiology
0.25
0.25
17.50
17.50
70210 TC
Radiology
0.72
0.72
50.40
50.40
70220 00
Radiology
1.13
1.13
79.10
79.10
70220 26
Radiology
0.31
0.31
21.70
21.70
70220 TC
Radiology
0.82
0.82
57.40
57.40
70240 00
Radiology
0.99
0.99
69.30
69.30
70240 26
Radiology
0.27
0.27
18.90
18.90
70240 TC
Radiology
0.72
0.72
50.40
50.40
70250 00
Radiology
1.09
1.09
76.30
76.30
70250 26
Radiology
0.26
0.26
18.20
18.20
70250 TC
Radiology
0.83
0.83
58.10
58.10
70260 00
Radiology
1.34
1.34
93.80
93.80
70260 26
Radiology
0.40
0.40
28.00
28.00
70260 TC
Radiology
0.94
0.94
65.80
65.80
70300 00
Radiology
0.39
0.39
27.30
27.30
70300 26
Radiology
0.15
0.15
10.50
10.50
70300 TC
Radiology
0.24
0.24
16.80
16.80
70310 00
Radiology
1.22
1.22
85.40
85.40
70310 26
Radiology
0.24
0.24
16.80
16.80
70310 TC
Radiology
0.98
0.98
68.60
68.60
70320 00
Radiology
1.60
1.60
112.00
112.00
70320 26
Radiology
0.32
0.32
22.40
22.40
70320 TC
Radiology
1.28
1.28
89.60
89.60
70328 00
Radiology
1.04
1.04
72.80
72.80
70328 26
Radiology
0.26
0.26
18.20
18.20
70328 TC
Radiology
0.78
0.78
54.60
54.60
70330 00
Radiology
1.59
1.59
111.30
111.30
70330 26
Radiology
0.34
0.34
23.80
23.80
70330 TC
Radiology
1.25
1.25
87.50
87.50
70332 00
Radiology
2.48
2.48
173.60
173.60
70332 26
Radiology
0.76
0.76
53.20
53.20
70332 TC
Radiology
1.72
1.72
120.40
120.40
70336 00
Radiology
8.15
8.15
570.50
570.50
70336 26
Radiology
2.07
2.07
144.90
144.90
70336 TC
Radiology
6.08
6.08
425.60
425.60
70350 00
Radiology
0.50
0.50
35.00
35.00
70350 26
Radiology
0.25
0.25
17.50
17.50
70350 TC
Radiology
0.25
0.25
17.50
17.50
70355 00
Radiology
0.55
0.55
38.50
38.50
70355 26
Radiology
0.29
0.29
20.30
20.30
70355 TC
Radiology
0.26
0.26
18.20
18.20
70360 00
Radiology
0.94
0.94
65.80
65.80
70360 26
Radiology
0.26
0.26
18.20
18.20
70360 TC
Radiology
0.68
0.68
47.60
47.60
70370 00
Radiology
3.15
3.15
220.50
220.50
70370 26
Radiology
0.45
0.45
31.50
31.50
70370 TC
Radiology
2.70
2.70
189.00
189.00
70371 00
Radiology
3.28
3.28
229.60
229.60
70371 26
Radiology
1.23
1.23
86.10
86.10
70371 TC
Radiology
2.05
2.05
143.50
143.50
70380 00
Radiology
1.13
1.13
79.10
79.10
70380 26
Radiology
0.24
0.24
16.80
16.80
70380 TC
Radiology
0.89
0.89
62.30
62.30
70390 00
Radiology
3.47
3.47
242.90
242.90
70390 26
Radiology
0.53
0.53
37.10
37.10
70390 TC
Radiology
2.94
2.94
205.80
205.80
70450 00
Radiology
3.26
3.26
228.20
228.20
70450 26
Radiology
1.19
1.19
83.30
83.30
70450 TC
Radiology
2.07
2.07
144.90
144.90
70460 00
Radiology
4.56
4.56
319.20
319.20
70460 26
Radiology
1.59
1.59
111.30
111.30
70460 TC
Radiology
2.97
2.97
207.90
207.90
70470 00
Radiology
5.34
5.34
373.80
373.80
70470 26
Radiology
1.79
1.79
125.30
125.30
70470 TC
Radiology
3.55
3.55
248.50
248.50
70480 00
Radiology
4.89
4.89
342.30
342.30
70480 26
Radiology
1.81
1.81
126.70
126.70
70480 TC
Radiology
3.08
3.08
215.60
215.60
70481 00
Radiology
5.56
5.56
389.20
389.20
70481 26
Radiology
1.59
1.59
111.30
111.30
70481 TC
Radiology
3.97
3.97
277.90
277.90
70482 00
Radiology
6.49
6.49
454.30
454.30
70482 26
Radiology
1.78
1.78
124.60
124.60
70482 TC
Radiology
4.71
4.71
329.70
329.70
70486 00
Radiology
3.94
3.94
275.80
275.80
70486 26
Radiology
1.20
1.20
84.00
84.00
70486 TC
Radiology
2.74
2.74
191.80
191.80
70487 00
Radiology
4.68
4.68
327.60
327.60
70487 26
Radiology
1.58
1.58
110.60
110.60
70487 TC
Radiology
3.10
3.10
217.00
217.00
70488 00
Radiology
5.67
5.67
396.90
396.90
70488 26
Radiology
1.78
1.78
124.60
124.60
70488 TC
Radiology
3.89
3.89
272.30
272.30
70490 00
Radiology
4.61
4.61
322.70
322.70
70490 26
Radiology
1.80
1.80
126.00
126.00
70490 TC
Radiology
2.81
2.81
196.70
196.70
70491 00
Radiology
5.67
5.67
396.90
396.90
70491 26
Radiology
1.94
1.94
135.80
135.80
70491 TC
Radiology
3.73
3.73
261.10
261.10
70492 00
Radiology
6.80
6.80
476.00
476.00
70492 26
Radiology
2.26
2.26
158.20
158.20
70492 TC
Radiology
4.54
4.54
317.80
317.80
70496 00
Radiology
8.49
8.49
594.30
594.30
70496 26
Radiology
2.45
2.45
171.50
171.50
70496 TC
Radiology
6.04
6.04
422.80
422.80
70498 00
Radiology
8.48
8.48
593.60
593.60
70498 26
Radiology
2.45
2.45
171.50
171.50
70498 TC
Radiology
6.03
6.03
422.10
422.10
70540 00
Radiology
6.98
6.98
488.60
488.60
70540 26
Radiology
1.89
1.89
132.30
132.30
70540 TC
Radiology
5.09
5.09
356.30
356.30
70542 00
Radiology
8.28
8.28
579.60
579.60
70542 26
Radiology
2.27
2.27
158.90
158.90
70542 TC
Radiology
6.01
6.01
420.70
420.70
70543 00
Radiology
10.45
10.45
731.50
731.50
70543 26
Radiology
3.01
3.01
210.70
210.70
70543 TC
Radiology
7.44
7.44
520.80
520.80
70544 00
Radiology
6.65
6.65
465.50
465.50
70544 26
Radiology
1.68
1.68
117.60
117.60
70544 TC
Radiology
4.97
4.97
347.90
347.90
70545 00
Radiology
7.01
7.01
490.70
490.70
70545 26
Radiology
1.68
1.68
117.60
117.60
70545 TC
Radiology
5.33
5.33
373.10
373.10
70546 00
Radiology
10.19
10.19
713.30
713.30
70546 26
Radiology
2.08
2.08
145.60
145.60
70546 TC
Radiology
8.11
8.11
567.70
567.70
70547 00
Radiology
6.66
6.66
466.20
466.20
70547 26
Radiology
1.68
1.68
117.60
117.60
70547 TC
Radiology
4.98
4.98
348.60
348.60
70548 00
Radiology
7.60
7.60
532.00
532.00
70548 26
Radiology
2.11
2.11
147.70
147.70
70548 TC
Radiology
5.49
5.49
384.30
384.30
70549 00
Radiology
10.66
10.66
746.20
746.20
70549 26
Radiology
2.52
2.52
176.40
176.40
70549 TC
Radiology
8.14
8.14
569.80
569.80
70551 00
Radiology
6.05
6.05
423.50
423.50
70551 26
Radiology
2.08
2.08
145.60
145.60
70551 TC
Radiology
3.97
3.97
277.90
277.90
70552 00
Radiology
8.34
8.34
583.80
583.80
70552 26
Radiology
2.50
2.50
175.00
175.00
70552 TC
Radiology
5.84
5.84
408.80
408.80
70553 00
Radiology
9.82
9.82
687.40
687.40
70553 26
Radiology
3.21
3.21
224.70
224.70
70553 TC
Radiology
6.61
6.61
462.70
462.70
70554 00
Radiology
11.73
11.73
821.10
821.10
70554 26
Radiology
2.98
2.98
208.60
208.60
70554 TC
Radiology
8.75
8.75
612.50
612.50
70555 00
Radiology
-
-
1441.30
1441.30
70555 26
Radiology
3.50
3.50
245.00
245.00
70555 TC
Radiology
-
-
1196.30
1196.30
70557 00
Radiology
-
-
315.00
315.00
70557 26
Radiology
4.50
4.50
315.00
315.00
70557 TC
Radiology
0.00
0.00
BR
BR
70558 00
Radiology
-
-
1388.80
1388.80
70558 26
Radiology
4.96
4.96
347.20
347.20
70558 TC
Radiology
-
-
1041.60
1041.60
70559 00
Radiology
-
-
905.80
905.80
70559 26
Radiology
4.66
4.66
326.20
326.20
70559 TC
Radiology
-
-
579.60
579.60
71045 00
Radiology
0.77
0.77
53.90
53.90
71045 26
Radiology
0.25
0.25
17.50
17.50
71045 TC
Radiology
0.52
0.52
36.40
36.40
71046 00
Radiology
1.01
1.01
70.70
70.70
71046 26
Radiology
0.31
0.31
21.70
21.70
71046 TC
Radiology
0.70
0.70
49.00
49.00
71047 00
Radiology
1.27
1.27
88.90
88.90
71047 26
Radiology
0.39
0.39
27.30
27.30
71047 TC
Radiology
0.88
0.88
61.60
61.60
71048 00
Radiology
1.37
1.37
95.90
95.90
71048 26
Radiology
0.43
0.43
30.10
30.10
71048 TC
Radiology
0.94
0.94
65.80
65.80
71100 00
Radiology
1.10
1.10
77.00
77.00
71100 26
Radiology
0.31
0.31
21.70
21.70
71100 TC
Radiology
0.79
0.79
55.30
55.30
71101 00
Radiology
1.27
1.27
88.90
88.90
71101 26
Radiology
0.38
0.38
26.60
26.60
71101 TC
Radiology
0.89
0.89
62.30
62.30
71110 00
Radiology
1.32
1.32
92.40
92.40
71110 26
Radiology
0.41
0.41
28.70
28.70
71110 TC
Radiology
0.91
0.91
63.70
63.70
71111 00
Radiology
1.58
1.58
110.60
110.60
71111 26
Radiology
0.46
0.46
32.20
32.20
71111 TC
Radiology
1.12
1.12
78.40
78.40
71120 00
Radiology
1.01
1.01
70.70
70.70
71120 26
Radiology
0.28
0.28
19.60
19.60
71120 TC
Radiology
0.73
0.73
51.10
51.10
71130 00
Radiology
1.24
1.24
86.80
86.80
71130 26
Radiology
0.31
0.31
21.70
21.70
71130 TC
Radiology
0.93
0.93
65.10
65.10
71250 00
Radiology
4.09
4.09
286.30
286.30
71250 26
Radiology
1.52
1.52
106.40
106.40
71250 TC
Radiology
2.57
2.57
179.90
179.90
71260 00
Radiology
5.14
5.14
359.80
359.80
71260 26
Radiology
1.64
1.64
114.80
114.80
71260 TC
Radiology
3.50
3.50
245.00
245.00
71270 00
Radiology
6.04
6.04
422.80
422.80
71270 26
Radiology
1.75
1.75
122.50
122.50
71270 TC
Radiology
4.29
4.29
300.30
300.30
71271 00
Radiology
4.23
4.23
296.10
296.10
71271 26
Radiology
1.52
1.52
106.40
106.40
71271 TC
Radiology
2.71
2.71
189.70
189.70
71275 00
Radiology
8.66
8.66
606.20
606.20
71275 26
Radiology
2.55
2.55
178.50
178.50
71275 TC
Radiology
6.11
6.11
427.70
427.70
71550 00
Radiology
10.43
10.43
730.10
730.10
71550 26
Radiology
2.05
2.05
143.50
143.50
71550 TC
Radiology
8.38
8.38
586.60
586.60
71551 00
Radiology
11.53
11.53
807.10
807.10
71551 26
Radiology
2.43
2.43
170.10
170.10
71551 TC
Radiology
9.10
9.10
637.00
637.00
71552 00
Radiology
14.55
14.55
1018.50
1018.50
71552 26
Radiology
3.17
3.17
221.90
221.90
71552 TC
Radiology
11.38
11.38
796.60
796.60
71555 00
Radiology
10.30
10.30
721.00
721.00
71555 26
Radiology
2.51
2.51
175.70
175.70
71555 TC
Radiology
7.79
7.79
545.30
545.30
72020 00
Radiology
0.73
0.73
51.10
51.10
72020 26
Radiology
0.23
0.23
16.10
16.10
72020 TC
Radiology
0.50
0.50
35.00
35.00
72040 00
Radiology
1.19
1.19
83.30
83.30
72040 26
Radiology
0.32
0.32
22.40
22.40
72040 TC
Radiology
0.87
0.87
60.90
60.90
72050 00
Radiology
1.61
1.61
112.70
112.70
72050 26
Radiology
0.38
0.38
26.60
26.60
72050 TC
Radiology
1.23
1.23
86.10
86.10
72052 00
Radiology
1.88
1.88
131.60
131.60
72052 26
Radiology
0.43
0.43
30.10
30.10
72052 TC
Radiology
1.45
1.45
101.50
101.50
72070 00
Radiology
0.99
0.99
69.30
69.30
72070 26
Radiology
0.29
0.29
20.30
20.30
72070 TC
Radiology
0.70
0.70
49.00
49.00
72072 00
Radiology
1.19
1.19
83.30
83.30
72072 26
Radiology
0.32
0.32
22.40
22.40
72072 TC
Radiology
0.87
0.87
60.90
60.90
72074 00
Radiology
1.34
1.34
93.80
93.80
72074 26
Radiology
0.35
0.35
24.50
24.50
72074 TC
Radiology
0.99
0.99
69.30
69.30
72080 00
Radiology
1.04
1.04
72.80
72.80
72080 26
Radiology
0.30
0.30
21.00
21.00
72080 TC
Radiology
0.74
0.74
51.80
51.80
72081 00
Radiology
1.28
1.28
89.60
89.60
72081 26
Radiology
0.37
0.37
25.90
25.90
72081 TC
Radiology
0.91
0.91
63.70
63.70
72082 00
Radiology
2.11
2.11
147.70
147.70
72082 26
Radiology
0.45
0.45
31.50
31.50
72082 TC
Radiology
1.66
1.66
116.20
116.20
72083 00
Radiology
2.39
2.39
167.30
167.30
72083 26
Radiology
0.51
0.51
35.70
35.70
72083 TC
Radiology
1.88
1.88
131.60
131.60
72084 00
Radiology
2.96
2.96
207.20
207.20
72084 26
Radiology
0.59
0.59
41.30
41.30
72084 TC
Radiology
2.37
2.37
165.90
165.90
72100 00
Radiology
1.20
1.20
84.00
84.00
72100 26
Radiology
0.32
0.32
22.40
22.40
72100 TC
Radiology
0.88
0.88
61.60
61.60
72110 00
Radiology
1.56
1.56
109.20
109.20
72110 26
Radiology
0.37
0.37
25.90
25.90
72110 TC
Radiology
1.19
1.19
83.30
83.30
72114 00
Radiology
1.84
1.84
128.80
128.80
72114 26
Radiology
0.43
0.43
30.10
30.10
72114 TC
Radiology
1.41
1.41
98.70
98.70
72120 00
Radiology
1.22
1.22
85.40
85.40
72120 26
Radiology
0.32
0.32
22.40
22.40
72120 TC
Radiology
0.90
0.90
63.00
63.00
72125 00
Radiology
4.00
4.00
280.00
280.00
72125 26
Radiology
1.40
1.40
98.00
98.00
72125 TC
Radiology
2.60
2.60
182.00
182.00
72126 00
Radiology
5.19
5.19
363.30
363.30
72126 26
Radiology
1.71
1.71
119.70
119.70
72126 TC
Radiology
3.48
3.48
243.60
243.60
72127 00
Radiology
6.08
6.08
425.60
425.60
72127 26
Radiology
1.78
1.78
124.60
124.60
72127 TC
Radiology
4.30
4.30
301.00
301.00
72128 00
Radiology
3.99
3.99
279.30
279.30
72128 26
Radiology
1.40
1.40
98.00
98.00
72128 TC
Radiology
2.59
2.59
181.30
181.30
72129 00
Radiology
5.23
5.23
366.10
366.10
72129 26
Radiology
1.72
1.72
120.40
120.40
72129 TC
Radiology
3.51
3.51
245.70
245.70
72130 00
Radiology
6.12
6.12
428.40
428.40
72130 26
Radiology
1.79
1.79
125.30
125.30
72130 TC
Radiology
4.33
4.33
303.10
303.10
72131 00
Radiology
3.97
3.97
277.90
277.90
72131 26
Radiology
1.40
1.40
98.00
98.00
72131 TC
Radiology
2.57
2.57
179.90
179.90
72132 00
Radiology
5.20
5.20
364.00
364.00
72132 26
Radiology
1.71
1.71
119.70
119.70
72132 TC
Radiology
3.49
3.49
244.30
244.30
72133 00
Radiology
6.09
6.09
426.30
426.30
72133 26
Radiology
1.78
1.78
124.60
124.60
72133 TC
Radiology
4.31
4.31
301.70
301.70
72141 00
Radiology
5.88
5.88
411.60
411.60
72141 26
Radiology
2.08
2.08
145.60
145.60
72141 TC
Radiology
3.80
3.80
266.00
266.00
72142 00
Radiology
8.50
8.50
595.00
595.00
72142 26
Radiology
2.52
2.52
176.40
176.40
72142 TC
Radiology
5.98
5.98
418.60
418.60
72146 00
Radiology
5.87
5.87
410.90
410.90
72146 26
Radiology
2.08
2.08
145.60
145.60
72146 TC
Radiology
3.79
3.79
265.30
265.30
72147 00
Radiology
8.42
8.42
589.40
589.40
72147 26
Radiology
2.50
2.50
175.00
175.00
72147 TC
Radiology
5.92
5.92
414.40
414.40
72148 00
Radiology
5.90
5.90
413.00
413.00
72148 26
Radiology
2.09
2.09
146.30
146.30
72148 TC
Radiology
3.81
3.81
266.70
266.70
72149 00
Radiology
8.35
8.35
584.50
584.50
72149 26
Radiology
2.51
2.51
175.70
175.70
72149 TC
Radiology
5.84
5.84
408.80
408.80
72156 00
Radiology
9.87
9.87
690.90
690.90
72156 26
Radiology
3.22
3.22
225.40
225.40
72156 TC
Radiology
6.65
6.65
465.50
465.50
72157 00
Radiology
9.89
9.89
692.30
692.30
72157 26
Radiology
3.22
3.22
225.40
225.40
72157 TC
Radiology
6.67
6.67
466.90
466.90
72158 00
Radiology
9.85
9.85
689.50
689.50
72158 26
Radiology
3.22
3.22
225.40
225.40
72158 TC
Radiology
6.63
6.63
464.10
464.10
72159 00
Radiology
10.66
10.66
746.20
746.20
72159 26
Radiology
2.53
2.53
177.10
177.10
72159 TC
Radiology
8.13
8.13
569.10
569.10
72170 00
Radiology
0.84
0.84
58.80
58.80
72170 26
Radiology
0.25
0.25
17.50
17.50
72170 TC
Radiology
0.59
0.59
41.30
41.30
72190 00
Radiology
1.27
1.27
88.90
88.90
72190 26
Radiology
0.36
0.36
25.20
25.20
72190 TC
Radiology
0.91
0.91
63.70
63.70
72191 00
Radiology
9.37
9.37
655.90
655.90
72191 26
Radiology
2.51
2.51
175.70
175.70
72191 TC
Radiology
6.86
6.86
480.20
480.20
72192 00
Radiology
4.09
4.09
286.30
286.30
72192 26
Radiology
1.53
1.53
107.10
107.10
72192 TC
Radiology
2.56
2.56
179.20
179.20
72193 00
Radiology
7.05
7.05
493.50
493.50
72193 26
Radiology
1.63
1.63
114.10
114.10
72193 TC
Radiology
5.42
5.42
379.40
379.40
72194 00
Radiology
7.78
7.78
544.60
544.60
72194 26
Radiology
1.70
1.70
119.00
119.00
72194 TC
Radiology
6.08
6.08
425.60
425.60
72195 00
Radiology
7.07
7.07
494.90
494.90
72195 26
Radiology
2.06
2.06
144.20
144.20
72195 TC
Radiology
5.01
5.01
350.70
350.70
72196 00
Radiology
8.28
8.28
579.60
579.60
72196 26
Radiology
2.42
2.42
169.40
169.40
72196 TC
Radiology
5.86
5.86
410.20
410.20
72197 00
Radiology
10.39
10.39
727.30
727.30
72197 26
Radiology
3.08
3.08
215.60
215.60
72197 TC
Radiology
7.31
7.31
511.70
511.70
72198 00
Radiology
10.43
10.43
730.10
730.10
72198 26
Radiology
2.50
2.50
175.00
175.00
72198 TC
Radiology
7.93
7.93
555.10
555.10
72200 00
Radiology
1.00
1.00
70.00
70.00
72200 26
Radiology
0.24
0.24
16.80
16.80
72200 TC
Radiology
0.76
0.76
53.20
53.20
72202 00
Radiology
1.18
1.18
82.60
82.60
72202 26
Radiology
0.32
0.32
22.40
22.40
72202 TC
Radiology
0.86
0.86
60.20
60.20
72220 00
Radiology
0.98
0.98
68.60
68.60
72220 26
Radiology
0.25
0.25
17.50
17.50
72220 TC
Radiology
0.73
0.73
51.10
51.10
72240 00
Radiology
3.36
3.36
235.20
235.20
72240 26
Radiology
1.29
1.29
90.30
90.30
72240 TC
Radiology
2.07
2.07
144.90
144.90
72255 00
Radiology
3.23
3.23
226.10
226.10
72255 26
Radiology
1.28
1.28
89.60
89.60
72255 TC
Radiology
1.95
1.95
136.50
136.50
72265 00
Radiology
3.27
3.27
228.90
228.90
72265 26
Radiology
1.18
1.18
82.60
82.60
72265 TC
Radiology
2.09
2.09
146.30
146.30
72270 00
Radiology
4.58
4.58
320.60
320.60
72270 26
Radiology
1.93
1.93
135.10
135.10
72270 TC
Radiology
2.65
2.65
185.50
185.50
72285 00
Radiology
3.96
3.96
277.20
277.20
72285 26
Radiology
1.65
1.65
115.50
115.50
72285 TC
Radiology
2.31
2.31
161.70
161.70
72295 00
Radiology
3.34
3.34
233.80
233.80
72295 26
Radiology
1.17
1.17
81.90
81.90
72295 TC
Radiology
2.17
2.17
151.90
151.90
73000 00
Radiology
0.98
0.98
68.60
68.60
73000 26
Radiology
0.24
0.24
16.80
16.80
73000 TC
Radiology
0.74
0.74
51.80
51.80
73010 00
Radiology
0.72
0.72
50.40
50.40
73010 26
Radiology
0.26
0.26
18.20
18.20
73010 TC
Radiology
0.46
0.46
32.20
32.20
73020 00
Radiology
0.65
0.65
45.50
45.50
73020 26
Radiology
0.22
0.22
15.40
15.40
73020 TC
Radiology
0.43
0.43
30.10
30.10
73030 00
Radiology
1.05
1.05
73.50
73.50
73030 26
Radiology
0.27
0.27
18.90
18.90
73030 TC
Radiology
0.78
0.78
54.60
54.60
73040 00
Radiology
3.95
3.95
276.50
276.50
73040 26
Radiology
0.79
0.79
55.30
55.30
73040 TC
Radiology
3.16
3.16
221.20
221.20
73050 00
Radiology
0.87
0.87
60.90
60.90
73050 26
Radiology
0.27
0.27
18.90
18.90
73050 TC
Radiology
0.60
0.60
42.00
42.00
73060 00
Radiology
0.96
0.96
67.20
67.20
73060 26
Radiology
0.23
0.23
16.10
16.10
73060 TC
Radiology
0.73
0.73
51.10
51.10
73070 00
Radiology
0.88
0.88
61.60
61.60
73070 26
Radiology
0.24
0.24
16.80
16.80
73070 TC
Radiology
0.64
0.64
44.80
44.80
73080 00
Radiology
0.99
0.99
69.30
69.30
73080 26
Radiology
0.25
0.25
17.50
17.50
73080 TC
Radiology
0.74
0.74
51.80
51.80
73085 00
Radiology
3.00
3.00
210.00
210.00
73085 26
Radiology
0.76
0.76
53.20
53.20
73085 TC
Radiology
2.24
2.24
156.80
156.80
73090 00
Radiology
0.88
0.88
61.60
61.60
73090 26
Radiology
0.23
0.23
16.10
16.10
73090 TC
Radiology
0.65
0.65
45.50
45.50
73092 00
Radiology
0.95
0.95
66.50
66.50
73092 26
Radiology
0.23
0.23
16.10
16.10
73092 TC
Radiology
0.72
0.72
50.40
50.40
73100 00
Radiology
1.02
1.02
71.40
71.40
73100 26
Radiology
0.24
0.24
16.80
16.80
73100 TC
Radiology
0.78
0.78
54.60
54.60
73110 00
Radiology
1.24
1.24
86.80
86.80
73110 26
Radiology
0.25
0.25
17.50
17.50
73110 TC
Radiology
0.99
0.99
69.30
69.30
73115 00
Radiology
4.05
4.05
283.50
283.50
73115 26
Radiology
0.80
0.80
56.00
56.00
73115 TC
Radiology
3.25
3.25
227.50
227.50
73120 00
Radiology
0.95
0.95
66.50
66.50
73120 26
Radiology
0.24
0.24
16.80
16.80
73120 TC
Radiology
0.71
0.71
49.70
49.70
73130 00
Radiology
1.12
1.12
78.40
78.40
73130 26
Radiology
0.25
0.25
17.50
17.50
73130 TC
Radiology
0.87
0.87
60.90
60.90
73140 00
Radiology
1.15
1.15
80.50
80.50
73140 26
Radiology
0.20
0.20
14.00
14.00
73140 TC
Radiology
0.95
0.95
66.50
66.50
73200 00
Radiology
4.96
4.96
347.20
347.20
73200 26
Radiology
1.40
1.40
98.00
98.00
73200 TC
Radiology
3.56
3.56
249.20
249.20
73201 00
Radiology
6.18
6.18
432.60
432.60
73201 26
Radiology
1.63
1.63
114.10
114.10
73201 TC
Radiology
4.55
4.55
318.50
318.50
73202 00
Radiology
7.66
7.66
536.20
536.20
73202 26
Radiology
1.70
1.70
119.00
119.00
73202 TC
Radiology
5.96
5.96
417.20
417.20
73206 00
Radiology
9.14
9.14
639.80
639.80
73206 26
Radiology
2.51
2.51
175.70
175.70
73206 TC
Radiology
6.63
6.63
464.10
464.10
73218 00
Radiology
9.37
9.37
655.90
655.90
73218 26
Radiology
1.91
1.91
133.70
133.70
73218 TC
Radiology
7.46
7.46
522.20
522.20
73219 00
Radiology
10.23
10.23
716.10
716.10
73219 26
Radiology
2.28
2.28
159.60
159.60
73219 TC
Radiology
7.95
7.95
556.50
556.50
73220 00
Radiology
12.65
12.65
885.50
885.50
73220 26
Radiology
3.02
3.02
211.40
211.40
73220 TC
Radiology
9.63
9.63
674.10
674.10
73221 00
Radiology
6.26
6.26
438.20
438.20
73221 26
Radiology
1.91
1.91
133.70
133.70
73221 TC
Radiology
4.35
4.35
304.50
304.50
73222 00
Radiology
9.67
9.67
676.90
676.90
73222 26
Radiology
2.29
2.29
160.30
160.30
73222 TC
Radiology
7.38
7.38
516.60
516.60
73223 00
Radiology
11.95
11.95
836.50
836.50
73223 26
Radiology
3.03
3.03
212.10
212.10
73223 TC
Radiology
8.92
8.92
624.40
624.40
73225 00
Radiology
10.56
10.56
739.20
739.20
73225 26
Radiology
2.43
2.43
170.10
170.10
73225 TC
Radiology
8.13
8.13
569.10
569.10
73501 00
Radiology
0.99
0.99
69.30
69.30
73501 26
Radiology
0.27
0.27
18.90
18.90
73501 TC
Radiology
0.72
0.72
50.40
50.40
73502 00
Radiology
1.43
1.43
100.10
100.10
73502 26
Radiology
0.32
0.32
22.40
22.40
73502 TC
Radiology
1.11
1.11
77.70
77.70
73503 00
Radiology
1.80
1.80
126.00
126.00
73503 26
Radiology
0.39
0.39
27.30
27.30
73503 TC
Radiology
1.41
1.41
98.70
98.70
73521 00
Radiology
1.24
1.24
86.80
86.80
73521 26
Radiology
0.32
0.32
22.40
22.40
73521 TC
Radiology
0.92
0.92
64.40
64.40
73522 00
Radiology
1.62
1.62
113.40
113.40
73522 26
Radiology
0.42
0.42
29.40
29.40
73522 TC
Radiology
1.20
1.20
84.00
84.00
73523 00
Radiology
1.86
1.86
130.20
130.20
73523 26
Radiology
0.45
0.45
31.50
31.50
73523 TC
Radiology
1.41
1.41
98.70
98.70
73525 00
Radiology
3.87
3.87
270.90
270.90
73525 26
Radiology
0.84
0.84
58.80
58.80
73525 TC
Radiology
3.03
3.03
212.10
212.10
73551 00
Radiology
0.88
0.88
61.60
61.60
73551 26
Radiology
0.24
0.24
16.80
16.80
73551 TC
Radiology
0.64
0.64
44.80
44.80
73552 00
Radiology
1.07
1.07
74.90
74.90
73552 26
Radiology
0.26
0.26
18.20
18.20
73552 TC
Radiology
0.81
0.81
56.70
56.70
73560 00
Radiology
1.03
1.03
72.10
72.10
73560 26
Radiology
0.24
0.24
16.80
16.80
73560 TC
Radiology
0.79
0.79
55.30
55.30
73562 00
Radiology
1.23
1.23
86.10
86.10
73562 26
Radiology
0.27
0.27
18.90
18.90
73562 TC
Radiology
0.96
0.96
67.20
67.20
73564 00
Radiology
1.42
1.42
99.40
99.40
73564 26
Radiology
0.33
0.33
23.10
23.10
73564 TC
Radiology
1.09
1.09
76.30
76.30
73565 00
Radiology
1.20
1.20
84.00
84.00
73565 26
Radiology
0.24
0.24
16.80
16.80
73565 TC
Radiology
0.96
0.96
67.20
67.20
73580 00
Radiology
3.32
3.32
232.40
232.40
73580 26
Radiology
0.91
0.91
63.70
63.70
73580 TC
Radiology
2.41
2.41
168.70
168.70
73590 00
Radiology
0.95
0.95
66.50
66.50
73590 26
Radiology
0.23
0.23
16.10
16.10
73590 TC
Radiology
0.72
0.72
50.40
50.40
73592 00
Radiology
0.95
0.95
66.50
66.50
73592 26
Radiology
0.23
0.23
16.10
16.10
73592 TC
Radiology
0.72
0.72
50.40
50.40
73600 00
Radiology
0.97
0.97
67.90
67.90
73600 26
Radiology
0.23
0.23
16.10
16.10
73600 TC
Radiology
0.74
0.74
51.80
51.80
73610 00
Radiology
1.10
1.10
77.00
77.00
73610 26
Radiology
0.25
0.25
17.50
17.50
73610 TC
Radiology
0.85
0.85
59.50
59.50
73615 00
Radiology
3.84
3.84
268.80
268.80
73615 26
Radiology
0.81
0.81
56.70
56.70
73615 TC
Radiology
3.03
3.03
212.10
212.10
73620 00
Radiology
0.86
0.86
60.20
60.20
73620 26
Radiology
0.22
0.22
15.40
15.40
73620 TC
Radiology
0.64
0.64
44.80
44.80
73630 00
Radiology
1.03
1.03
72.10
72.10
73630 26
Radiology
0.24
0.24
16.80
16.80
73630 TC
Radiology
0.79
0.79
55.30
55.30
73650 00
Radiology
0.86
0.86
60.20
60.20
73650 26
Radiology
0.23
0.23
16.10
16.10
73650 TC
Radiology
0.63
0.63
44.10
44.10
73660 00
Radiology
0.88
0.88
61.60
61.60
73660 26
Radiology
0.19
0.19
13.30
13.30
73660 TC
Radiology
0.69
0.69
48.30
48.30
73700 00
Radiology
3.98
3.98
278.60
278.60
73700 26
Radiology
1.40
1.40
98.00
98.00
73700 TC
Radiology
2.58
2.58
180.60
180.60
73701 00
Radiology
5.13
5.13
359.10
359.10
73701 26
Radiology
1.63
1.63
114.10
114.10
73701 TC
Radiology
3.50
3.50
245.00
245.00
73702 00
Radiology
6.01
6.01
420.70
420.70
73702 26
Radiology
1.70
1.70
119.00
119.00
73702 TC
Radiology
4.31
4.31
301.70
301.70
73706 00
Radiology
9.94
9.94
695.80
695.80
73706 26
Radiology
2.64
2.64
184.80
184.80
73706 TC
Radiology
7.30
7.30
511.00
511.00
73718 00
Radiology
6.89
6.89
482.30
482.30
73718 26
Radiology
1.89
1.89
132.30
132.30
73718 TC
Radiology
5.00
5.00
350.00
350.00
73719 00
Radiology
8.12
8.12
568.40
568.40
73719 26
Radiology
2.27
2.27
158.90
158.90
73719 TC
Radiology
5.85
5.85
409.50
409.50
73720 00
Radiology
10.40
10.40
728.00
728.00
73720 26
Radiology
3.01
3.01
210.70
210.70
73720 TC
Radiology
7.39
7.39
517.30
517.30
73721 00
Radiology
6.25
6.25
437.50
437.50
73721 26
Radiology
1.91
1.91
133.70
133.70
73721 TC
Radiology
4.34
4.34
303.80
303.80
73722 00
Radiology
9.68
9.68
677.60
677.60
73722 26
Radiology
2.28
2.28
159.60
159.60
73722 TC
Radiology
7.40
7.40
518.00
518.00
73723 00
Radiology
11.90
11.90
833.00
833.00
73723 26
Radiology
3.02
3.02
211.40
211.40
73723 TC
Radiology
8.88
8.88
621.60
621.60
73725 00
Radiology
10.36
10.36
725.20
725.20
73725 26
Radiology
2.52
2.52
176.40
176.40
73725 TC
Radiology
7.84
7.84
548.80
548.80
74018 00
Radiology
0.91
0.91
63.70
63.70
74018 26
Radiology
0.26
0.26
18.20
18.20
74018 TC
Radiology
0.65
0.65
45.50
45.50
74019 00
Radiology
1.10
1.10
77.00
77.00
74019 26
Radiology
0.32
0.32
22.40
22.40
74019 TC
Radiology
0.78
0.78
54.60
54.60
74021 00
Radiology
1.29
1.29
90.30
90.30
74021 26
Radiology
0.38
0.38
26.60
26.60
74021 TC
Radiology
0.91
0.91
63.70
63.70
74022 00
Radiology
1.50
1.50
105.00
105.00
74022 26
Radiology
0.45
0.45
31.50
31.50
74022 TC
Radiology
1.05
1.05
73.50
73.50
74150 00
Radiology
4.20
4.20
294.00
294.00
74150 26
Radiology
1.67
1.67
116.90
116.90
74150 TC
Radiology
2.53
2.53
177.10
177.10
74160 00
Radiology
7.18
7.18
502.60
502.60
74160 26
Radiology
1.79
1.79
125.30
125.30
74160 TC
Radiology
5.39
5.39
377.30
377.30
74170 00
Radiology
8.07
8.07
564.90
564.90
74170 26
Radiology
1.96
1.96
137.20
137.20
74170 TC
Radiology
6.11
6.11
427.70
427.70
74174 00
Radiology
11.71
11.71
819.70
819.70
74174 26
Radiology
3.07
3.07
214.90
214.90
74174 TC
Radiology
8.64
8.64
604.80
604.80
74175 00
Radiology
9.41
9.41
658.70
658.70
74175 26
Radiology
2.54
2.54
177.80
177.80
74175 TC
Radiology
6.87
6.87
480.90
480.90
74176 00
Radiology
5.63
5.63
394.10
394.10
74176 26
Radiology
2.44
2.44
170.80
170.80
74176 TC
Radiology
3.19
3.19
223.30
223.30
74177 00
Radiology
9.34
9.34
653.80
653.80
74177 26
Radiology
2.55
2.55
178.50
178.50
74177 TC
Radiology
6.79
6.79
475.30
475.30
74178 00
Radiology
10.48
10.48
733.60
733.60
74178 26
Radiology
2.81
2.81
196.70
196.70
74178 TC
Radiology
7.67
7.67
536.90
536.90
74181 00
Radiology
6.04
6.04
422.80
422.80
74181 26
Radiology
2.05
2.05
143.50
143.50
74181 TC
Radiology
3.99
3.99
279.30
279.30
74182 00
Radiology
9.33
9.33
653.10
653.10
74182 26
Radiology
2.42
2.42
169.40
169.40
74182 TC
Radiology
6.91
6.91
483.70
483.70
74183 00
Radiology
10.43
10.43
730.10
730.10
74183 26
Radiology
3.08
3.08
215.60
215.60
74183 TC
Radiology
7.35
7.35
514.50
514.50
74185 00
Radiology
10.39
10.39
727.30
727.30
74185 26
Radiology
2.50
2.50
175.00
175.00
74185 TC
Radiology
7.89
7.89
552.30
552.30
74190 00
Radiology
-
-
151.90
151.90
74190 26
Radiology
0.65
0.65
45.50
45.50
74190 TC
Radiology
-
-
106.40
106.40
74210 00
Radiology
2.84
2.84
198.80
198.80
74210 26
Radiology
0.82
0.82
57.40
57.40
74210 TC
Radiology
2.02
2.02
141.40
141.40
74220 00
Radiology
2.92
2.92
204.40
204.40
74220 26
Radiology
0.84
0.84
58.80
58.80
74220 TC
Radiology
2.08
2.08
145.60
145.60
74221 00
Radiology
3.29
3.29
230.30
230.30
74221 26
Radiology
0.98
0.98
68.60
68.60
74221 TC
Radiology
2.31
2.31
161.70
161.70
74230 00
Radiology
3.74
3.74
261.80
261.80
74230 26
Radiology
0.75
0.75
52.50
52.50
74230 TC
Radiology
2.99
2.99
209.30
209.30
74235 00
Radiology
-
-
333.90
333.90
74235 26
Radiology
1.67
1.67
116.90
116.90
74235 TC
Radiology
-
-
217.00
217.00
74240 00
Radiology
3.68
3.68
257.60
257.60
74240 26
Radiology
1.13
1.13
79.10
79.10
74240 TC
Radiology
2.55
2.55
178.50
178.50
74246 00
Radiology
4.17
4.17
291.90
291.90
74246 26
Radiology
1.26
1.26
88.20
88.20
74246 TC
Radiology
2.91
2.91
203.70
203.70
74248 00
Radiology
2.47
2.47
172.90
172.90
74248 26
Radiology
0.98
0.98
68.60
68.60
74248 TC
Radiology
1.49
1.49
104.30
104.30
74250 00
Radiology
3.65
3.65
255.50
255.50
74250 26
Radiology
1.13
1.13
79.10
79.10
74250 TC
Radiology
2.52
2.52
176.40
176.40
74251 00
Radiology
10.87
10.87
760.90
760.90
74251 26
Radiology
1.64
1.64
114.80
114.80
74251 TC
Radiology
9.23
9.23
646.10
646.10
74261 00
Radiology
12.76
12.76
893.20
893.20
74261 26
Radiology
3.36
3.36
235.20
235.20
74261 TC
Radiology
9.40
9.40
658.00
658.00
74262 00
Radiology
14.36
14.36
1005.20
1005.20
74262 26
Radiology
3.51
3.51
245.70
245.70
74262 TC
Radiology
10.85
10.85
759.50
759.50
74263 00
Radiology
20.22
20.22
1415.40
1415.40
74263 26
Radiology
3.21
3.21
224.70
224.70
74263 TC
Radiology
17.01
17.01
1190.70
1190.70
74270 00
Radiology
4.60
4.60
322.00
322.00
74270 26
Radiology
1.45
1.45
101.50
101.50
74270 TC
Radiology
3.15
3.15
220.50
220.50
74280 00
Radiology
6.59
6.59
461.30
461.30
74280 26
Radiology
1.77
1.77
123.90
123.90
74280 TC
Radiology
4.82
4.82
337.40
337.40
74283 00
Radiology
7.64
7.64
534.80
534.80
74283 26
Radiology
2.95
2.95
206.50
206.50
74283 TC
Radiology
4.69
4.69
328.30
328.30
74290 00
Radiology
2.55
2.55
178.50
178.50
74290 26
Radiology
0.45
0.45
31.50
31.50
74290 TC
Radiology
2.10
2.10
147.00
147.00
74300 00
Radiology
-
-
91.00
91.00
74300 26
Radiology
0.39
0.39
27.30
27.30
74300 TC
Radiology
-
-
63.70
63.70
74301 00
Radiology
-
-
81.20
81.20
74301 26
Radiology
0.29
0.29
20.30
20.30
74301 TC
Radiology
-
-
60.90
60.90
74328 00
Radiology
-
-
226.80
226.80
74328 26
Radiology
0.68
0.68
47.60
47.60
74328 TC
Radiology
-
-
179.20
179.20
74329 00
Radiology
-
-
219.80
219.80
74329 26
Radiology
0.69
0.69
48.30
48.30
74329 TC
Radiology
-
-
171.50
171.50
74330 00
Radiology
-
-
207.20
207.20
74330 26
Radiology
0.80
0.80
56.00
56.00
74330 TC
Radiology
-
-
151.20
151.20
74340 00
Radiology
-
-
276.50
276.50
74340 26
Radiology
0.75
0.75
52.50
52.50
74340 TC
Radiology
-
-
224.00
224.00
74355 00
Radiology
-
-
277.20
277.20
74355 26
Radiology
1.07
1.07
74.90
74.90
74355 TC
Radiology
-
-
202.30
202.30
74360 00
Radiology
-
-
329.70
329.70
74360 26
Radiology
0.80
0.80
56.00
56.00
74360 TC
Radiology
-
-
273.70
273.70
74363 00
Radiology
-
-
449.40
449.40
74363 26
Radiology
1.22
1.22
85.40
85.40
74363 TC
Radiology
-
-
364.00
364.00
74400 00
Radiology
4.05
4.05
283.50
283.50
74400 26
Radiology
0.69
0.69
48.30
48.30
74400 TC
Radiology
3.36
3.36
235.20
235.20
74410 00
Radiology
4.25
4.25
297.50
297.50
74410 26
Radiology
0.68
0.68
47.60
47.60
74410 TC
Radiology
3.57
3.57
249.90
249.90
74415 00
Radiology
4.53
4.53
317.10
317.10
74415 26
Radiology
0.68
0.68
47.60
47.60
74415 TC
Radiology
3.85
3.85
269.50
269.50
74420 00
Radiology
2.34
2.34
163.80
163.80
74420 26
Radiology
0.72
0.72
50.40
50.40
74420 TC
Radiology
1.62
1.62
113.40
113.40
74425 00
Radiology
4.07
4.07
284.90
284.90
74425 26
Radiology
0.70
0.70
49.00
49.00
74425 TC
Radiology
3.37
3.37
235.90
235.90
74430 00
Radiology
1.24
1.24
86.80
86.80
74430 26
Radiology
0.45
0.45
31.50
31.50
74430 TC
Radiology
0.79
0.79
55.30
55.30
74440 00
Radiology
2.92
2.92
204.40
204.40
74440 26
Radiology
0.52
0.52
36.40
36.40
74440 TC
Radiology
2.40
2.40
168.00
168.00
74445 00
Radiology
-
-
193.90
193.90
74445 26
Radiology
1.58
1.58
110.60
110.60
74445 TC
Radiology
-
-
83.30
83.30
74450 00
Radiology
-
-
140.00
140.00
74450 26
Radiology
0.46
0.46
32.20
32.20
74450 TC
Radiology
-
-
107.80
107.80
74455 00
Radiology
3.12
3.12
218.40
218.40
74455 26
Radiology
0.46
0.46
32.20
32.20
74455 TC
Radiology
2.66
2.66
186.20
186.20
74470 00
Radiology
-
-
142.10
142.10
74470 26
Radiology
0.73
0.73
51.10
51.10
74470 TC
Radiology
-
-
91.00
91.00
74485 00
Radiology
3.58
3.58
250.60
250.60
74485 26
Radiology
1.15
1.15
80.50
80.50
74485 TC
Radiology
2.43
2.43
170.10
170.10
74712 00
Radiology
12.60
12.60
882.00
882.00
74712 26
Radiology
4.22
4.22
295.40
295.40
74712 TC
Radiology
8.38
8.38
586.60
586.60
74713 00
Radiology
6.12
6.12
428.40
428.40
74713 26
Radiology
2.60
2.60
182.00
182.00
74713 TC
Radiology
3.52
3.52
246.40
246.40
74740 00
Radiology
2.81
2.81
196.70
196.70
74740 26
Radiology
0.54
0.54
37.80
37.80
74740 TC
Radiology
2.27
2.27
158.90
158.90
74742 00
Radiology
-
-
240.80
240.80
74742 26
Radiology
0.86
0.86
60.20
60.20
74742 TC
Radiology
-
-
180.60
180.60
74775 00
Radiology
-
-
196.70
196.70
74775 26
Radiology
0.87
0.87
60.90
60.90
74775 TC
Radiology
-
-
135.80
135.80
75557 00
Radiology
8.58
8.58
600.60
600.60
75557 26
Radiology
3.26
3.26
228.20
228.20
75557 TC
Radiology
5.32
5.32
372.40
372.40
75559 00
Radiology
11.54
11.54
807.80
807.80
75559 26
Radiology
4.05
4.05
283.50
283.50
75559 TC
Radiology
7.49
7.49
524.30
524.30
75561 00
Radiology
11.21
11.21
784.70
784.70
75561 26
Radiology
3.61
3.61
252.70
252.70
75561 TC
Radiology
7.60
7.60
532.00
532.00
75563 00
Radiology
13.07
13.07
914.90
914.90
75563 26
Radiology
4.13
4.13
289.10
289.10
75563 TC
Radiology
8.94
8.94
625.80
625.80
75565 00
Radiology
1.40
1.40
98.00
98.00
75565 26
Radiology
0.35
0.35
24.50
24.50
75565 TC
Radiology
1.05
1.05
73.50
73.50
75571 00
Radiology
3.07
3.07
214.90
214.90
75571 26
Radiology
0.81
0.81
56.70
56.70
75571 TC
Radiology
2.26
2.26
158.20
158.20
75572 00
Radiology
7.00
7.00
490.00
490.00
75572 26
Radiology
2.43
2.43
170.10
170.10
75572 TC
Radiology
4.57
4.57
319.90
319.90
75573 00
Radiology
9.34
9.34
653.80
653.80
75573 26
Radiology
3.55
3.55
248.50
248.50
75573 TC
Radiology
5.79
5.79
405.30
405.30
75574 00
Radiology
9.90
9.90
693.00
693.00
75574 26
Radiology
3.34
3.34
233.80
233.80
75574 TC
Radiology
6.56
6.56
459.20
459.20
75580 00
Radiology
27.12
27.12
1898.40
1898.40
75580 26
Radiology
1.04
1.04
72.80
72.80
75580 TC
Radiology
26.08
26.08
1825.60
1825.60
75600 00
Radiology
5.47
5.47
382.90
382.90
75600 26
Radiology
0.69
0.69
48.30
48.30
75600 TC
Radiology
4.78
4.78
334.60
334.60
75605 00
Radiology
3.62
3.62
253.40
253.40
75605 26
Radiology
1.57
1.57
109.90
109.90
75605 TC
Radiology
2.05
2.05
143.50
143.50
75625 00
Radiology
3.79
3.79
265.30
265.30
75625 26
Radiology
1.99
1.99
139.30
139.30
75625 TC
Radiology
1.80
1.80
126.00
126.00
75630 00
Radiology
4.70
4.70
329.00
329.00
75630 26
Radiology
2.76
2.76
193.20
193.20
75630 TC
Radiology
1.94
1.94
135.80
135.80
75635 00
Radiology
12.64
12.64
884.80
884.80
75635 26
Radiology
3.32
3.32
232.40
232.40
75635 TC
Radiology
9.32
9.32
652.40
652.40
75705 00
Radiology
7.51
7.51
525.70
525.70
75705 26
Radiology
3.44
3.44
240.80
240.80
75705 TC
Radiology
4.07
4.07
284.90
284.90
75710 00
Radiology
4.50
4.50
315.00
315.00
75710 26
Radiology
2.43
2.43
170.10
170.10
75710 TC
Radiology
2.07
2.07
144.90
144.90
75716 00
Radiology
4.88
4.88
341.60
341.60
75716 26
Radiology
2.72
2.72
190.40
190.40
75716 TC
Radiology
2.16
2.16
151.20
151.20
75726 00
Radiology
5.09
5.09
356.30
356.30
75726 26
Radiology
2.76
2.76
193.20
193.20
75726 TC
Radiology
2.33
2.33
163.10
163.10
75731 00
Radiology
4.60
4.60
322.00
322.00
75731 26
Radiology
1.60
1.60
112.00
112.00
75731 TC
Radiology
3.00
3.00
210.00
210.00
75733 00
Radiology
5.17
5.17
361.90
361.90
75733 26
Radiology
1.80
1.80
126.00
126.00
75733 TC
Radiology
3.37
3.37
235.90
235.90
75736 00
Radiology
4.30
4.30
301.00
301.00
75736 26
Radiology
1.53
1.53
107.10
107.10
75736 TC
Radiology
2.77
2.77
193.90
193.90
75741 00
Radiology
3.89
3.89
272.30
272.30
75741 26
Radiology
1.77
1.77
123.90
123.90
75741 TC
Radiology
2.12
2.12
148.40
148.40
75743 00
Radiology
4.42
4.42
309.40
309.40
75743 26
Radiology
2.26
2.26
158.20
158.20
75743 TC
Radiology
2.16
2.16
151.20
151.20
75746 00
Radiology
4.04
4.04
282.80
282.80
75746 26
Radiology
1.55
1.55
108.50
108.50
75746 TC
Radiology
2.49
2.49
174.30
174.30
75756 00
Radiology
4.95
4.95
346.50
346.50
75756 26
Radiology
1.61
1.61
112.70
112.70
75756 TC
Radiology
3.34
3.34
233.80
233.80
75774 00
Radiology
2.89
2.89
202.30
202.30
75774 26
Radiology
1.36
1.36
95.20
95.20
75774 TC
Radiology
1.53
1.53
107.10
107.10
75801 00
Radiology
-
-
518.70
518.70
75801 26
Radiology
1.26
1.26
88.20
88.20
75801 TC
Radiology
-
-
430.50
430.50
75803 00
Radiology
-
-
525.00
525.00
75803 26
Radiology
1.65
1.65
115.50
115.50
75803 TC
Radiology
-
-
409.50
409.50
75805 00
Radiology
-
-
532.00
532.00
75805 26
Radiology
1.14
1.14
79.80
79.80
75805 TC
Radiology
-
-
452.20
452.20
75807 00
Radiology
-
-
542.50
542.50
75807 26
Radiology
1.55
1.55
108.50
108.50
75807 TC
Radiology
-
-
434.00
434.00
75809 00
Radiology
2.45
2.45
171.50
171.50
75809 26
Radiology
0.67
0.67
46.90
46.90
75809 TC
Radiology
1.78
1.78
124.60
124.60
75810 00
Radiology
-
-
903.70
903.70
75810 26
Radiology
1.42
1.42
99.40
99.40
75810 TC
Radiology
-
-
804.30
804.30
75820 00
Radiology
3.23
3.23
226.10
226.10
75820 26
Radiology
1.45
1.45
101.50
101.50
75820 TC
Radiology
1.78
1.78
124.60
124.60
75822 00
Radiology
4.00
4.00
280.00
280.00
75822 26
Radiology
2.03
2.03
142.10
142.10
75822 TC
Radiology
1.97
1.97
137.90
137.90
75825 00
Radiology
3.42
3.42
239.40
239.40
75825 26
Radiology
1.57
1.57
109.90
109.90
75825 TC
Radiology
1.85
1.85
129.50
129.50
75827 00
Radiology
3.56
3.56
249.20
249.20
75827 26
Radiology
1.58
1.58
110.60
110.60
75827 TC
Radiology
1.98
1.98
138.60
138.60
75831 00
Radiology
3.58
3.58
250.60
250.60
75831 26
Radiology
1.52
1.52
106.40
106.40
75831 TC
Radiology
2.06
2.06
144.20
144.20
75833 00
Radiology
4.43
4.43
310.10
310.10
75833 26
Radiology
2.05
2.05
143.50
143.50
75833 TC
Radiology
2.38
2.38
166.60
166.60
75840 00
Radiology
3.85
3.85
269.50
269.50
75840 26
Radiology
1.60
1.60
112.00
112.00
75840 TC
Radiology
2.25
2.25
157.50
157.50
75842 00
Radiology
4.76
4.76
333.20
333.20
75842 26
Radiology
2.10
2.10
147.00
147.00
75842 TC
Radiology
2.66
2.66
186.20
186.20
75860 00
Radiology
3.76
3.76
263.20
263.20
75860 26
Radiology
1.57
1.57
109.90
109.90
75860 TC
Radiology
2.19
2.19
153.30
153.30
75870 00
Radiology
4.66
4.66
326.20
326.20
75870 26
Radiology
1.72
1.72
120.40
120.40
75870 TC
Radiology
2.94
2.94
205.80
205.80
75872 00
Radiology
3.85
3.85
269.50
269.50
75872 26
Radiology
1.60
1.60
112.00
112.00
75872 TC
Radiology
2.25
2.25
157.50
157.50
75880 00
Radiology
3.23
3.23
226.10
226.10
75880 26
Radiology
0.99
0.99
69.30
69.30
75880 TC
Radiology
2.24
2.24
156.80
156.80
75885 00
Radiology
4.09
4.09
286.30
286.30
75885 26
Radiology
1.92
1.92
134.40
134.40
75885 TC
Radiology
2.17
2.17
151.90
151.90
75887 00
Radiology
4.12
4.12
288.40
288.40
75887 26
Radiology
1.93
1.93
135.10
135.10
75887 TC
Radiology
2.19
2.19
153.30
153.30
75889 00
Radiology
3.70
3.70
259.00
259.00
75889 26
Radiology
1.53
1.53
107.10
107.10
75889 TC
Radiology
2.17
2.17
151.90
151.90
75891 00
Radiology
3.72
3.72
260.40
260.40
75891 26
Radiology
1.53
1.53
107.10
107.10
75891 TC
Radiology
2.19
2.19
153.30
153.30
75893 00
Radiology
3.15
3.15
220.50
220.50
75893 26
Radiology
0.75
0.75
52.50
52.50
75893 TC
Radiology
2.40
2.40
168.00
168.00
75894 00
Radiology
-
-
2109.80
2109.80
75894 26
Radiology
2.11
2.11
147.70
147.70
75894 TC
Radiology
-
-
1962.10
1962.10
75898 00
Radiology
-
-
280.70
280.70
75898 26
Radiology
2.69
2.69
188.30
188.30
75898 TC
Radiology
-
-
92.40
92.40
75901 00
Radiology
6.82
6.82
477.40
477.40
75901 26
Radiology
0.66
0.66
46.20
46.20
75901 TC
Radiology
6.16
6.16
431.20
431.20
75902 00
Radiology
2.63
2.63
184.10
184.10
75902 26
Radiology
0.53
0.53
37.10
37.10
75902 TC
Radiology
2.10
2.10
147.00
147.00
75956 00
Radiology
-
-
1711.50
1711.50
75956 26
Radiology
9.78
9.78
684.60
684.60
75956 TC
Radiology
-
-
1026.90
1026.90
75957 00
Radiology
-
-
1633.10
1633.10
75957 26
Radiology
8.40
8.40
588.00
588.00
75957 TC
Radiology
-
-
1045.10
1045.10
75958 00
Radiology
-
-
1071.70
1071.70
75958 26
Radiology
5.51
5.51
385.70
385.70
75958 TC
Radiology
-
-
686.00
686.00
75959 00
Radiology
-
-
977.90
977.90
75959 26
Radiology
4.89
4.89
342.30
342.30
75959 TC
Radiology
-
-
635.60
635.60
75970 00
Radiology
-
-
863.10
863.10
75970 26
Radiology
1.11
1.11
77.70
77.70
75970 TC
Radiology
-
-
785.40
785.40
75984 00
Radiology
2.86
2.86
200.20
200.20
75984 26
Radiology
1.12
1.12
78.40
78.40
75984 TC
Radiology
1.74
1.74
121.80
121.80
75989 00
Radiology
3.34
3.34
233.80
233.80
75989 26
Radiology
1.63
1.63
114.10
114.10
75989 TC
Radiology
1.71
1.71
119.70
119.70
76000 00
Radiology
1.28
1.28
89.60
89.60
76000 26
Radiology
0.44
0.44
30.80
30.80
76000 TC
Radiology
0.84
0.84
58.80
58.80
76010 00
Radiology
0.88
0.88
61.60
61.60
76010 26
Radiology
0.25
0.25
17.50
17.50
76010 TC
Radiology
0.63
0.63
44.10
44.10
76080 00
Radiology
1.79
1.79
125.30
125.30
76080 26
Radiology
0.73
0.73
51.10
51.10
76080 TC
Radiology
1.06
1.06
74.20
74.20
76098 00
Radiology
1.28
1.28
89.60
89.60
76098 26
Radiology
0.45
0.45
31.50
31.50
76098 TC
Radiology
0.83
0.83
58.10
58.10
76100 00
Radiology
2.68
2.68
187.60
187.60
76100 26
Radiology
0.82
0.82
57.40
57.40
76100 TC
Radiology
1.86
1.86
130.20
130.20
76120 00
Radiology
3.54
3.54
247.80
247.80
76120 26
Radiology
0.57
0.57
39.90
39.90
76120 TC
Radiology
2.97
2.97
207.90
207.90
76125 00
Radiology
-
-
88.20
88.20
76125 26
Radiology
0.39
0.39
27.30
27.30
76125 TC
Radiology
-
-
60.90
60.90
76140 00
Radiology
0.00
0.00
BR
BR
76145 00
Radiology
27.21
27.21
1904.70
1904.70
76376 00
Radiology
0.75
0.75
52.50
52.50
76376 26
Radiology
0.28
0.28
19.60
19.60
76376 TC
Radiology
0.47
0.47
32.90
32.90
76377 00
Radiology
2.34
2.34
163.80
163.80
76377 26
Radiology
1.12
1.12
78.40
78.40
76377 TC
Radiology
1.22
1.22
85.40
85.40
76380 00
Radiology
4.02
4.02
281.40
281.40
76380 26
Radiology
1.34
1.34
93.80
93.80
76380 TC
Radiology
2.68
2.68
187.60
187.60
76390 00
Radiology
-
-
1099.00
1099.00
76390 26
Radiology
-
-
186.90
186.90
76390 TC
Radiology
-
-
912.10
912.10
76391 00
Radiology
6.20
6.20
434.00
434.00
76391 26
Radiology
1.55
1.55
108.50
108.50
76391 TC
Radiology
4.65
4.65
325.50
325.50
76496 00
Radiology
0.00
0.00
BR
BR
76496 26
Radiology
0.00
0.00
BR
BR
76496 TC
Radiology
0.00
0.00
BR
BR
76497 00
Radiology
0.00
0.00
BR
BR
76497 26
Radiology
0.00
0.00
BR
BR
76497 TC
Radiology
0.00
0.00
BR
BR
76498 00
Radiology
0.00
0.00
BR
BR
76498 26
Radiology
0.00
0.00
BR
BR
76498 TC
Radiology
0.00
0.00
BR
BR
76499 00
Radiology
0.00
0.00
BR
BR
76499 26
Radiology
0.00
0.00
BR
BR
76499 TC
Radiology
0.00
0.00
BR
BR
76506 00
Radiology
3.39
3.39
237.30
237.30
76506 26
Radiology
0.92
0.92
64.40
64.40
76506 TC
Radiology
2.47
2.47
172.90
172.90
76510 00
Radiology
2.06
2.06
144.20
144.20
76510 26
Radiology
1.15
1.15
80.50
80.50
76510 TC
Radiology
0.91
0.91
63.70
63.70
76511 00
Radiology
1.71
1.71
119.70
119.70
76511 26
Radiology
1.05
1.05
73.50
73.50
76511 TC
Radiology
0.66
0.66
46.20
46.20
76512 00
Radiology
1.44
1.44
100.80
100.80
76512 26
Radiology
0.90
0.90
63.00
63.00
76512 TC
Radiology
0.54
0.54
37.80
37.80
76513 00
Radiology
2.25
2.25
157.50
157.50
76513 26
Radiology
0.95
0.95
66.50
66.50
76513 TC
Radiology
1.30
1.30
91.00
91.00
76514 00
Radiology
0.34
0.34
23.80
23.80
76514 26
Radiology
0.23
0.23
16.10
16.10
76514 TC
Radiology
0.11
0.11
7.70
7.70
76516 00
Radiology
1.40
1.40
98.00
98.00
76516 26
Radiology
0.66
0.66
46.20
46.20
76516 TC
Radiology
0.74
0.74
51.80
51.80
76519 00
Radiology
2.04
2.04
142.80
142.80
76519 26
Radiology
0.89
0.89
62.30
62.30
76519 TC
Radiology
1.15
1.15
80.50
80.50
76529 00
Radiology
2.57
2.57
179.90
179.90
76529 26
Radiology
0.95
0.95
66.50
66.50
76529 TC
Radiology
1.62
1.62
113.40
113.40
76536 00
Radiology
3.31
3.31
231.70
231.70
76536 26
Radiology
0.79
0.79
55.30
55.30
76536 TC
Radiology
2.52
2.52
176.40
176.40
76604 00
Radiology
1.71
1.71
119.70
119.70
76604 26
Radiology
0.80
0.80
56.00
56.00
76604 TC
Radiology
0.91
0.91
63.70
63.70
76641 00
Radiology
3.08
3.08
215.60
215.60
76641 26
Radiology
1.03
1.03
72.10
72.10
76641 TC
Radiology
2.05
2.05
143.50
143.50
76642 00
Radiology
2.55
2.55
178.50
178.50
76642 26
Radiology
0.96
0.96
67.20
67.20
76642 TC
Radiology
1.59
1.59
111.30
111.30
76700 00
Radiology
3.49
3.49
244.30
244.30
76700 26
Radiology
1.13
1.13
79.10
79.10
76700 TC
Radiology
2.36
2.36
165.20
165.20
76705 00
Radiology
2.61
2.61
182.70
182.70
76705 26
Radiology
0.82
0.82
57.40
57.40
76705 TC
Radiology
1.79
1.79
125.30
125.30
76706 00
Radiology
3.20
3.20
224.00
224.00
76706 26
Radiology
0.77
0.77
53.90
53.90
76706 TC
Radiology
2.43
2.43
170.10
170.10
76770 00
Radiology
3.25
3.25
227.50
227.50
76770 26
Radiology
1.04
1.04
72.80
72.80
76770 TC
Radiology
2.21
2.21
154.70
154.70
76775 00
Radiology
1.79
1.79
125.30
125.30
76775 26
Radiology
0.81
0.81
56.70
56.70
76775 TC
Radiology
0.98
0.98
68.60
68.60
76776 00
Radiology
4.42
4.42
309.40
309.40
76776 26
Radiology
1.06
1.06
74.20
74.20
76776 TC
Radiology
3.36
3.36
235.20
235.20
76800 00
Radiology
5.19
5.19
363.30
363.30
76800 26
Radiology
1.84
1.84
128.80
128.80
76800 TC
Radiology
3.35
3.35
234.50
234.50
76801 00
Radiology
3.52
3.52
246.40
246.40
76801 26
Radiology
1.39
1.39
97.30
97.30
76801 TC
Radiology
2.13
2.13
149.10
149.10
76802 00
Radiology
1.80
1.80
126.00
126.00
76802 26
Radiology
1.17
1.17
81.90
81.90
76802 TC
Radiology
0.63
0.63
44.10
44.10
76805 00
Radiology
4.07
4.07
284.90
284.90
76805 26
Radiology
1.40
1.40
98.00
98.00
76805 TC
Radiology
2.67
2.67
186.90
186.90
76810 00
Radiology
2.62
2.62
183.40
183.40
76810 26
Radiology
1.38
1.38
96.60
96.60
76810 TC
Radiology
1.24
1.24
86.80
86.80
76811 00
Radiology
5.32
5.32
372.40
372.40
76811 26
Radiology
2.67
2.67
186.90
186.90
76811 TC
Radiology
2.65
2.65
185.50
185.50
76812 00
Radiology
5.75
5.75
402.50
402.50
76812 26
Radiology
2.51
2.51
175.70
175.70
76812 TC
Radiology
3.24
3.24
226.80
226.80
76813 00
Radiology
3.47
3.47
242.90
242.90
76813 26
Radiology
1.66
1.66
116.20
116.20
76813 TC
Radiology
1.81
1.81
126.70
126.70
76814 00
Radiology
2.23
2.23
156.10
156.10
76814 26
Radiology
1.39
1.39
97.30
97.30
76814 TC
Radiology
0.84
0.84
58.80
58.80
76815 00
Radiology
2.43
2.43
170.10
170.10
76815 26
Radiology
0.91
0.91
63.70
63.70
76815 TC
Radiology
1.52
1.52
106.40
106.40
76816 00
Radiology
3.30
3.30
231.00
231.00
76816 26
Radiology
1.20
1.20
84.00
84.00
76816 TC
Radiology
2.10
2.10
147.00
147.00
76817 00
Radiology
2.78
2.78
194.60
194.60
76817 26
Radiology
1.06
1.06
74.20
74.20
76817 TC
Radiology
1.72
1.72
120.40
120.40
76818 00
Radiology
3.56
3.56
249.20
249.20
76818 26
Radiology
1.48
1.48
103.60
103.60
76818 TC
Radiology
2.08
2.08
145.60
145.60
76819 00
Radiology
2.57
2.57
179.90
179.90
76819 26
Radiology
1.08
1.08
75.60
75.60
76819 TC
Radiology
1.49
1.49
104.30
104.30
76820 00
Radiology
1.34
1.34
93.80
93.80
76820 26
Radiology
0.70
0.70
49.00
49.00
76820 TC
Radiology
0.64
0.64
44.80
44.80
76821 00
Radiology
2.67
2.67
186.90
186.90
76821 26
Radiology
0.99
0.99
69.30
69.30
76821 TC
Radiology
1.68
1.68
117.60
117.60
76825 00
Radiology
7.85
7.85
549.50
549.50
76825 26
Radiology
2.34
2.34
163.80
163.80
76825 TC
Radiology
5.51
5.51
385.70
385.70
76826 00
Radiology
4.70
4.70
329.00
329.00
76826 26
Radiology
1.16
1.16
81.20
81.20
76826 TC
Radiology
3.54
3.54
247.80
247.80
76827 00
Radiology
2.10
2.10
147.00
147.00
76827 26
Radiology
0.82
0.82
57.40
57.40
76827 TC
Radiology
1.28
1.28
89.60
89.60
76828 00
Radiology
1.46
1.46
102.20
102.20
76828 26
Radiology
0.78
0.78
54.60
54.60
76828 TC
Radiology
0.68
0.68
47.60
47.60
76830 00
Radiology
3.58
3.58
250.60
250.60
76830 26
Radiology
0.97
0.97
67.90
67.90
76830 TC
Radiology
2.61
2.61
182.70
182.70
76831 00
Radiology
3.49
3.49
244.30
244.30
76831 26
Radiology
1.02
1.02
71.40
71.40
76831 TC
Radiology
2.47
2.47
172.90
172.90
76856 00
Radiology
3.16
3.16
221.20
221.20
76856 26
Radiology
0.96
0.96
67.20
67.20
76856 TC
Radiology
2.20
2.20
154.00
154.00
76857 00
Radiology
1.48
1.48
103.60
103.60
76857 26
Radiology
0.69
0.69
48.30
48.30
76857 TC
Radiology
0.79
0.79
55.30
55.30
76870 00
Radiology
3.00
3.00
210.00
210.00
76870 26
Radiology
0.89
0.89
62.30
62.30
76870 TC
Radiology
2.11
2.11
147.70
147.70
76872 00
Radiology
6.04
6.04
422.80
422.80
76872 26
Radiology
0.96
0.96
67.20
67.20
76872 TC
Radiology
5.08
5.08
355.60
355.60
76873 00
Radiology
5.27
5.27
368.90
368.90
76873 26
Radiology
2.26
2.26
158.20
158.20
76873 TC
Radiology
3.01
3.01
210.70
210.70
76881 00
Radiology
1.61
1.61
112.70
112.70
76881 26
Radiology
1.28
1.28
89.60
89.60
76881 TC
Radiology
0.33
0.33
23.10
23.10
76882 00
Radiology
1.90
1.90
133.00
133.00
76882 26
Radiology
0.97
0.97
67.90
67.90
76882 TC
Radiology
0.93
0.93
65.10
65.10
76883 00
Radiology
2.14
2.14
149.80
149.80
76883 26
Radiology
1.71
1.71
119.70
119.70
76883 TC
Radiology
0.43
0.43
30.10
30.10
76885 00
Radiology
4.07
4.07
284.90
284.90
76885 26
Radiology
1.04
1.04
72.80
72.80
76885 TC
Radiology
3.03
3.03
212.10
212.10
76886 00
Radiology
2.99
2.99
209.30
209.30
76886 26
Radiology
0.87
0.87
60.90
60.90
76886 TC
Radiology
2.12
2.12
148.40
148.40
76932 00
Radiology
-
-
200.20
200.20
76932 26
Radiology
1.06
1.06
74.20
74.20
76932 TC
Radiology
-
-
126.00
126.00
76936 00
Radiology
7.81
7.81
546.70
546.70
76936 26
Radiology
2.76
2.76
193.20
193.20
76936 TC
Radiology
5.05
5.05
353.50
353.50
76937 00
Radiology
1.15
1.15
80.50
80.50
76937 26
Radiology
0.41
0.41
28.70
28.70
76937 TC
Radiology
0.74
0.74
51.80
51.80
76940 00
Radiology
-
-
333.90
333.90
76940 26
Radiology
2.96
2.96
207.20
207.20
76940 TC
Radiology
-
-
126.70
126.70
76941 00
Radiology
-
-
245.00
245.00
76941 26
Radiology
1.89
1.89
132.30
132.30
76941 TC
Radiology
-
-
112.70
112.70
76942 00
Radiology
1.74
1.74
121.80
121.80
76942 26
Radiology
0.89
0.89
62.30
62.30
76942 TC
Radiology
0.85
0.85
59.50
59.50
76945 00
Radiology
-
-
182.70
182.70
76945 26
Radiology
0.94
0.94
65.80
65.80
76945 TC
Radiology
-
-
116.90
116.90
76946 00
Radiology
1.00
1.00
70.00
70.00
76946 26
Radiology
0.54
0.54
37.80
37.80
76946 TC
Radiology
0.46
0.46
32.20
32.20
76948 00
Radiology
2.42
2.42
169.40
169.40
76948 26
Radiology
0.94
0.94
65.80
65.80
76948 TC
Radiology
1.48
1.48
103.60
103.60
76965 00
Radiology
2.83
2.83
198.10
198.10
76965 26
Radiology
2.00
2.00
140.00
140.00
76965 TC
Radiology
0.83
0.83
58.10
58.10
76975 00
Radiology
-
-
205.10
205.10
76975 26
Radiology
1.20
1.20
84.00
84.00
76975 TC
Radiology
-
-
121.10
121.10
76977 00
Radiology
0.22
0.22
15.40
15.40
76977 26
Radiology
0.08
0.08
5.60
5.60
76977 TC
Radiology
0.14
0.14
9.80
9.80
76978 00
Radiology
6.65
6.65
465.50
465.50
76978 26
Radiology
2.28
2.28
159.60
159.60
76978 TC
Radiology
4.37
4.37
305.90
305.90
76979 00
Radiology
4.28
4.28
299.60
299.60
76979 26
Radiology
1.19
1.19
83.30
83.30
76979 TC
Radiology
3.09
3.09
216.30
216.30
76981 00
Radiology
3.13
3.13
219.10
219.10
76981 26
Radiology
0.84
0.84
58.80
58.80
76981 TC
Radiology
2.29
2.29
160.30
160.30
76982 00
Radiology
2.80
2.80
196.00
196.00
76982 26
Radiology
0.84
0.84
58.80
58.80
76982 TC
Radiology
1.96
1.96
137.20
137.20
76983 00
Radiology
1.85
1.85
129.50
129.50
76983 26
Radiology
0.74
0.74
51.80
51.80
76983 TC
Radiology
1.11
1.11
77.70
77.70
76984 00
Radiology
-
-
149.80
149.80
76984 26
Radiology
0.92
0.92
64.40
64.40
76984 TC
Radiology
-
-
85.40
85.40
76987 00
Radiology
-
-
457.10
457.10
76987 26
Radiology
2.81
2.81
196.70
196.70
76987 TC
Radiology
-
-
260.40
260.40
76988 00
Radiology
-
-
291.20
291.20
76988 26
Radiology
1.79
1.79
125.30
125.30
76988 TC
Radiology
-
-
165.90
165.90
76989 00
Radiology
-
-
170.80
170.80
76989 26
Radiology
1.05
1.05
73.50
73.50
76989 TC
Radiology
-
-
97.30
97.30
76998 00
Radiology
-
-
224.70
224.70
76998 26
Radiology
1.38
1.38
96.60
96.60
76998 TC
Radiology
-
-
128.10
128.10
76999 00
Radiology
0.00
0.00
BR
BR
76999 26
Radiology
0.00
0.00
BR
BR
76999 TC
Radiology
0.00
0.00
BR
BR
77001 00
Radiology
2.96
2.96
207.20
207.20
77001 26
Radiology
0.53
0.53
37.10
37.10
77001 TC
Radiology
2.43
2.43
170.10
170.10
77002 00
Radiology
3.48
3.48
243.60
243.60
77002 26
Radiology
0.79
0.79
55.30
55.30
77002 TC
Radiology
2.69
2.69
188.30
188.30
77003 00
Radiology
3.16
3.16
221.20
221.20
77003 26
Radiology
0.85
0.85
59.50
59.50
77003 TC
Radiology
2.31
2.31
161.70
161.70
77011 00
Radiology
6.64
6.64
464.80
464.80
77011 26
Radiology
1.82
1.82
127.40
127.40
77011 TC
Radiology
4.82
4.82
337.40
337.40
77012 00
Radiology
4.17
4.17
291.90
291.90
77012 26
Radiology
2.05
2.05
143.50
143.50
77012 TC
Radiology
2.12
2.12
148.40
148.40
77013 00
Radiology
-
-
1044.40
1044.40
77013 26
Radiology
5.37
5.37
375.90
375.90
77013 TC
Radiology
-
-
668.50
668.50
77014 00
Radiology
3.59
3.59
251.30
251.30
77014 26
Radiology
1.33
1.33
93.10
93.10
77014 TC
Radiology
2.26
2.26
158.20
158.20
77021 00
Radiology
12.77
12.77
893.90
893.90
77021 26
Radiology
2.09
2.09
146.30
146.30
77021 TC
Radiology
10.68
10.68
747.60
747.60
77022 00
Radiology
-
-
1323.00
1323.00
77022 26
Radiology
5.86
5.86
410.20
410.20
77022 TC
Radiology
-
-
912.80
912.80
77046 00
Radiology
6.57
6.57
459.90
459.90
77046 26
Radiology
2.03
2.03
142.10
142.10
77046 TC
Radiology
4.54
4.54
317.80
317.80
77047 00
Radiology
6.75
6.75
472.50
472.50
77047 26
Radiology
2.24
2.24
156.80
156.80
77047 TC
Radiology
4.51
4.51
315.70
315.70
77048 00
Radiology
10.36
10.36
725.20
725.20
77048 26
Radiology
2.95
2.95
206.50
206.50
77048 TC
Radiology
7.41
7.41
518.70
518.70
77049 00
Radiology
10.57
10.57
739.90
739.90
77049 26
Radiology
3.23
3.23
226.10
226.10
77049 TC
Radiology
7.34
7.34
513.80
513.80
77053 00
Radiology
1.62
1.62
113.40
113.40
77053 26
Radiology
0.51
0.51
35.70
35.70
77053 TC
Radiology
1.11
1.11
77.70
77.70
77054 00
Radiology
2.08
2.08
145.60
145.60
77054 26
Radiology
0.63
0.63
44.10
44.10
77054 TC
Radiology
1.45
1.45
101.50
101.50
77061 00
Radiology
-
-
132.30
132.30
77061 26
Radiology
0.00
0.00
BR
BR
77061 TC
Radiology
-
-
132.30
132.30
77062 00
Radiology
-
-
132.30
132.30
77062 26
Radiology
0.00
0.00
BR
BR
77062 TC
Radiology
-
-
132.30
132.30
77063 00
Radiology
1.56
1.56
109.20
109.20
77063 26
Radiology
0.84
0.84
58.80
58.80
77063 TC
Radiology
0.72
0.72
50.40
50.40
77065 00
Radiology
3.76
3.76
263.20
263.20
77065 26
Radiology
1.14
1.14
79.80
79.80
77065 TC
Radiology
2.62
2.62
183.40
183.40
77066 00
Radiology
4.76
4.76
333.20
333.20
77066 26
Radiology
1.40
1.40
98.00
98.00
77066 TC
Radiology
3.36
3.36
235.20
235.20
77067 00
Radiology
3.84
3.84
268.80
268.80
77067 26
Radiology
1.07
1.07
74.90
74.90
77067 TC
Radiology
2.77
2.77
193.90
193.90
77071 00
Radiology
1.65
1.65
115.50
115.50
77072 00
Radiology
0.78
0.78
54.60
54.60
77072 26
Radiology
0.27
0.27
18.90
18.90
77072 TC
Radiology
0.51
0.51
35.70
35.70
77073 00
Radiology
1.36
1.36
95.20
95.20
77073 26
Radiology
0.39
0.39
27.30
27.30
77073 TC
Radiology
0.97
0.97
67.90
67.90
77074 00
Radiology
1.96
1.96
137.20
137.20
77074 26
Radiology
0.62
0.62
43.40
43.40
77074 TC
Radiology
1.34
1.34
93.80
93.80
77075 00
Radiology
2.99
2.99
209.30
209.30
77075 26
Radiology
0.78
0.78
54.60
54.60
77075 TC
Radiology
2.21
2.21
154.70
154.70
77076 00
Radiology
3.22
3.22
225.40
225.40
77076 26
Radiology
0.99
0.99
69.30
69.30
77076 TC
Radiology
2.23
2.23
156.10
156.10
77077 00
Radiology
1.41
1.41
98.70
98.70
77077 26
Radiology
0.49
0.49
34.30
34.30
77077 TC
Radiology
0.92
0.92
64.40
64.40
77078 00
Radiology
3.10
3.10
217.00
217.00
77078 26
Radiology
0.35
0.35
24.50
24.50
77078 TC
Radiology
2.75
2.75
192.50
192.50
77080 00
Radiology
1.17
1.17
81.90
81.90
77080 26
Radiology
0.28
0.28
19.60
19.60
77080 TC
Radiology
0.89
0.89
62.30
62.30
77081 00
Radiology
0.95
0.95
66.50
66.50
77081 26
Radiology
0.28
0.28
19.60
19.60
77081 TC
Radiology
0.67
0.67
46.90
46.90
77084 00
Radiology
9.78
9.78
684.60
684.60
77084 26
Radiology
2.25
2.25
157.50
157.50
77084 TC
Radiology
7.53
7.53
527.10
527.10
77085 00
Radiology
1.60
1.60
112.00
112.00
77085 26
Radiology
0.42
0.42
29.40
29.40
77085 TC
Radiology
1.18
1.18
82.60
82.60
77086 00
Radiology
1.01
1.01
70.70
70.70
77086 26
Radiology
0.24
0.24
16.80
16.80
77086 TC
Radiology
0.77
0.77
53.90
53.90
77089 00
Radiology
1.21
1.21
84.70
84.70
77090 00
Radiology
0.08
0.08
5.60
5.60
77091 00
Radiology
0.84
0.84
58.80
58.80
77092 00
Radiology
0.29
0.29
20.30
20.30
77261 00
Radiology
2.11
2.11
147.70
147.70
77262 00
Radiology
3.23
3.23
226.10
226.10
77263 00
Radiology
5.01
5.01
350.70
350.70
77280 00
Radiology
8.08
8.08
565.60
565.60
77280 26
Radiology
1.12
1.12
78.40
78.40
77280 TC
Radiology
6.96
6.96
487.20
487.20
77285 00
Radiology
13.23
13.23
926.10
926.10
77285 26
Radiology
1.69
1.69
118.30
118.30
77285 TC
Radiology
11.54
11.54
807.80
807.80
77290 00
Radiology
13.43
13.43
940.10
940.10
77290 26
Radiology
2.45
2.45
171.50
171.50
77290 TC
Radiology
10.98
10.98
768.60
768.60
77293 00
Radiology
12.25
12.25
857.50
857.50
77293 26
Radiology
3.13
3.13
219.10
219.10
77293 TC
Radiology
9.12
9.12
638.40
638.40
77295 00
Radiology
14.42
14.42
1009.40
1009.40
77295 26
Radiology
6.70
6.70
469.00
469.00
77295 TC
Radiology
7.72
7.72
540.40
540.40
77299 00
Radiology
0.00
0.00
BR
BR
77299 26
Radiology
0.00
0.00
BR
BR
77299 TC
Radiology
0.00
0.00
BR
BR
77300 00
Radiology
1.98
1.98
138.60
138.60
77300 26
Radiology
0.97
0.97
67.90
67.90
77300 TC
Radiology
1.01
1.01
70.70
70.70
77301 00
Radiology
55.36
55.36
3875.20
3875.20
77301 26
Radiology
12.49
12.49
874.30
874.30
77301 TC
Radiology
42.87
42.87
3000.90
3000.90
77306 00
Radiology
4.45
4.45
311.50
311.50
77306 26
Radiology
2.19
2.19
153.30
153.30
77306 TC
Radiology
2.26
2.26
158.20
158.20
77307 00
Radiology
8.62
8.62
603.40
603.40
77307 26
Radiology
4.53
4.53
317.10
317.10
77307 TC
Radiology
4.09
4.09
286.30
286.30
77316 00
Radiology
7.39
7.39
517.30
517.30
77316 26
Radiology
2.19
2.19
153.30
153.30
77316 TC
Radiology
5.20
5.20
364.00
364.00
77317 00
Radiology
9.72
9.72
680.40
680.40
77317 26
Radiology
2.87
2.87
200.90
200.90
77317 TC
Radiology
6.85
6.85
479.50
479.50
77318 00
Radiology
13.78
13.78
964.60
964.60
77318 26
Radiology
4.52
4.52
316.40
316.40
77318 TC
Radiology
9.26
9.26
648.20
648.20
77321 00
Radiology
2.83
2.83
198.10
198.10
77321 26
Radiology
1.49
1.49
104.30
104.30
77321 TC
Radiology
1.34
1.34
93.80
93.80
77331 00
Radiology
1.95
1.95
136.50
136.50
77331 26
Radiology
1.37
1.37
95.90
95.90
77331 TC
Radiology
0.58
0.58
40.60
40.60
77332 00
Radiology
1.18
1.18
82.60
82.60
77332 26
Radiology
0.71
0.71
49.70
49.70
77332 TC
Radiology
0.47
0.47
32.90
32.90
77333 00
Radiology
4.11
4.11
287.70
287.70
77333 26
Radiology
1.17
1.17
81.90
81.90
77333 TC
Radiology
2.94
2.94
205.80
205.80
77334 00
Radiology
3.77
3.77
263.90
263.90
77334 26
Radiology
1.80
1.80
126.00
126.00
77334 TC
Radiology
1.97
1.97
137.90
137.90
77336 00
Radiology
2.67
2.67
186.90
186.90
77338 00
Radiology
14.06
14.06
984.20
984.20
77338 26
Radiology
6.71
6.71
469.70
469.70
77338 TC
Radiology
7.35
7.35
514.50
514.50
77370 00
Radiology
4.34
4.34
303.80
303.80
77371 00
Radiology
-
-
4751.60
4751.60
77372 00
Radiology
28.59
28.59
2001.30
2001.30
77373 00
Radiology
29.85
29.85
2089.50
2089.50
77385 00
Radiology
-
-
1461.60
1461.60
77386 00
Radiology
-
-
1461.60
1461.60
77387 00
Radiology
-
-
191.80
191.80
77399 00
Radiology
0.00
0.00
BR
BR
77399 26
Radiology
0.00
0.00
BR
BR
77399 TC
Radiology
0.00
0.00
BR
BR
77401 00
Radiology
1.25
1.25
87.50
87.50
77402 00
Radiology
-
-
211.40
211.40
77407 00
Radiology
0.00
0.00
BR
BR
77412 00
Radiology
-
-
370.30
370.30
77417 00
Radiology
0.45
0.45
31.50
31.50
77423 00
Radiology
0.00
0.00
BR
BR
77424 00
Radiology
0.00
0.00
BR
BR
77425 00
Radiology
0.00
0.00
BR
BR
77427 00
Radiology
5.70
5.70
399.00
399.00
77431 00
Radiology
3.22
3.22
225.40
225.40
77432 00
Radiology
12.67
12.67
886.90
886.90
77435 00
Radiology
19.16
19.16
1341.20
1341.20
77469 00
Radiology
9.53
9.53
667.10
667.10
77470 00
Radiology
4.26
4.26
298.20
298.20
77470 26
Radiology
3.18
3.18
222.60
222.60
77470 TC
Radiology
1.08
1.08
75.60
75.60
77499 00
Radiology
0.00
0.00
BR
BR
77499 26
Radiology
0.00
0.00
BR
BR
77499 TC
Radiology
0.00
0.00
BR
BR
77520 00
Radiology
-
-
2664.20
2664.20
77522 00
Radiology
-
-
2487.10
2487.10
77523 00
Radiology
-
-
2804.90
2804.90
77525 00
Radiology
-
-
3495.10
3495.10
77600 00
Radiology
16.35
16.35
1144.50
1144.50
77600 26
Radiology
2.12
2.12
148.40
148.40
77600 TC
Radiology
14.23
14.23
996.10
996.10
77605 00
Radiology
28.35
28.35
1984.50
1984.50
77605 26
Radiology
2.99
2.99
209.30
209.30
77605 TC
Radiology
25.36
25.36
1775.20
1775.20
77610 00
Radiology
20.54
20.54
1437.80
1437.80
77610 26
Radiology
2.06
2.06
144.20
144.20
77610 TC
Radiology
18.48
18.48
1293.60
1293.60
77615 00
Radiology
32.25
32.25
2257.50
2257.50
77615 26
Radiology
2.89
2.89
202.30
202.30
77615 TC
Radiology
29.36
29.36
2055.20
2055.20
77620 00
Radiology
19.12
19.12
1338.40
1338.40
77620 26
Radiology
2.47
2.47
172.90
172.90
77620 TC
Radiology
16.65
16.65
1165.50
1165.50
77750 00
Radiology
11.80
11.80
826.00
826.00
77750 26
Radiology
7.82
7.82
547.40
547.40
77750 TC
Radiology
3.98
3.98
278.60
278.60
77761 00
Radiology
12.65
12.65
885.50
885.50
77761 26
Radiology
6.02
6.02
421.40
421.40
77761 TC
Radiology
6.63
6.63
464.10
464.10
77762 00
Radiology
16.62
16.62
1163.40
1163.40
77762 26
Radiology
9.01
9.01
630.70
630.70
77762 TC
Radiology
7.61
7.61
532.70
532.70
77763 00
Radiology
23.48
23.48
1643.60
1643.60
77763 26
Radiology
13.54
13.54
947.80
947.80
77763 TC
Radiology
9.94
9.94
695.80
695.80
77767 00
Radiology
7.50
7.50
525.00
525.00
77767 26
Radiology
1.64
1.64
114.80
114.80
77767 TC
Radiology
5.86
5.86
410.20
410.20
77768 00
Radiology
10.99
10.99
769.30
769.30
77768 26
Radiology
2.19
2.19
153.30
153.30
77768 TC
Radiology
8.80
8.80
616.00
616.00
77770 00
Radiology
10.45
10.45
731.50
731.50
77770 26
Radiology
3.05
3.05
213.50
213.50
77770 TC
Radiology
7.40
7.40
518.00
518.00
77771 00
Radiology
18.17
18.17
1271.90
1271.90
77771 26
Radiology
5.94
5.94
415.80
415.80
77771 TC
Radiology
12.23
12.23
856.10
856.10
77772 00
Radiology
27.14
27.14
1899.80
1899.80
77772 26
Radiology
8.39
8.39
587.30
587.30
77772 TC
Radiology
18.75
18.75
1312.50
1312.50
77778 00
Radiology
27.63
27.63
1934.10
1934.10
77778 26
Radiology
13.70
13.70
959.00
959.00
77778 TC
Radiology
13.93
13.93
975.10
975.10
77789 00
Radiology
4.00
4.00
280.00
280.00
77789 26
Radiology
1.79
1.79
125.30
125.30
77789 TC
Radiology
2.21
2.21
154.70
154.70
77790 00
Radiology
0.54
0.54
37.80
37.80
77799 00
Radiology
0.00
0.00
BR
BR
77799 26
Radiology
0.00
0.00
BR
BR
77799 TC
Radiology
0.00
0.00
BR
BR
78012 00
Radiology
2.43
2.43
170.10
170.10
78012 26
Radiology
0.26
0.26
18.20
18.20
78012 TC
Radiology
2.17
2.17
151.90
151.90
78013 00
Radiology
5.14
5.14
359.80
359.80
78013 26
Radiology
0.51
0.51
35.70
35.70
78013 TC
Radiology
4.63
4.63
324.10
324.10
78014 00
Radiology
6.53
6.53
457.10
457.10
78014 26
Radiology
0.68
0.68
47.60
47.60
78014 TC
Radiology
5.85
5.85
409.50
409.50
78015 00
Radiology
6.36
6.36
445.20
445.20
78015 26
Radiology
0.94
0.94
65.80
65.80
78015 TC
Radiology
5.42
5.42
379.40
379.40
78016 00
Radiology
7.58
7.58
530.60
530.60
78016 26
Radiology
0.96
0.96
67.20
67.20
78016 TC
Radiology
6.62
6.62
463.40
463.40
78018 00
Radiology
8.52
8.52
596.40
596.40
78018 26
Radiology
1.14
1.14
79.80
79.80
78018 TC
Radiology
7.38
7.38
516.60
516.60
78020 00
Radiology
2.34
2.34
163.80
163.80
78020 26
Radiology
0.77
0.77
53.90
53.90
78020 TC
Radiology
1.57
1.57
109.90
109.90
78070 00
Radiology
8.08
8.08
565.60
565.60
78070 26
Radiology
1.11
1.11
77.70
77.70
78070 TC
Radiology
6.97
6.97
487.90
487.90
78071 00
Radiology
9.61
9.61
672.70
672.70
78071 26
Radiology
1.65
1.65
115.50
115.50
78071 TC
Radiology
7.96
7.96
557.20
557.20
78072 00
Radiology
11.92
11.92
834.40
834.40
78072 26
Radiology
2.16
2.16
151.20
151.20
78072 TC
Radiology
9.76
9.76
683.20
683.20
78075 00
Radiology
12.17
12.17
851.90
851.90
78075 26
Radiology
1.04
1.04
72.80
72.80
78075 TC
Radiology
11.13
11.13
779.10
779.10
78099 00
Radiology
0.00
0.00
BR
BR
78099 26
Radiology
0.00
0.00
BR
BR
78099 TC
Radiology
0.00
0.00
BR
BR
78102 00
Radiology
4.81
4.81
336.70
336.70
78102 26
Radiology
0.73
0.73
51.10
51.10
78102 TC
Radiology
4.08
4.08
285.60
285.60
78103 00
Radiology
5.13
5.13
359.10
359.10
78103 26
Radiology
0.88
0.88
61.60
61.60
78103 TC
Radiology
4.25
4.25
297.50
297.50
78104 00
Radiology
6.89
6.89
482.30
482.30
78104 26
Radiology
1.08
1.08
75.60
75.60
78104 TC
Radiology
5.81
5.81
406.70
406.70
78110 00
Radiology
2.07
2.07
144.90
144.90
78110 26
Radiology
0.23
0.23
16.10
16.10
78110 TC
Radiology
1.84
1.84
128.80
128.80
78111 00
Radiology
2.19
2.19
153.30
153.30
78111 26
Radiology
0.26
0.26
18.20
18.20
78111 TC
Radiology
1.93
1.93
135.10
135.10
78120 00
Radiology
2.12
2.12
148.40
148.40
78120 26
Radiology
0.28
0.28
19.60
19.60
78120 TC
Radiology
1.84
1.84
128.80
128.80
78121 00
Radiology
2.31
2.31
161.70
161.70
78121 26
Radiology
0.38
0.38
26.60
26.60
78121 TC
Radiology
1.93
1.93
135.10
135.10
78122 00
Radiology
2.94
2.94
205.80
205.80
78122 26
Radiology
0.60
0.60
42.00
42.00
78122 TC
Radiology
2.34
2.34
163.80
163.80
78130 00
Radiology
3.72
3.72
260.40
260.40
78130 26
Radiology
0.72
0.72
50.40
50.40
78130 TC
Radiology
3.00
3.00
210.00
210.00
78140 00
Radiology
3.28
3.28
229.60
229.60
78140 26
Radiology
0.72
0.72
50.40
50.40
78140 TC
Radiology
2.56
2.56
179.20
179.20
78185 00
Radiology
4.64
4.64
324.80
324.80
78185 26
Radiology
0.47
0.47
32.90
32.90
78185 TC
Radiology
4.17
4.17
291.90
291.90
78191 00
Radiology
3.72
3.72
260.40
260.40
78191 26
Radiology
0.72
0.72
50.40
50.40
78191 TC
Radiology
3.00
3.00
210.00
210.00
78195 00
Radiology
9.71
9.71
679.70
679.70
78195 26
Radiology
1.64
1.64
114.80
114.80
78195 TC
Radiology
8.07
8.07
564.90
564.90
78199 00
Radiology
0.00
0.00
BR
BR
78199 26
Radiology
0.00
0.00
BR
BR
78199 TC
Radiology
0.00
0.00
BR
BR
78201 00
Radiology
5.30
5.30
371.00
371.00
78201 26
Radiology
0.59
0.59
41.30
41.30
78201 TC
Radiology
4.71
4.71
329.70
329.70
78202 00
Radiology
5.83
5.83
408.10
408.10
78202 26
Radiology
0.69
0.69
48.30
48.30
78202 TC
Radiology
5.14
5.14
359.80
359.80
78215 00
Radiology
5.46
5.46
382.20
382.20
78215 26
Radiology
0.67
0.67
46.90
46.90
78215 TC
Radiology
4.79
4.79
335.30
335.30
78216 00
Radiology
3.83
3.83
268.10
268.10
78216 26
Radiology
0.76
0.76
53.20
53.20
78216 TC
Radiology
3.07
3.07
214.90
214.90
78226 00
Radiology
8.90
8.90
623.00
623.00
78226 26
Radiology
1.03
1.03
72.10
72.10
78226 TC
Radiology
7.87
7.87
550.90
550.90
78227 00
Radiology
11.94
11.94
835.80
835.80
78227 26
Radiology
1.24
1.24
86.80
86.80
78227 TC
Radiology
10.70
10.70
749.00
749.00
78230 00
Radiology
4.91
4.91
343.70
343.70
78230 26
Radiology
0.63
0.63
44.10
44.10
78230 TC
Radiology
4.28
4.28
299.60
299.60
78231 00
Radiology
3.11
3.11
217.70
217.70
78231 26
Radiology
0.61
0.61
42.70
42.70
78231 TC
Radiology
2.50
2.50
175.00
175.00
78232 00
Radiology
3.05
3.05
213.50
213.50
78232 26
Radiology
0.55
0.55
38.50
38.50
78232 TC
Radiology
2.50
2.50
175.00
175.00
78258 00
Radiology
5.93
5.93
415.10
415.10
78258 26
Radiology
0.98
0.98
68.60
68.60
78258 TC
Radiology
4.95
4.95
346.50
346.50
78261 00
Radiology
5.55
5.55
388.50
388.50
78261 26
Radiology
0.81
0.81
56.70
56.70
78261 TC
Radiology
4.74
4.74
331.80
331.80
78262 00
Radiology
6.79
6.79
475.30
475.30
78262 26
Radiology
0.95
0.95
66.50
66.50
78262 TC
Radiology
5.84
5.84
408.80
408.80
78264 00
Radiology
9.06
9.06
634.20
634.20
78264 26
Radiology
1.09
1.09
76.30
76.30
78264 TC
Radiology
7.97
7.97
557.90
557.90
78265 00
Radiology
10.77
10.77
753.90
753.90
78265 26
Radiology
1.34
1.34
93.80
93.80
78265 TC
Radiology
9.43
9.43
660.10
660.10
78266 00
Radiology
12.25
12.25
857.50
857.50
78266 26
Radiology
1.44
1.44
100.80
100.80
78266 TC
Radiology
10.81
10.81
756.70
756.70
78267 00
Radiology
0.34
0.34
23.64
23.64
78268 00
Radiology
2.88
2.88
201.83
201.83
78278 00
Radiology
9.56
9.56
669.20
669.20
78278 26
Radiology
1.37
1.37
95.90
95.90
78278 TC
Radiology
8.19
8.19
573.30
573.30
78282 00
Radiology
-
-
185.50
185.50
78282 26
Radiology
0.45
0.45
31.50
31.50
78282 TC
Radiology
-
-
154.00
154.00
78290 00
Radiology
9.01
9.01
630.70
630.70
78290 26
Radiology
0.93
0.93
65.10
65.10
78290 TC
Radiology
8.08
8.08
565.60
565.60
78291 00
Radiology
7.27
7.27
508.90
508.90
78291 26
Radiology
1.24
1.24
86.80
86.80
78291 TC
Radiology
6.03
6.03
422.10
422.10
78299 00
Radiology
0.00
0.00
BR
BR
78299 26
Radiology
0.00
0.00
BR
BR
78299 TC
Radiology
0.00
0.00
BR
BR
78300 00
Radiology
6.20
6.20
434.00
434.00
78300 26
Radiology
0.86
0.86
60.20
60.20
78300 TC
Radiology
5.34
5.34
373.80
373.80
78305 00
Radiology
7.48
7.48
523.60
523.60
78305 26
Radiology
1.14
1.14
79.80
79.80
78305 TC
Radiology
6.34
6.34
443.80
443.80
78306 00
Radiology
8.08
8.08
565.60
565.60
78306 26
Radiology
1.18
1.18
82.60
82.60
78306 TC
Radiology
6.90
6.90
483.00
483.00
78315 00
Radiology
9.50
9.50
665.00
665.00
78315 26
Radiology
1.41
1.41
98.70
98.70
78315 TC
Radiology
8.09
8.09
566.30
566.30
78350 00
Radiology
0.96
0.96
67.20
67.20
78350 26
Radiology
0.32
0.32
22.40
22.40
78350 TC
Radiology
0.64
0.64
44.80
44.80
78351 00
Radiology
0.44
0.44
30.80
30.80
78399 00
Radiology
0.00
0.00
BR
BR
78399 26
Radiology
0.00
0.00
BR
BR
78399 TC
Radiology
0.00
0.00
BR
BR
78414 00
Radiology
-
-
289.10
289.10
78414 26
Radiology
0.62
0.62
43.40
43.40
78414 TC
Radiology
-
-
245.70
245.70
78428 00
Radiology
5.21
5.21
364.70
364.70
78428 26
Radiology
1.06
1.06
74.20
74.20
78428 TC
Radiology
4.15
4.15
290.50
290.50
78429 00
Radiology
-
-
2011.10
2011.10
78429 26
Radiology
2.32
2.32
162.40
162.40
78429 TC
Radiology
-
-
1848.70
1848.70
78430 00
Radiology
0.00
0.00
BR
BR
78430 26
Radiology
2.21
2.21
154.70
154.70
78430 TC
Radiology
0.00
0.00
BR
BR
78431 00
Radiology
-
-
2646.00
2646.00
78431 26
Radiology
2.58
2.58
180.60
180.60
78431 TC
Radiology
-
-
2465.40
2465.40
78432 00
Radiology
0.00
0.00
BR
BR
78432 26
Radiology
2.76
2.76
193.20
193.20
78432 TC
Radiology
0.00
0.00
BR
BR
78433 00
Radiology
-
-
3175.20
3175.20
78433 26
Radiology
3.02
3.02
211.40
211.40
78433 TC
Radiology
-
-
2963.80
2963.80
78434 00
Radiology
-
-
224.70
224.70
78434 26
Radiology
0.85
0.85
59.50
59.50
78434 TC
Radiology
-
-
165.20
165.20
78445 00
Radiology
5.66
5.66
396.20
396.20
78445 26
Radiology
0.72
0.72
50.40
50.40
78445 TC
Radiology
4.94
4.94
345.80
345.80
78451 00
Radiology
9.39
9.39
657.30
657.30
78451 26
Radiology
1.89
1.89
132.30
132.30
78451 TC
Radiology
7.50
7.50
525.00
525.00
78452 00
Radiology
13.00
13.00
910.00
910.00
78452 26
Radiology
2.23
2.23
156.10
156.10
78452 TC
Radiology
10.77
10.77
753.90
753.90
78453 00
Radiology
8.00
8.00
560.00
560.00
78453 26
Radiology
1.34
1.34
93.80
93.80
78453 TC
Radiology
6.66
6.66
466.20
466.20
78454 00
Radiology
11.95
11.95
836.50
836.50
78454 26
Radiology
1.87
1.87
130.90
130.90
78454 TC
Radiology
10.08
10.08
705.60
705.60
78456 00
Radiology
8.65
8.65
605.50
605.50
78456 26
Radiology
1.37
1.37
95.90
95.90
78456 TC
Radiology
7.28
7.28
509.60
509.60
78457 00
Radiology
4.64
4.64
324.80
324.80
78457 26
Radiology
1.06
1.06
74.20
74.20
78457 TC
Radiology
3.58
3.58
250.60
250.60
78458 00
Radiology
5.78
5.78
404.60
404.60
78458 26
Radiology
1.27
1.27
88.90
88.90
78458 TC
Radiology
4.51
4.51
315.70
315.70
78459 00
Radiology
-
-
3762.50
3762.50
78459 26
Radiology
2.15
2.15
150.50
150.50
78459 TC
Radiology
-
-
3612.00
3612.00
78466 00
Radiology
5.00
5.00
350.00
350.00
78466 26
Radiology
0.94
0.94
65.80
65.80
78466 TC
Radiology
4.06
4.06
284.20
284.20
78468 00
Radiology
5.50
5.50
385.00
385.00
78468 26
Radiology
1.10
1.10
77.00
77.00
78468 TC
Radiology
4.40
4.40
308.00
308.00
78469 00
Radiology
6.16
6.16
431.20
431.20
78469 26
Radiology
1.26
1.26
88.20
88.20
78469 TC
Radiology
4.90
4.90
343.00
343.00
78472 00
Radiology
6.31
6.31
441.70
441.70
78472 26
Radiology
1.35
1.35
94.50
94.50
78472 TC
Radiology
4.96
4.96
347.20
347.20
78473 00
Radiology
8.04
8.04
562.80
562.80
78473 26
Radiology
2.01
2.01
140.70
140.70
78473 TC
Radiology
6.03
6.03
422.10
422.10
78481 00
Radiology
4.96
4.96
347.20
347.20
78481 26
Radiology
1.35
1.35
94.50
94.50
78481 TC
Radiology
3.61
3.61
252.70
252.70
78483 00
Radiology
6.66
6.66
466.20
466.20
78483 26
Radiology
2.02
2.02
141.40
141.40
78483 TC
Radiology
4.64
4.64
324.80
324.80
78491 00
Radiology
-
-
1640.80
1640.80
78491 26
Radiology
2.11
2.11
147.70
147.70
78491 TC
Radiology
-
-
1493.10
1493.10
78492 00
Radiology
-
-
2893.80
2893.80
78492 26
Radiology
2.48
2.48
173.60
173.60
78492 TC
Radiology
-
-
2720.20
2720.20
78494 00
Radiology
6.36
6.36
445.20
445.20
78494 26
Radiology
1.63
1.63
114.10
114.10
78494 TC
Radiology
4.73
4.73
331.10
331.10
78496 00
Radiology
1.26
1.26
88.20
88.20
78496 26
Radiology
0.69
0.69
48.30
48.30
78496 TC
Radiology
0.57
0.57
39.90
39.90
78499 00
Radiology
0.00
0.00
BR
BR
78499 26
Radiology
0.00
0.00
BR
BR
78499 TC
Radiology
0.00
0.00
BR
BR
78579 00
Radiology
5.17
5.17
361.90
361.90
78579 26
Radiology
0.67
0.67
46.90
46.90
78579 TC
Radiology
4.50
4.50
315.00
315.00
78580 00
Radiology
6.50
6.50
455.00
455.00
78580 26
Radiology
1.02
1.02
71.40
71.40
78580 TC
Radiology
5.48
5.48
383.60
383.60
78582 00
Radiology
9.10
9.10
637.00
637.00
78582 26
Radiology
1.47
1.47
102.90
102.90
78582 TC
Radiology
7.63
7.63
534.10
534.10
78597 00
Radiology
5.51
5.51
385.70
385.70
78597 26
Radiology
0.99
0.99
69.30
69.30
78597 TC
Radiology
4.52
4.52
316.40
316.40
78598 00
Radiology
8.26
8.26
578.20
578.20
78598 26
Radiology
1.14
1.14
79.80
79.80
78598 TC
Radiology
7.12
7.12
498.40
498.40
78599 00
Radiology
0.00
0.00
BR
BR
78599 26
Radiology
0.00
0.00
BR
BR
78599 TC
Radiology
0.00
0.00
BR
BR
78600 00
Radiology
5.05
5.05
353.50
353.50
78600 26
Radiology
0.61
0.61
42.70
42.70
78600 TC
Radiology
4.44
4.44
310.80
310.80
78601 00
Radiology
6.01
6.01
420.70
420.70
78601 26
Radiology
0.70
0.70
49.00
49.00
78601 TC
Radiology
5.31
5.31
371.70
371.70
78605 00
Radiology
5.58
5.58
390.60
390.60
78605 26
Radiology
0.75
0.75
52.50
52.50
78605 TC
Radiology
4.83
4.83
338.10
338.10
78606 00
Radiology
9.04
9.04
632.80
632.80
78606 26
Radiology
0.88
0.88
61.60
61.60
78606 TC
Radiology
8.16
8.16
571.20
571.20
78608 00
Radiology
-
-
3552.50
3552.50
78608 26
Radiology
2.03
2.03
142.10
142.10
78608 TC
Radiology
-
-
3410.40
3410.40
78609 00
Radiology
2.11
2.11
147.70
147.70
78609 26
Radiology
2.11
2.11
147.70
147.70
78609 TC
Radiology
0.00
0.00
BR
BR
78610 00
Radiology
4.86
4.86
340.20
340.20
78610 26
Radiology
0.41
0.41
28.70
28.70
78610 TC
Radiology
4.45
4.45
311.50
311.50
78630 00
Radiology
9.23
9.23
646.10
646.10
78630 26
Radiology
0.93
0.93
65.10
65.10
78630 TC
Radiology
8.30
8.30
581.00
581.00
78635 00
Radiology
9.26
9.26
648.20
648.20
78635 26
Radiology
0.86
0.86
60.20
60.20
78635 TC
Radiology
8.40
8.40
588.00
588.00
78645 00
Radiology
8.86
8.86
620.20
620.20
78645 26
Radiology
0.78
0.78
54.60
54.60
78645 TC
Radiology
8.08
8.08
565.60
565.60
78650 00
Radiology
7.43
7.43
520.10
520.10
78650 26
Radiology
0.72
0.72
50.40
50.40
78650 TC
Radiology
6.71
6.71
469.70
469.70
78660 00
Radiology
3.98
3.98
278.60
278.60
78660 26
Radiology
0.62
0.62
43.40
43.40
78660 TC
Radiology
3.36
3.36
235.20
235.20
78699 00
Radiology
0.00
0.00
BR
BR
78699 26
Radiology
0.00
0.00
BR
BR
78699 TC
Radiology
0.00
0.00
BR
BR
78700 00
Radiology
4.75
4.75
332.50
332.50
78700 26
Radiology
0.61
0.61
42.70
42.70
78700 TC
Radiology
4.14
4.14
289.80
289.80
78701 00
Radiology
6.24
6.24
436.80
436.80
78701 26
Radiology
0.68
0.68
47.60
47.60
78701 TC
Radiology
5.56
5.56
389.20
389.20
78707 00
Radiology
6.45
6.45
451.50
451.50
78707 26
Radiology
1.30
1.30
91.00
91.00
78707 TC
Radiology
5.15
5.15
360.50
360.50
78708 00
Radiology
5.25
5.25
367.50
367.50
78708 26
Radiology
1.65
1.65
115.50
115.50
78708 TC
Radiology
3.60
3.60
252.00
252.00
78709 00
Radiology
10.13
10.13
709.10
709.10
78709 26
Radiology
1.92
1.92
134.40
134.40
78709 TC
Radiology
8.21
8.21
574.70
574.70
78725 00
Radiology
2.90
2.90
203.00
203.00
78725 26
Radiology
0.50
0.50
35.00
35.00
78725 TC
Radiology
2.40
2.40
168.00
168.00
78730 00
Radiology
2.05
2.05
143.50
143.50
78730 26
Radiology
0.22
0.22
15.40
15.40
78730 TC
Radiology
1.83
1.83
128.10
128.10
78740 00
Radiology
6.31
6.31
441.70
441.70
78740 26
Radiology
0.78
0.78
54.60
54.60
78740 TC
Radiology
5.53
5.53
387.10
387.10
78761 00
Radiology
5.91
5.91
413.70
413.70
78761 26
Radiology
1.00
1.00
70.00
70.00
78761 TC
Radiology
4.91
4.91
343.70
343.70
78799 00
Radiology
0.00
0.00
BR
BR
78799 26
Radiology
0.00
0.00
BR
BR
78799 TC
Radiology
0.00
0.00
BR
BR
78800 00
Radiology
6.97
6.97
487.90
487.90
78800 26
Radiology
0.91
0.91
63.70
63.70
78800 TC
Radiology
6.06
6.06
424.20
424.20
78801 00
Radiology
7.47
7.47
522.90
522.90
78801 26
Radiology
1.00
1.00
70.00
70.00
78801 TC
Radiology
6.47
6.47
452.90
452.90
78802 00
Radiology
8.44
8.44
590.80
590.80
78802 26
Radiology
1.09
1.09
76.30
76.30
78802 TC
Radiology
7.35
7.35
514.50
514.50
78803 00
Radiology
10.42
10.42
729.40
729.40
78803 26
Radiology
1.48
1.48
103.60
103.60
78803 TC
Radiology
8.94
8.94
625.80
625.80
78804 00
Radiology
17.58
17.58
1230.60
1230.60
78804 26
Radiology
1.38
1.38
96.60
96.60
78804 TC
Radiology
16.20
16.20
1134.00
1134.00
78808 00
Radiology
1.19
1.19
83.30
83.30
78811 00
Radiology
-
-
3657.50
3657.50
78811 26
Radiology
2.09
2.09
146.30
146.30
78811 TC
Radiology
-
-
3511.20
3511.20
78812 00
Radiology
-
-
4620.00
4620.00
78812 26
Radiology
2.64
2.64
184.80
184.80
78812 TC
Radiology
-
-
4435.20
4435.20
78813 00
Radiology
-
-
4725.00
4725.00
78813 26
Radiology
2.70
2.70
189.00
189.00
78813 TC
Radiology
-
-
4536.00
4536.00
78814 00
Radiology
-
-
5232.50
5232.50
78814 26
Radiology
2.99
2.99
209.30
209.30
78814 TC
Radiology
-
-
5023.20
5023.20
78815 00
Radiology
-
-
5827.50
5827.50
78815 26
Radiology
3.33
3.33
233.10
233.10
78815 TC
Radiology
-
-
5594.40
5594.40
78816 00
Radiology
-
-
5880.00
5880.00
78816 26
Radiology
3.36
3.36
235.20
235.20
78816 TC
Radiology
-
-
5644.80
5644.80
78830 00
Radiology
13.05
13.05
913.50
913.50
78830 26
Radiology
1.98
1.98
138.60
138.60
78830 TC
Radiology
11.07
11.07
774.90
774.90
78831 00
Radiology
19.52
19.52
1366.40
1366.40
78831 26
Radiology
2.50
2.50
175.00
175.00
78831 TC
Radiology
17.02
17.02
1191.40
1191.40
78832 00
Radiology
24.66
24.66
1726.20
1726.20
78832 26
Radiology
2.84
2.84
198.80
198.80
78832 TC
Radiology
21.82
21.82
1527.40
1527.40
78835 00
Radiology
2.67
2.67
186.90
186.90
78835 26
Radiology
0.62
0.62
43.40
43.40
78835 TC
Radiology
2.05
2.05
143.50
143.50
78999 00
Radiology
0.00
0.00
BR
BR
78999 26
Radiology
0.00
0.00
BR
BR
78999 TC
Radiology
0.00
0.00
BR
BR
79005 00
Radiology
4.01
4.01
280.70
280.70
79005 26
Radiology
2.47
2.47
172.90
172.90
79005 TC
Radiology
1.54
1.54
107.80
107.80
79101 00
Radiology
4.36
4.36
305.20
305.20
79101 26
Radiology
2.75
2.75
192.50
192.50
79101 TC
Radiology
1.61
1.61
112.70
112.70
79200 00
Radiology
3.90
3.90
273.00
273.00
79200 26
Radiology
2.32
2.32
162.40
162.40
79200 TC
Radiology
1.58
1.58
110.60
110.60
79300 00
Radiology
-
-
467.60
467.60
79300 26
Radiology
1.87
1.87
130.90
130.90
79300 TC
Radiology
-
-
336.70
336.70
79403 00
Radiology
6.27
6.27
438.90
438.90
79403 26
Radiology
3.24
3.24
226.80
226.80
79403 TC
Radiology
3.03
3.03
212.10
212.10
79440 00
Radiology
3.51
3.51
245.70
245.70
79440 26
Radiology
2.32
2.32
162.40
162.40
79440 TC
Radiology
1.19
1.19
83.30
83.30
79445 00
Radiology
-
-
408.80
408.80
79445 26
Radiology
3.21
3.21
224.70
224.70
79445 TC
Radiology
-
-
184.10
184.10
79999 00
Radiology
0.00
0.00
BR
BR
79999 26
Radiology
0.00
0.00
BR
BR
79999 TC
Radiology
0.00
0.00
BR
BR
PATHOLOGY AND LABORATORY GUIDELINES
Information regarding publications incorporated by reference
				  is found in the Introduction Section of the Fee Schedule.
The following Commission guidelines are in addition to the
				  CPT® guidelines and represent additional
				  guidance from the Commission relative to unit values for these services. To the
				  extent that a conflict may exist between an incorporated portion of the
				  CPT® publication or HCPCS code and a code,
				  guideline, identifier, or modifier unique to Arizona, then the Arizona code,
				  guideline, identifier, or modifier shall control. Codes that are unique to
				  Arizona are preceded by an AZ identifier and numbered in the following format:
				  AZxxx.
A healthcare provider seeking reimbursement for presumptive,
				  or "point of care" drug testing shall submit to the payer written documentation
				  establishing:
1. That the testing is medically necessary and reasonably
				  required;
2. The type of drug testing utilized; and
3. The healthcare provider's interpretation of the "point of
				  care" testing.
For purposes of this section, presumptive or "point of care"
				  testing is testing that is performed at or near the site of patient care
				  (
i.e.,
the healthcare provider's office).
CPT® codes 80305-80307 are
				  used for reporting presumptive drug class screening. Each code represents all
				  drugs and drug classes performed by the respective methodology per date of
				  service.
Healthcare providers performing validity testing on urine
				  specimens utilized for drug testing shall not separately bill the validity
				  testing. For example, if a laboratory performs a urinary pH, specific gravity,
				  creatinine, nitrates, oxidants, or other tests to confirm that a urine specimen
				  is not adulterated, this testing is not separately billed.
Definitive drug testing may be reported with HCPCS codes
				  G0480 - G0483. These codes differ based on the number of drug classes including
				  metabolites tested. Only one code from this group of codes may be reported per
				  date of service. Requests for quantitative or definitive testing require
				  documentation that qualifies necessity.
G0480 - Definitive drug testing 1 - 7 drug class(es)
				  including metabolites(s) if performed
G0481 - Definitive drug testing 8 - 14 drug class(es)
				  including metabolite(s) if performed
G0482 - Definitive drug testing 15 - 21 drug class(es)
				  including metabolites(s) if performed
G0483 - Definitive drug testing of 22 or more drug class(es),
				  including metabolite(s) if performed.
ARIZONA PHYSICIANS' FEE
							 SCHEDULE
Pathology Codes
							 2024
Pathology Conversion Factor
							 $68.00
Code
Category
FY24 NF
							 RVU
FY24 FAC
							 RVU
FY24 NF RBRVS Rate
FY24 FAC RBRVS
							 Rate
80047 00
Pathology
0.42
0.42
28.51
28.51
80048 00
Pathology
0.26
0.26
17.57
17.57
80050 00
Pathology
-
-
320.96
320.96
80051 00
Pathology
0.21
0.21
14.56
14.56
80053 00
Pathology
0.32
0.32
21.93
21.93
80055 00
Pathology
1.46
1.46
99.29
99.29
80061 00
Pathology
0.41
0.41
27.81
27.81
80069 00
Pathology
0.27
0.27
18.03
18.03
80074 00
Pathology
1.45
1.45
98.91
98.91
80076 00
Pathology
0.25
0.25
16.97
16.97
80081 00
Pathology
2.29
2.29
155.46
155.46
80143 00
Pathology
0.57
0.57
38.71
38.71
80145 00
Pathology
1.18
1.18
80.10
80.10
80150 00
Pathology
0.46
0.46
31.32
31.32
80151 00
Pathology
0.57
0.57
38.71
38.71
80155 00
Pathology
1.18
1.18
80.10
80.10
80156 00
Pathology
0.44
0.44
30.26
30.26
80157 00
Pathology
0.40
0.40
27.52
27.52
80158 00
Pathology
0.55
0.55
37.48
37.48
80159 00
Pathology
0.62
0.62
41.85
41.85
80161 00
Pathology
0.57
0.57
38.71
38.71
80162 00
Pathology
0.41
0.41
27.58
27.58
80163 00
Pathology
0.41
0.41
27.58
27.58
80164 00
Pathology
0.41
0.41
28.12
28.12
80165 00
Pathology
0.41
0.41
28.12
28.12
80167 00
Pathology
0.57
0.57
38.71
38.71
80168 00
Pathology
0.50
0.50
33.93
33.93
80169 00
Pathology
0.42
0.42
28.51
28.51
80170 00
Pathology
0.50
0.50
34.02
34.02
80171 00
Pathology
0.66
0.66
45.00
45.00
80173 00
Pathology
0.48
0.48
32.77
32.77
80175 00
Pathology
0.40
0.40
27.52
27.52
80176 00
Pathology
0.45
0.45
30.51
30.51
80177 00
Pathology
0.40
0.40
27.52
27.52
80178 00
Pathology
0.20
0.20
13.73
13.73
80179 00
Pathology
0.57
0.57
38.71
38.71
80180 00
Pathology
0.55
0.55
37.48
37.48
80181 00
Pathology
0.57
0.57
38.71
38.71
80183 00
Pathology
0.40
0.40
27.52
27.52
80184 00
Pathology
0.47
0.47
31.77
31.77
80185 00
Pathology
0.40
0.40
27.52
27.52
80186 00
Pathology
0.42
0.42
28.58
28.58
80187 00
Pathology
0.83
0.83
56.30
56.30
80188 00
Pathology
0.51
0.51
34.45
34.45
80189 00
Pathology
0.83
0.83
56.30
56.30
80190 00
Pathology
1.83
1.83
124.60
124.60
80192 00
Pathology
0.51
0.51
34.78
34.78
80193 00
Pathology
1.18
1.18
80.10
80.10
80194 00
Pathology
0.45
0.45
30.32
30.32
80195 00
Pathology
0.42
0.42
28.51
28.51
80197 00
Pathology
0.42
0.42
28.51
28.51
80198 00
Pathology
0.43
0.43
29.36
29.36
80199 00
Pathology
0.83
0.83
56.30
56.30
80200 00
Pathology
0.49
0.49
33.50
33.50
80201 00
Pathology
0.36
0.36
24.75
24.75
80202 00
Pathology
0.41
0.41
28.12
28.12
80203 00
Pathology
0.40
0.40
27.52
27.52
80204 00
Pathology
1.18
1.18
80.10
80.10
80210 00
Pathology
0.83
0.83
56.30
56.30
80220 00
Pathology
0.57
0.57
38.71
38.71
80230 00
Pathology
1.18
1.18
80.10
80.10
80235 00
Pathology
0.83
0.83
56.30
56.30
80280 00
Pathology
1.18
1.18
80.10
80.10
80285 00
Pathology
0.83
0.83
56.30
56.30
80299 00
Pathology
0.57
0.57
38.71
38.71
80305 00
Pathology
0.38
0.38
26.17
26.17
80306 00
Pathology
0.52
0.52
35.59
35.59
80307 00
Pathology
1.90
1.90
129.05
129.05
80320 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80321 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80322 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80323 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80324 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80325 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80326 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80327 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80328 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80329 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80330 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80331 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80332 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80333 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80334 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80335 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80336 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80337 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80338 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80339 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80340 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80341 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80342 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80343 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80344 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80345 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80346 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80347 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80348 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80349 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80350 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80351 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80352 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80353 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80354 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80355 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80356 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80357 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80358 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80359 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80360 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80361 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80362 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80363 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80364 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80365 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80366 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80367 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80368 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80369 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80370 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80371 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80372 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80373 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80374 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80375 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80376 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80377 00
Pathology
0.00
0.00
See G0480-G0483
See G0480-G0483
80400 00
Pathology
1.00
1.00
67.74
67.74
80402 00
Pathology
2.66
2.66
180.59
180.59
80406 00
Pathology
2.39
2.39
162.52
162.52
80408 00
Pathology
3.83
3.83
260.63
260.63
80410 00
Pathology
2.45
2.45
166.90
166.90
80412 00
Pathology
24.48
24.48
1664.73
1664.73
80414 00
Pathology
1.58
1.58
107.24
107.24
80415 00
Pathology
1.71
1.71
116.07
116.07
80416 00
Pathology
6.39
6.39
434.70
434.70
80417 00
Pathology
1.34
1.34
91.35
91.35
80418 00
Pathology
17.70
17.70
1203.41
1203.41
80420 00
Pathology
4.94
4.94
336.18
336.18
80422 00
Pathology
1.41
1.41
95.67
95.67
80424 00
Pathology
1.54
1.54
104.87
104.87
80426 00
Pathology
4.53
4.53
308.20
308.20
80428 00
Pathology
2.04
2.04
138.52
138.52
80430 00
Pathology
3.95
3.95
268.58
268.58
80432 00
Pathology
5.06
5.06
343.92
343.92
80434 00
Pathology
8.70
8.70
591.92
591.92
80435 00
Pathology
3.15
3.15
213.90
213.90
80436 00
Pathology
2.78
2.78
189.31
189.31
80438 00
Pathology
1.54
1.54
104.69
104.69
80439 00
Pathology
2.05
2.05
139.58
139.58
80503 00
Pathology
0.80
0.65
54.40
44.20
80504 00
Pathology
1.58
1.40
107.44
95.20
80505 00
Pathology
2.85
2.63
193.80
178.84
80506 00
Pathology
1.26
1.26
85.68
85.68
81000 00
Pathology
0.12
0.12
8.35
8.35
81001 00
Pathology
0.10
0.10
6.58
6.58
81002 00
Pathology
0.11
0.11
7.23
7.23
81003 00
Pathology
0.07
0.07
4.67
4.67
81005 00
Pathology
0.07
0.07
4.51
4.51
81007 00
Pathology
0.92
0.92
62.26
62.26
81015 00
Pathology
0.09
0.09
6.33
6.33
81020 00
Pathology
0.14
0.14
9.76
9.76
81025 00
Pathology
0.26
0.26
17.88
17.88
81050 00
Pathology
0.11
0.11
7.56
7.56
81099 00
Pathology
0.00
0.00
BR
BR
81105 00
Pathology
3.73
3.73
253.81
253.81
81106 00
Pathology
3.73
3.73
253.81
253.81
81107 00
Pathology
3.73
3.73
253.81
253.81
81108 00
Pathology
3.73
3.73
253.81
253.81
81109 00
Pathology
3.73
3.73
253.81
253.81
81110 00
Pathology
3.73
3.73
253.81
253.81
81111 00
Pathology
3.73
3.73
253.81
253.81
81112 00
Pathology
3.73
3.73
253.81
253.81
81120 00
Pathology
5.90
5.90
401.32
401.32
81121 00
Pathology
9.03
9.03
614.27
614.27
81161 00
Pathology
8.52
8.52
579.40
579.40
81162 00
Pathology
55.73
55.73
3789.73
3789.73
81163 00
Pathology
14.29
14.29
971.90
971.90
81164 00
Pathology
17.84
17.84
1213.27
1213.27
81165 00
Pathology
8.64
8.64
587.46
587.46
81166 00
Pathology
9.20
9.20
625.81
625.81
81167 00
Pathology
8.64
8.64
587.46
587.46
81168 00
Pathology
6.33
6.33
430.52
430.52
81170 00
Pathology
9.16
9.16
623.01
623.01
81171 00
Pathology
4.18
4.18
284.51
284.51
81172 00
Pathology
8.39
8.39
570.74
570.74
81173 00
Pathology
9.20
9.20
625.81
625.81
81174 00
Pathology
5.66
5.66
384.61
384.61
81175 00
Pathology
20.66
20.66
1404.89
1404.89
81176 00
Pathology
7.39
7.39
502.35
502.35
81177 00
Pathology
4.18
4.18
284.51
284.51
81178 00
Pathology
4.18
4.18
284.51
284.51
81179 00
Pathology
4.18
4.18
284.51
284.51
81180 00
Pathology
4.18
4.18
284.51
284.51
81181 00
Pathology
4.18
4.18
284.51
284.51
81182 00
Pathology
4.18
4.18
284.51
284.51
81183 00
Pathology
4.18
4.18
284.51
284.51
81184 00
Pathology
4.18
4.18
284.51
284.51
81185 00
Pathology
25.84
25.84
1757.45
1757.45
81186 00
Pathology
5.66
5.66
384.61
384.61
81187 00
Pathology
4.18
4.18
284.51
284.51
81188 00
Pathology
4.18
4.18
284.51
284.51
81189 00
Pathology
8.39
8.39
570.74
570.74
81190 00
Pathology
5.66
5.66
384.61
384.61
81191 00
Pathology
6.33
6.33
430.52
430.52
81192 00
Pathology
6.33
6.33
430.52
430.52
81193 00
Pathology
6.33
6.33
430.52
430.52
81194 00
Pathology
15.83
15.83
1076.31
1076.31
81200 00
Pathology
1.44
1.44
98.12
98.12
81201 00
Pathology
23.82
23.82
1619.83
1619.83
81202 00
Pathology
8.55
8.55
581.48
581.48
81203 00
Pathology
6.11
6.11
415.34
415.34
81204 00
Pathology
4.18
4.18
284.51
284.51
81205 00
Pathology
2.90
2.90
197.27
197.27
81206 00
Pathology
5.01
5.01
340.50
340.50
81207 00
Pathology
4.42
4.42
300.79
300.79
81208 00
Pathology
6.55
6.55
445.70
445.70
81209 00
Pathology
1.20
1.20
81.64
81.64
81210 00
Pathology
5.36
5.36
364.25
364.25
81212 00
Pathology
13.44
13.44
913.75
913.75
81215 00
Pathology
11.46
11.46
779.28
779.28
81216 00
Pathology
5.65
5.65
384.44
384.44
81217 00
Pathology
11.46
11.46
779.28
779.28
81218 00
Pathology
7.39
7.39
502.35
502.35
81219 00
Pathology
3.71
3.71
252.59
252.59
81220 00
Pathology
17.00
17.00
1155.89
1155.89
81221 00
Pathology
2.97
2.97
201.90
201.90
81222 00
Pathology
13.29
13.29
903.51
903.51
81223 00
Pathology
15.24
15.24
1036.28
1036.28
81224 00
Pathology
5.15
5.15
350.44
350.44
81225 00
Pathology
8.90
8.90
605.07
605.07
81226 00
Pathology
13.77
13.77
936.41
936.41
81227 00
Pathology
5.34
5.34
363.03
363.03
81228 00
Pathology
27.49
27.49
1869.03
1869.03
81229 00
Pathology
35.43
35.43
2408.98
2408.98
81230 00
Pathology
5.34
5.34
363.03
363.03
81231 00
Pathology
5.34
5.34
363.03
363.03
81232 00
Pathology
5.34
5.34
363.03
363.03
81233 00
Pathology
5.36
5.36
364.25
364.25
81234 00
Pathology
4.18
4.18
284.51
284.51
81235 00
Pathology
9.91
9.91
674.06
674.06
81236 00
Pathology
8.64
8.64
587.46
587.46
81237 00
Pathology
5.36
5.36
364.25
364.25
81238 00
Pathology
18.32
18.32
1246.02
1246.02
81239 00
Pathology
8.39
8.39
570.74
570.74
81240 00
Pathology
2.01
2.01
136.42
136.42
81241 00
Pathology
2.24
2.24
152.37
152.37
81242 00
Pathology
1.12
1.12
76.05
76.05
81243 00
Pathology
1.74
1.74
118.46
118.46
81244 00
Pathology
1.37
1.37
93.22
93.22
81245 00
Pathology
5.05
5.05
343.72
343.72
81246 00
Pathology
2.53
2.53
172.37
172.37
81247 00
Pathology
5.34
5.34
363.03
363.03
81248 00
Pathology
11.46
11.46
779.28
779.28
81249 00
Pathology
18.32
18.32
1246.02
1246.02
81250 00
Pathology
1.79
1.79
121.47
121.47
81251 00
Pathology
1.44
1.44
98.12
98.12
81252 00
Pathology
3.09
3.09
210.00
210.00
81253 00
Pathology
1.88
1.88
127.76
127.76
81254 00
Pathology
1.07
1.07
72.68
72.68
81255 00
Pathology
1.57
1.57
106.85
106.85
81256 00
Pathology
2.00
2.00
135.73
135.73
81257 00
Pathology
3.12
3.12
212.36
212.36
81258 00
Pathology
11.46
11.46
779.28
779.28
81259 00
Pathology
18.32
18.32
1246.02
1246.02
81260 00
Pathology
1.20
1.20
81.64
81.64
81261 00
Pathology
6.05
6.05
411.17
411.17
81262 00
Pathology
2.09
2.09
142.36
142.36
81263 00
Pathology
8.99
8.99
611.63
611.63
81264 00
Pathology
5.28
5.28
358.71
358.71
81265 00
Pathology
7.12
7.12
484.02
484.02
81266 00
Pathology
9.31
9.31
633.00
633.00
81267 00
Pathology
6.34
6.34
430.83
430.83
81268 00
Pathology
7.96
7.96
541.58
541.58
81269 00
Pathology
6.18
6.18
420.32
420.32
81270 00
Pathology
2.80
2.80
190.35
190.35
81271 00
Pathology
4.18
4.18
284.51
284.51
81272 00
Pathology
10.06
10.06
684.29
684.29
81273 00
Pathology
3.81
3.81
259.32
259.32
81274 00
Pathology
8.39
8.39
570.74
570.74
81275 00
Pathology
5.90
5.90
401.32
401.32
81276 00
Pathology
5.90
5.90
401.32
401.32
81277 00
Pathology
35.43
35.43
2408.98
2408.98
81278 00
Pathology
6.33
6.33
430.52
430.52
81279 00
Pathology
5.66
5.66
384.61
384.61
81283 00
Pathology
2.24
2.24
152.37
152.37
81284 00
Pathology
4.18
4.18
284.51
284.51
81285 00
Pathology
8.39
8.39
570.74
570.74
81286 00
Pathology
8.39
8.39
570.74
570.74
81287 00
Pathology
3.81
3.81
258.84
258.84
81288 00
Pathology
5.87
5.87
399.39
399.39
81289 00
Pathology
5.66
5.66
384.61
384.61
81290 00
Pathology
1.20
1.20
81.64
81.64
81291 00
Pathology
2.00
2.00
135.69
135.69
81292 00
Pathology
20.63
20.63
1402.61
1402.61
81293 00
Pathology
10.11
10.11
687.39
687.39
81294 00
Pathology
6.18
6.18
420.32
420.32
81295 00
Pathology
11.66
11.66
792.68
792.68
81296 00
Pathology
10.31
10.31
701.37
701.37
81297 00
Pathology
6.51
6.51
442.96
442.96
81298 00
Pathology
19.60
19.60
1332.93
1332.93
81299 00
Pathology
9.41
9.41
639.62
639.62
81300 00
Pathology
7.27
7.27
494.26
494.26
81301 00
Pathology
10.64
10.64
723.86
723.86
81302 00
Pathology
16.12
16.12
1096.23
1096.23
81303 00
Pathology
3.66
3.66
249.20
249.20
81304 00
Pathology
4.58
4.58
311.51
311.51
81305 00
Pathology
5.36
5.36
364.25
364.25
81306 00
Pathology
8.90
8.90
605.07
605.07
81307 00
Pathology
20.66
20.66
1404.89
1404.89
81308 00
Pathology
9.20
9.20
625.81
625.81
81309 00
Pathology
8.39
8.39
570.74
570.74
81310 00
Pathology
7.53
7.53
511.95
511.95
81311 00
Pathology
9.03
9.03
614.27
614.27
81312 00
Pathology
4.18
4.18
284.51
284.51
81313 00
Pathology
7.79
7.79
529.66
529.66
81314 00
Pathology
10.06
10.06
684.29
684.29
81315 00
Pathology
6.33
6.33
430.52
430.52
81316 00
Pathology
6.33
6.33
430.52
430.52
81317 00
Pathology
20.66
20.66
1404.89
1404.89
81318 00
Pathology
10.11
10.11
687.39
687.39
81319 00
Pathology
6.21
6.21
422.61
422.61
81320 00
Pathology
8.90
8.90
605.07
605.07
81321 00
Pathology
18.32
18.32
1246.02
1246.02
81322 00
Pathology
1.42
1.42
96.77
96.77
81323 00
Pathology
9.16
9.16
623.01
623.01
81324 00
Pathology
23.16
23.16
1574.89
1574.89
81325 00
Pathology
23.50
23.50
1598.19
1598.19
81326 00
Pathology
1.42
1.42
96.77
96.77
81327 00
Pathology
5.86
5.86
398.73
398.73
81328 00
Pathology
5.34
5.34
363.03
363.03
81329 00
Pathology
4.18
4.18
284.51
284.51
81330 00
Pathology
1.44
1.44
97.61
97.61
81331 00
Pathology
1.56
1.56
106.06
106.06
81332 00
Pathology
1.33
1.33
90.65
90.65
81333 00
Pathology
4.18
4.18
284.51
284.51
81334 00
Pathology
10.06
10.06
684.29
684.29
81335 00
Pathology
5.34
5.34
363.03
363.03
81336 00
Pathology
9.20
9.20
625.81
625.81
81337 00
Pathology
5.66
5.66
384.61
384.61
81338 00
Pathology
4.59
4.59
312.19
312.19
81339 00
Pathology
5.66
5.66
384.61
384.61
81340 00
Pathology
6.38
6.38
433.86
433.86
81341 00
Pathology
1.51
1.51
102.98
102.98
81342 00
Pathology
6.15
6.15
418.46
418.46
81343 00
Pathology
4.18
4.18
284.51
284.51
81344 00
Pathology
4.18
4.18
284.51
284.51
81345 00
Pathology
5.66
5.66
384.61
384.61
81346 00
Pathology
5.34
5.34
363.03
363.03
81347 00
Pathology
5.90
5.90
401.32
401.32
81348 00
Pathology
5.36
5.36
364.25
364.25
81349 00
Pathology
35.43
35.43
2408.98
2408.98
81350 00
Pathology
7.15
7.15
485.95
485.95
81351 00
Pathology
19.60
19.60
1332.93
1332.93
81352 00
Pathology
10.06
10.06
684.29
684.29
81353 00
Pathology
9.41
9.41
639.62
639.62
81355 00
Pathology
2.69
2.69
183.17
183.17
81357 00
Pathology
5.90
5.90
401.32
401.32
81360 00
Pathology
5.90
5.90
401.32
401.32
81361 00
Pathology
5.34
5.34
363.03
363.03
81362 00
Pathology
11.46
11.46
779.28
779.28
81363 00
Pathology
6.18
6.18
420.32
420.32
81364 00
Pathology
9.91
9.91
674.06
674.06
81370 00
Pathology
12.28
12.28
835.08
835.08
81371 00
Pathology
12.35
12.35
840.07
840.07
81372 00
Pathology
12.33
12.33
838.14
838.14
81373 00
Pathology
3.89
3.89
264.63
264.63
81374 00
Pathology
2.27
2.27
154.36
154.36
81375 00
Pathology
6.74
6.74
458.41
458.41
81376 00
Pathology
3.73
3.73
253.81
253.81
81377 00
Pathology
2.89
2.89
196.75
196.75
81378 00
Pathology
10.55
10.55
717.65
717.65
81379 00
Pathology
10.24
10.24
696.48
696.48
81380 00
Pathology
5.41
5.41
368.10
368.10
81381 00
Pathology
5.19
5.19
352.83
352.83
81382 00
Pathology
3.78
3.78
256.85
256.85
81383 00
Pathology
3.33
3.33
226.63
226.63
81400 00
Pathology
1.95
1.95
132.83
132.83
81401 00
Pathology
4.18
4.18
284.51
284.51
81402 00
Pathology
4.59
4.59
312.19
312.19
81403 00
Pathology
5.66
5.66
384.61
384.61
81404 00
Pathology
8.39
8.39
570.74
570.74
81405 00
Pathology
9.20
9.20
625.81
625.81
81406 00
Pathology
8.64
8.64
587.46
587.46
81407 00
Pathology
25.84
25.84
1757.45
1757.45
81408 00
Pathology
61.08
61.08
4153.41
4153.41
81410 00
Pathology
15.39
15.39
1046.66
1046.66
81411 00
Pathology
41.23
41.23
2803.94
2803.94
81412 00
Pathology
74.78
74.78
5084.93
5084.93
81413 00
Pathology
17.86
17.86
1214.66
1214.66
81414 00
Pathology
17.86
17.86
1214.66
1214.66
81415 00
Pathology
145.98
145.98
9926.64
9926.64
81416 00
Pathology
366.48
366.48
24920.44
24920.44
81417 00
Pathology
9.77
9.77
664.55
664.55
81418 00
Pathology
28.01
28.01
1904.50
1904.50
81419 00
Pathology
74.78
74.78
5084.93
5084.93
81420 00
Pathology
23.18
23.18
1576.32
1576.32
81422 00
Pathology
23.18
23.18
1576.32
1576.32
81425 00
Pathology
153.65
153.65
10448.31
10448.31
81426 00
Pathology
82.76
82.76
5627.76
5627.76
81427 00
Pathology
71.39
71.39
4854.61
4854.61
81430 00
Pathology
49.63
49.63
3374.64
3374.64
81431 00
Pathology
20.75
20.75
1411.27
1411.27
81432 00
Pathology
20.74
20.74
1410.19
1410.19
81433 00
Pathology
13.40
13.40
911.53
911.53
81434 00
Pathology
18.26
18.26
1241.68
1241.68
81435 00
Pathology
17.86
17.86
1214.66
1214.66
81436 00
Pathology
17.86
17.86
1214.66
1214.66
81437 00
Pathology
13.40
13.40
911.53
911.53
81438 00
Pathology
13.40
13.40
911.53
911.53
81439 00
Pathology
17.86
17.86
1214.66
1214.66
81440 00
Pathology
101.51
101.51
6902.96
6902.96
81441 00
Pathology
74.78
74.78
5084.93
5084.93
81442 00
Pathology
65.47
65.47
4451.62
4451.62
81443 00
Pathology
74.78
74.78
5084.93
5084.93
81445 00
Pathology
18.26
18.26
1241.68
1241.68
81448 00
Pathology
17.86
17.86
1214.66
1214.66
81449 00
Pathology
18.26
18.26
1241.68
1241.68
81450 00
Pathology
23.20
23.20
1577.32
1577.32
81451 00
Pathology
23.20
23.20
1577.32
1577.32
81455 00
Pathology
89.16
89.16
6063.14
6063.14
81456 00
Pathology
89.16
89.16
6063.14
6063.14
81457 00
Pathology
0.00
0.00
BR
BR
81458 00
Pathology
0.00
0.00
BR
BR
81459 00
Pathology
0.00
0.00
BR
BR
81460 00
Pathology
39.30
39.30
2672.72
2672.72
81462 00
Pathology
0.00
0.00
BR
BR
81463 00
Pathology
0.00
0.00
BR
BR
81464 00
Pathology
0.00
0.00
BR
BR
81465 00
Pathology
28.59
28.59
1943.79
1943.79
81470 00
Pathology
27.91
27.91
1898.11
1898.11
81471 00
Pathology
27.91
27.91
1898.11
1898.11
81479 00
Pathology
0.00
0.00
BR
BR
81490 00
Pathology
25.67
25.67
1745.78
1745.78
81493 00
Pathology
32.07
32.07
2180.54
2180.54
81500 00
Pathology
7.96
7.96
540.98
540.98
81503 00
Pathology
27.39
27.39
1862.80
1862.80
81504 00
Pathology
15.88
15.88
1079.89
1079.89
81506 00
Pathology
2.10
2.10
143.13
143.13
81507 00
Pathology
24.28
24.28
1650.98
1650.98
81508 00
Pathology
1.66
1.66
112.77
112.77
81509 00
Pathology
45.42
45.42
3088.83
3088.83
81510 00
Pathology
1.70
1.70
115.34
115.34
81511 00
Pathology
4.69
4.69
318.77
318.77
81512 00
Pathology
2.12
2.12
144.37
144.37
81513 00
Pathology
4.36
4.36
296.20
296.20
81514 00
Pathology
8.03
8.03
546.15
546.15
81517 00
Pathology
5.38
5.38
365.89
365.89
81518 00
Pathology
118.28
118.28
8043.07
8043.07
81519 00
Pathology
118.28
118.28
8043.07
8043.07
81520 00
Pathology
76.66
76.66
5212.96
5212.96
81521 00
Pathology
118.28
118.28
8043.07
8043.07
81522 00
Pathology
118.28
118.28
8043.07
8043.07
81523 00
Pathology
118.28
118.28
8043.07
8043.07
81525 00
Pathology
95.16
95.16
6471.01
6471.01
81528 00
Pathology
15.54
15.54
1056.77
1056.77
81529 00
Pathology
219.67
219.67
14937.73
14937.73
81535 00
Pathology
17.70
17.70
1203.37
1203.37
81536 00
Pathology
5.42
5.42
368.74
368.74
81538 00
Pathology
87.68
87.68
5962.22
5962.22
81539 00
Pathology
23.21
23.21
1578.29
1578.29
81540 00
Pathology
114.52
114.52
7787.64
7787.64
81541 00
Pathology
118.28
118.28
8043.07
8043.07
81542 00
Pathology
118.28
118.28
8043.07
8043.07
81546 00
Pathology
109.94
109.94
7476.13
7476.13
81551 00
Pathology
62.00
62.00
4215.71
4215.71
81552 00
Pathology
237.48
237.48
16148.45
16148.45
81554 00
Pathology
167.97
167.97
11421.87
11421.87
81560 00
Pathology
19.57
19.57
1330.61
1330.61
81595 00
Pathology
98.95
98.95
6728.52
6728.52
81596 00
Pathology
2.20
2.20
149.92
149.92
81599 00
Pathology
0.00
0.00
BR
BR
82009 00
Pathology
0.14
0.14
9.39
9.39
82010 00
Pathology
0.25
0.25
16.97
16.97
82013 00
Pathology
0.38
0.38
25.52
25.52
82016 00
Pathology
0.50
0.50
34.24
34.24
82017 00
Pathology
0.52
0.52
35.03
35.03
82024 00
Pathology
1.18
1.18
80.20
80.20
82030 00
Pathology
0.79
0.79
53.58
53.58
82040 00
Pathology
0.15
0.15
10.28
10.28
82042 00
Pathology
0.24
0.24
16.16
16.16
82043 00
Pathology
0.18
0.18
12.00
12.00
82044 00
Pathology
0.19
0.19
12.94
12.94
82045 00
Pathology
1.04
1.04
70.48
70.48
82075 00
Pathology
0.92
0.92
62.30
62.30
82077 00
Pathology
0.53
0.53
35.86
35.86
82085 00
Pathology
0.30
0.30
20.16
20.16
82088 00
Pathology
1.24
1.24
84.63
84.63
82103 00
Pathology
0.41
0.41
27.91
27.91
82104 00
Pathology
0.44
0.44
30.03
30.03
82105 00
Pathology
0.51
0.51
34.83
34.83
82106 00
Pathology
0.52
0.52
35.30
35.30
82107 00
Pathology
1.97
1.97
133.76
133.76
82108 00
Pathology
0.78
0.78
52.91
52.91
82120 00
Pathology
0.18
0.18
12.44
12.44
82127 00
Pathology
0.43
0.43
29.45
29.45
82128 00
Pathology
0.42
0.42
28.80
28.80
82131 00
Pathology
0.70
0.70
47.72
47.72
82135 00
Pathology
0.50
0.50
34.16
34.16
82136 00
Pathology
0.60
0.60
40.72
40.72
82139 00
Pathology
0.52
0.52
35.03
35.03
82140 00
Pathology
0.44
0.44
30.26
30.26
82143 00
Pathology
0.29
0.29
19.42
19.42
82150 00
Pathology
0.20
0.20
13.46
13.46
82154 00
Pathology
0.88
0.88
59.87
59.87
82157 00
Pathology
0.89
0.89
60.81
60.81
82160 00
Pathology
0.78
0.78
53.06
53.06
82163 00
Pathology
0.63
0.63
42.61
42.61
82164 00
Pathology
0.45
0.45
30.32
30.32
82166 00
Pathology
1.18
1.18
80.20
80.20
82172 00
Pathology
0.64
0.64
43.80
43.80
82175 00
Pathology
0.58
0.58
39.40
39.40
82180 00
Pathology
0.30
0.30
20.54
20.54
82190 00
Pathology
0.49
0.49
33.02
33.02
82232 00
Pathology
0.49
0.49
33.60
33.60
82239 00
Pathology
0.52
0.52
35.55
35.55
82240 00
Pathology
0.81
0.81
55.20
55.20
82247 00
Pathology
0.15
0.15
10.43
10.43
82248 00
Pathology
0.15
0.15
10.43
10.43
82252 00
Pathology
0.14
0.14
9.47
9.47
82261 00
Pathology
0.52
0.52
35.03
35.03
82270 00
Pathology
0.13
0.13
9.10
9.10
82271 00
Pathology
0.16
0.16
11.05
11.05
82272 00
Pathology
0.13
0.13
8.78
8.78
82274 00
Pathology
0.49
0.49
33.06
33.06
82286 00
Pathology
0.16
0.16
10.72
10.72
82300 00
Pathology
0.72
0.72
49.09
49.09
82306 00
Pathology
0.90
0.90
61.47
61.47
82308 00
Pathology
0.82
0.82
55.63
55.63
82310 00
Pathology
0.16
0.16
10.72
10.72
82330 00
Pathology
0.42
0.42
28.41
28.41
82331 00
Pathology
0.41
0.41
27.70
27.70
82340 00
Pathology
0.18
0.18
12.52
12.52
82355 00
Pathology
0.35
0.35
24.05
24.05
82360 00
Pathology
0.39
0.39
26.73
26.73
82365 00
Pathology
0.39
0.39
26.79
26.79
82370 00
Pathology
0.38
0.38
26.00
26.00
82373 00
Pathology
0.55
0.55
37.51
37.51
82374 00
Pathology
0.15
0.15
10.13
10.13
82375 00
Pathology
0.38
0.38
25.58
25.58
82376 00
Pathology
0.43
0.43
29.22
29.22
82378 00
Pathology
0.58
0.58
39.37
39.37
82379 00
Pathology
0.52
0.52
35.03
35.03
82380 00
Pathology
0.28
0.28
19.15
19.15
82382 00
Pathology
0.83
0.83
56.69
56.69
82383 00
Pathology
0.89
0.89
60.39
60.39
82384 00
Pathology
0.77
0.77
52.44
52.44
82387 00
Pathology
0.55
0.55
37.51
37.51
82390 00
Pathology
0.33
0.33
22.30
22.30
82397 00
Pathology
0.43
0.43
29.32
29.32
82415 00
Pathology
0.39
0.39
26.31
26.31
82435 00
Pathology
0.14
0.14
9.55
9.55
82436 00
Pathology
0.18
0.18
11.94
11.94
82438 00
Pathology
0.15
0.15
10.38
10.38
82441 00
Pathology
0.18
0.18
12.48
12.48
82465 00
Pathology
0.13
0.13
9.03
9.03
82480 00
Pathology
0.24
0.24
16.34
16.34
82482 00
Pathology
0.30
0.30
20.37
20.37
82485 00
Pathology
0.63
0.63
42.88
42.88
82495 00
Pathology
0.62
0.62
42.12
42.12
82507 00
Pathology
0.85
0.85
57.73
57.73
82523 00
Pathology
0.57
0.57
38.79
38.79
82525 00
Pathology
0.38
0.38
25.77
25.77
82528 00
Pathology
0.69
0.69
46.77
46.77
82530 00
Pathology
0.51
0.51
34.70
34.70
82533 00
Pathology
0.50
0.50
33.85
33.85
82540 00
Pathology
0.14
0.14
9.64
9.64
82542 00
Pathology
0.74
0.74
50.03
50.03
82550 00
Pathology
0.20
0.20
13.52
13.52
82552 00
Pathology
0.41
0.41
27.81
27.81
82553 00
Pathology
0.35
0.35
23.99
23.99
82554 00
Pathology
0.36
0.36
24.65
24.65
82565 00
Pathology
0.16
0.16
10.63
10.63
82570 00
Pathology
0.16
0.16
10.76
10.76
82575 00
Pathology
0.29
0.29
19.65
19.65
82585 00
Pathology
0.43
0.43
29.36
29.36
82595 00
Pathology
0.20
0.20
13.44
13.44
82600 00
Pathology
0.59
0.59
40.29
40.29
82607 00
Pathology
0.46
0.46
31.32
31.32
82608 00
Pathology
0.44
0.44
29.74
29.74
82610 00
Pathology
0.57
0.57
38.46
38.46
82615 00
Pathology
0.29
0.29
19.83
19.83
82626 00
Pathology
0.77
0.77
52.48
52.48
82627 00
Pathology
0.68
0.68
46.17
46.17
82633 00
Pathology
0.95
0.95
64.34
64.34
82634 00
Pathology
0.89
0.89
60.81
60.81
82638 00
Pathology
0.37
0.37
25.44
25.44
82642 00
Pathology
0.89
0.89
60.81
60.81
82652 00
Pathology
1.18
1.18
79.95
79.95
82653 00
Pathology
0.70
0.70
47.70
47.70
82656 00
Pathology
0.35
0.35
23.94
23.94
82657 00
Pathology
0.68
0.68
46.04
46.04
82658 00
Pathology
1.34
1.34
91.44
91.44
82664 00
Pathology
1.88
1.88
127.72
127.72
82668 00
Pathology
0.57
0.57
39.02
39.02
82670 00
Pathology
0.85
0.85
58.02
58.02
82671 00
Pathology
0.99
0.99
67.08
67.08
82672 00
Pathology
0.66
0.66
45.06
45.06
82677 00
Pathology
0.74
0.74
50.21
50.21
82679 00
Pathology
0.76
0.76
51.81
51.81
82681 00
Pathology
0.85
0.85
58.02
58.02
82693 00
Pathology
0.46
0.46
30.94
30.94
82696 00
Pathology
0.80
0.80
54.49
54.49
82705 00
Pathology
0.16
0.16
10.59
10.59
82710 00
Pathology
0.51
0.51
34.89
34.89
82715 00
Pathology
0.70
0.70
47.70
47.70
82725 00
Pathology
0.57
0.57
38.98
38.98
82726 00
Pathology
0.60
0.60
41.01
41.01
82728 00
Pathology
0.42
0.42
28.31
28.31
82731 00
Pathology
1.97
1.97
133.76
133.76
82735 00
Pathology
0.57
0.57
38.50
38.50
82746 00
Pathology
0.45
0.45
30.53
30.53
82747 00
Pathology
0.54
0.54
36.65
36.65
82757 00
Pathology
0.53
0.53
36.01
36.01
82759 00
Pathology
0.66
0.66
44.61
44.61
82760 00
Pathology
0.34
0.34
23.26
23.26
82775 00
Pathology
0.64
0.64
43.76
43.76
82776 00
Pathology
0.36
0.36
24.38
24.38
82777 00
Pathology
1.35
1.35
91.89
91.89
82784 00
Pathology
0.28
0.28
19.31
19.31
82785 00
Pathology
0.50
0.50
34.18
34.18
82787 00
Pathology
0.24
0.24
16.66
16.66
82800 00
Pathology
0.34
0.34
22.84
22.84
82803 00
Pathology
0.80
0.80
54.14
54.14
82805 00
Pathology
2.41
2.41
163.58
163.58
82810 00
Pathology
0.30
0.30
20.29
20.29
82820 00
Pathology
0.41
0.41
27.70
27.70
82930 00
Pathology
0.20
0.20
13.93
13.93
82938 00
Pathology
0.54
0.54
36.74
36.74
82941 00
Pathology
0.54
0.54
36.61
36.61
82943 00
Pathology
0.44
0.44
29.68
29.68
82945 00
Pathology
0.12
0.12
8.16
8.16
82946 00
Pathology
0.54
0.54
36.90
36.90
82947 00
Pathology
0.12
0.12
8.16
8.16
82948 00
Pathology
0.15
0.15
10.47
10.47
82950 00
Pathology
0.15
0.15
9.86
9.86
82951 00
Pathology
0.39
0.39
26.73
26.73
82952 00
Pathology
0.12
0.12
8.14
8.14
82955 00
Pathology
0.30
0.30
20.14
20.14
82960 00
Pathology
0.18
0.18
12.56
12.56
82962 00
Pathology
0.10
0.10
6.81
6.81
82963 00
Pathology
0.66
0.66
44.61
44.61
82965 00
Pathology
0.40
0.40
27.31
27.31
82977 00
Pathology
0.22
0.22
14.95
14.95
82978 00
Pathology
0.47
0.47
32.09
32.09
82979 00
Pathology
0.29
0.29
19.60
19.60
82985 00
Pathology
0.51
0.51
34.81
34.81
83001 00
Pathology
0.57
0.57
38.59
38.59
83002 00
Pathology
0.57
0.57
38.46
38.46
83003 00
Pathology
0.51
0.51
34.62
34.62
83006 00
Pathology
2.31
2.31
157.00
157.00
83009 00
Pathology
2.06
2.06
139.89
139.89
83010 00
Pathology
0.38
0.38
26.12
26.12
83012 00
Pathology
0.82
0.82
55.84
55.84
83013 00
Pathology
2.06
2.06
139.89
139.89
83014 00
Pathology
0.24
0.24
16.32
16.32
83015 00
Pathology
0.64
0.64
43.49
43.49
83018 00
Pathology
0.67
0.67
45.60
45.60
83020 00
Pathology
0.39
0.39
26.73
26.73
83020 26
Pathology
0.52
0.52
35.36
35.36
83021 00
Pathology
0.55
0.55
37.51
37.51
83026 00
Pathology
0.12
0.12
8.33
8.33
83030 00
Pathology
0.33
0.33
22.30
22.30
83033 00
Pathology
0.24
0.24
16.61
16.61
83036 00
Pathology
0.30
0.30
20.16
20.16
83037 00
Pathology
0.30
0.30
20.16
20.16
83045 00
Pathology
0.20
0.20
13.48
13.48
83050 00
Pathology
0.25
0.25
17.03
17.03
83051 00
Pathology
0.22
0.22
15.18
15.18
83060 00
Pathology
0.27
0.27
18.27
18.27
83065 00
Pathology
0.27
0.27
18.69
18.69
83068 00
Pathology
0.29
0.29
19.67
19.67
83069 00
Pathology
0.12
0.12
8.20
8.20
83070 00
Pathology
0.15
0.15
9.86
9.86
83080 00
Pathology
0.52
0.52
35.03
35.03
83088 00
Pathology
0.90
0.90
61.33
61.33
83090 00
Pathology
0.55
0.55
37.21
37.21
83150 00
Pathology
0.68
0.68
46.54
46.54
83491 00
Pathology
0.55
0.55
37.17
37.17
83497 00
Pathology
0.39
0.39
26.79
26.79
83498 00
Pathology
0.83
0.83
56.42
56.42
83500 00
Pathology
0.69
0.69
47.04
47.04
83505 00
Pathology
0.74
0.74
50.46
50.46
83516 00
Pathology
0.35
0.35
23.94
23.94
83518 00
Pathology
0.29
0.29
20.02
20.02
83519 00
Pathology
0.56
0.56
38.21
38.21
83520 00
Pathology
0.53
0.53
35.86
35.86
83521 00
Pathology
0.53
0.53
35.86
35.86
83525 00
Pathology
0.35
0.35
23.74
23.74
83527 00
Pathology
0.40
0.40
26.89
26.89
83528 00
Pathology
0.61
0.61
41.16
41.16
83529 00
Pathology
0.53
0.53
35.86
35.86
83540 00
Pathology
0.20
0.20
13.44
13.44
83550 00
Pathology
0.27
0.27
18.15
18.15
83570 00
Pathology
0.27
0.27
18.38
18.38
83582 00
Pathology
0.47
0.47
32.13
32.13
83586 00
Pathology
0.39
0.39
26.58
26.58
83593 00
Pathology
0.87
0.87
59.19
59.19
83605 00
Pathology
0.35
0.35
24.03
24.03
83615 00
Pathology
0.18
0.18
12.54
12.54
83625 00
Pathology
0.39
0.39
26.56
26.56
83630 00
Pathology
0.60
0.60
40.91
40.91
83631 00
Pathology
0.60
0.60
40.77
40.77
83632 00
Pathology
0.62
0.62
41.99
41.99
83633 00
Pathology
0.34
0.34
23.36
23.36
83655 00
Pathology
0.37
0.37
25.15
25.15
83661 00
Pathology
0.67
0.67
45.67
45.67
83662 00
Pathology
0.58
0.58
39.27
39.27
83663 00
Pathology
0.58
0.58
39.27
39.27
83664 00
Pathology
0.59
0.59
40.12
40.12
83670 00
Pathology
0.30
0.30
20.37
20.37
83690 00
Pathology
0.21
0.21
14.31
14.31
83695 00
Pathology
0.44
0.44
29.74
29.74
83698 00
Pathology
1.41
1.41
96.17
96.17
83700 00
Pathology
0.34
0.34
23.38
23.38
83701 00
Pathology
1.03
1.03
70.32
70.32
83704 00
Pathology
1.04
1.04
71.00
71.00
83718 00
Pathology
0.25
0.25
17.01
17.01
83719 00
Pathology
0.39
0.39
26.48
26.48
83721 00
Pathology
0.32
0.32
21.81
21.81
83722 00
Pathology
1.04
1.04
71.00
71.00
83727 00
Pathology
0.52
0.52
35.70
35.70
83735 00
Pathology
0.20
0.20
13.91
13.91
83775 00
Pathology
0.23
0.23
15.31
15.31
83785 00
Pathology
0.81
0.81
55.34
55.34
83789 00
Pathology
0.74
0.74
50.07
50.07
83825 00
Pathology
0.50
0.50
33.77
33.77
83835 00
Pathology
0.52
0.52
35.18
35.18
83857 00
Pathology
0.33
0.33
22.30
22.30
83861 00
Pathology
0.69
0.69
46.68
46.68
83864 00
Pathology
0.87
0.87
59.19
59.19
83872 00
Pathology
0.18
0.18
12.17
12.17
83873 00
Pathology
0.53
0.53
35.72
35.72
83874 00
Pathology
0.39
0.39
26.83
26.83
83876 00
Pathology
1.55
1.55
105.62
105.62
83880 00
Pathology
1.20
1.20
81.53
81.53
83883 00
Pathology
0.42
0.42
28.24
28.24
83885 00
Pathology
0.75
0.75
50.90
50.90
83915 00
Pathology
0.34
0.34
23.16
23.16
83916 00
Pathology
0.84
0.84
56.88
56.88
83918 00
Pathology
0.72
0.72
49.01
49.01
83919 00
Pathology
0.50
0.50
34.16
34.16
83921 00
Pathology
0.65
0.65
44.05
44.05
83930 00
Pathology
0.20
0.20
13.73
13.73
83935 00
Pathology
0.21
0.21
14.16
14.16
83937 00
Pathology
0.91
0.91
61.99
61.99
83945 00
Pathology
0.44
0.44
30.01
30.01
83950 00
Pathology
1.97
1.97
133.76
133.76
83951 00
Pathology
1.97
1.97
133.76
133.76
83970 00
Pathology
1.26
1.26
85.73
85.73
83986 00
Pathology
0.11
0.11
7.43
7.43
83987 00
Pathology
0.11
0.11
7.43
7.43
83992 00
Pathology
-
-
79.56
79.56
83993 00
Pathology
0.60
0.60
40.77
40.77
84030 00
Pathology
0.17
0.17
11.42
11.42
84035 00
Pathology
0.12
0.12
8.27
8.27
84060 00
Pathology
0.23
0.23
15.87
15.87
84066 00
Pathology
0.30
0.30
20.06
20.06
84075 00
Pathology
0.16
0.16
10.76
10.76
84078 00
Pathology
0.25
0.25
17.15
17.15
84080 00
Pathology
0.45
0.45
30.69
30.69
84081 00
Pathology
0.50
0.50
34.31
34.31
84085 00
Pathology
0.29
0.29
19.60
19.60
84087 00
Pathology
0.33
0.33
22.28
22.28
84100 00
Pathology
0.14
0.14
9.84
9.84
84105 00
Pathology
0.18
0.18
12.00
12.00
84106 00
Pathology
0.18
0.18
12.09
12.09
84110 00
Pathology
0.26
0.26
17.53
17.53
84112 00
Pathology
3.00
3.00
203.75
203.75
84119 00
Pathology
0.41
0.41
27.74
27.74
84120 00
Pathology
0.45
0.45
30.55
30.55
84126 00
Pathology
1.19
1.19
81.22
81.22
84132 00
Pathology
0.15
0.15
9.89
9.89
84133 00
Pathology
0.14
0.14
9.82
9.82
84134 00
Pathology
0.45
0.45
30.30
30.30
84135 00
Pathology
0.65
0.65
44.17
44.17
84138 00
Pathology
0.64
0.64
43.71
43.71
84140 00
Pathology
0.63
0.63
42.93
42.93
84143 00
Pathology
0.70
0.70
47.37
47.37
84144 00
Pathology
0.64
0.64
43.32
43.32
84145 00
Pathology
0.83
0.83
56.53
56.53
84146 00
Pathology
0.59
0.59
40.25
40.25
84150 00
Pathology
1.28
1.28
86.74
86.74
84152 00
Pathology
0.56
0.56
38.19
38.19
84153 00
Pathology
0.56
0.56
38.19
38.19
84154 00
Pathology
0.56
0.56
38.19
38.19
84155 00
Pathology
0.11
0.11
7.62
7.62
84156 00
Pathology
0.11
0.11
7.62
7.62
84157 00
Pathology
0.12
0.12
8.31
8.31
84160 00
Pathology
0.17
0.17
11.65
11.65
84163 00
Pathology
0.46
0.46
31.25
31.25
84165 00
Pathology
0.33
0.33
22.30
22.30
84165 26
Pathology
0.52
0.52
35.36
35.36
84166 00
Pathology
0.54
0.54
37.03
37.03
84166 26
Pathology
0.52
0.52
35.36
35.36
84181 00
Pathology
0.52
0.52
35.37
35.37
84181 26
Pathology
0.52
0.52
35.36
35.36
84182 00
Pathology
0.89
0.89
60.66
60.66
84182 26
Pathology
0.52
0.52
35.36
35.36
84202 00
Pathology
0.44
0.44
29.80
29.80
84203 00
Pathology
0.30
0.30
20.23
20.23
84206 00
Pathology
0.82
0.82
55.43
55.43
84207 00
Pathology
0.86
0.86
58.36
58.36
84210 00
Pathology
0.44
0.44
30.07
30.07
84220 00
Pathology
0.29
0.29
19.60
19.60
84228 00
Pathology
0.36
0.36
24.15
24.15
84233 00
Pathology
2.68
2.68
182.50
182.50
84234 00
Pathology
1.98
1.98
134.74
134.74
84235 00
Pathology
2.18
2.18
147.92
147.92
84238 00
Pathology
1.12
1.12
75.95
75.95
84244 00
Pathology
0.67
0.67
45.67
45.67
84252 00
Pathology
0.62
0.62
42.03
42.03
84255 00
Pathology
0.78
0.78
53.02
53.02
84260 00
Pathology
0.95
0.95
64.34
64.34
84270 00
Pathology
0.66
0.66
45.13
45.13
84275 00
Pathology
0.41
0.41
27.91
27.91
84285 00
Pathology
0.77
0.77
52.35
52.35
84295 00
Pathology
0.15
0.15
9.99
9.99
84300 00
Pathology
0.15
0.15
10.51
10.51
84302 00
Pathology
0.15
0.15
10.09
10.09
84305 00
Pathology
0.65
0.65
44.15
44.15
84307 00
Pathology
0.56
0.56
37.96
37.96
84311 00
Pathology
0.25
0.25
16.82
16.82
84315 00
Pathology
0.10
0.10
6.81
6.81
84375 00
Pathology
1.19
1.19
80.99
80.99
84376 00
Pathology
0.17
0.17
11.42
11.42
84377 00
Pathology
0.17
0.17
11.42
11.42
84378 00
Pathology
0.35
0.35
23.94
23.94
84379 00
Pathology
0.35
0.35
23.94
23.94
84392 00
Pathology
0.17
0.17
11.40
11.40
84402 00
Pathology
0.78
0.78
52.89
52.89
84403 00
Pathology
0.79
0.79
53.60
53.60
84410 00
Pathology
1.57
1.57
106.49
106.49
84425 00
Pathology
0.65
0.65
44.09
44.09
84430 00
Pathology
0.36
0.36
24.15
24.15
84431 00
Pathology
1.07
1.07
72.91
72.91
84432 00
Pathology
0.49
0.49
33.35
33.35
84433 00
Pathology
0.68
0.68
46.04
46.04
84436 00
Pathology
0.21
0.21
14.27
14.27
84437 00
Pathology
0.20
0.20
13.44
13.44
84439 00
Pathology
0.28
0.28
18.73
18.73
84442 00
Pathology
0.45
0.45
30.69
30.69
84443 00
Pathology
0.51
0.51
34.89
34.89
84445 00
Pathology
1.55
1.55
105.62
105.62
84446 00
Pathology
0.43
0.43
29.45
29.45
84449 00
Pathology
0.55
0.55
37.38
37.38
84450 00
Pathology
0.16
0.16
10.76
10.76
84460 00
Pathology
0.16
0.16
11.01
11.01
84466 00
Pathology
0.39
0.39
26.50
26.50
84478 00
Pathology
0.18
0.18
11.92
11.92
84479 00
Pathology
0.20
0.20
13.44
13.44
84480 00
Pathology
0.43
0.43
29.45
29.45
84481 00
Pathology
0.52
0.52
35.18
35.18
84482 00
Pathology
0.48
0.48
32.73
32.73
84484 00
Pathology
0.38
0.38
25.90
25.90
84485 00
Pathology
0.22
0.22
14.95
14.95
84488 00
Pathology
0.22
0.22
15.16
15.16
84490 00
Pathology
0.30
0.30
20.62
20.62
84510 00
Pathology
0.32
0.32
22.08
22.08
84512 00
Pathology
0.31
0.31
20.95
20.95
84520 00
Pathology
0.12
0.12
8.20
8.20
84525 00
Pathology
0.16
0.16
10.65
10.65
84540 00
Pathology
0.17
0.17
11.55
11.55
84545 00
Pathology
0.22
0.22
14.95
14.95
84550 00
Pathology
0.14
0.14
9.39
9.39
84560 00
Pathology
0.16
0.16
10.55
10.55
84577 00
Pathology
0.51
0.51
34.89
34.89
84578 00
Pathology
0.14
0.14
9.28
9.28
84580 00
Pathology
0.29
0.29
19.83
19.83
84583 00
Pathology
0.18
0.18
12.56
12.56
84585 00
Pathology
0.47
0.47
32.19
32.19
84586 00
Pathology
1.08
1.08
73.37
73.37
84588 00
Pathology
1.04
1.04
70.48
70.48
84590 00
Pathology
0.35
0.35
24.11
24.11
84591 00
Pathology
0.52
0.52
35.43
35.43
84597 00
Pathology
0.42
0.42
28.49
28.49
84600 00
Pathology
0.52
0.52
35.53
35.53
84620 00
Pathology
0.39
0.39
26.81
26.81
84630 00
Pathology
0.35
0.35
23.65
23.65
84681 00
Pathology
0.64
0.64
43.22
43.22
84702 00
Pathology
0.46
0.46
31.25
31.25
84703 00
Pathology
0.23
0.23
15.62
15.62
84704 00
Pathology
0.47
0.47
31.75
31.75
84830 00
Pathology
0.39
0.39
26.37
26.37
84999 00
Pathology
0.00
0.00
BR
BR
85002 00
Pathology
0.15
0.15
10.01
10.01
85004 00
Pathology
0.20
0.20
13.44
13.44
85007 00
Pathology
0.12
0.12
7.89
7.89
85008 00
Pathology
0.10
0.10
7.12
7.12
85009 00
Pathology
0.15
0.15
10.53
10.53
85013 00
Pathology
0.21
0.21
14.54
14.54
85014 00
Pathology
0.07
0.07
4.92
4.92
85018 00
Pathology
0.07
0.07
4.92
4.92
85025 00
Pathology
0.24
0.24
16.14
16.14
85027 00
Pathology
0.20
0.20
13.44
13.44
85032 00
Pathology
0.13
0.13
8.95
8.95
85041 00
Pathology
0.09
0.09
6.27
6.27
85044 00
Pathology
0.13
0.13
8.95
8.95
85045 00
Pathology
0.12
0.12
8.29
8.29
85046 00
Pathology
0.17
0.17
11.57
11.57
85048 00
Pathology
0.08
0.08
5.27
5.27
85049 00
Pathology
0.14
0.14
9.30
9.30
85055 00
Pathology
1.09
1.09
74.22
74.22
85060 00
Pathology
0.70
0.70
47.60
47.60
85097 00
Pathology
2.08
1.41
141.44
95.88
85130 00
Pathology
0.36
0.36
24.69
24.69
85170 00
Pathology
0.50
0.50
33.85
33.85
85175 00
Pathology
0.62
0.62
42.30
42.30
85210 00
Pathology
0.40
0.40
26.96
26.96
85220 00
Pathology
0.54
0.54
36.65
36.65
85230 00
Pathology
0.55
0.55
37.17
37.17
85240 00
Pathology
0.55
0.55
37.17
37.17
85244 00
Pathology
0.62
0.62
42.41
42.41
85245 00
Pathology
0.70
0.70
47.64
47.64
85246 00
Pathology
0.70
0.70
47.64
47.64
85247 00
Pathology
0.70
0.70
47.64
47.64
85250 00
Pathology
0.58
0.58
39.54
39.54
85260 00
Pathology
0.55
0.55
37.17
37.17
85270 00
Pathology
0.55
0.55
37.17
37.17
85280 00
Pathology
0.59
0.59
40.18
40.18
85290 00
Pathology
0.50
0.50
33.93
33.93
85291 00
Pathology
0.28
0.28
18.92
18.92
85292 00
Pathology
0.58
0.58
39.31
39.31
85293 00
Pathology
0.58
0.58
39.31
39.31
85300 00
Pathology
0.36
0.36
24.61
24.61
85301 00
Pathology
0.33
0.33
22.45
22.45
85302 00
Pathology
0.37
0.37
24.94
24.94
85303 00
Pathology
0.42
0.42
28.74
28.74
85305 00
Pathology
0.35
0.35
24.11
24.11
85306 00
Pathology
0.47
0.47
31.82
31.82
85307 00
Pathology
0.47
0.47
31.82
31.82
85335 00
Pathology
0.39
0.39
26.73
26.73
85337 00
Pathology
0.53
0.53
35.86
35.86
85345 00
Pathology
0.14
0.14
9.74
9.74
85347 00
Pathology
0.13
0.13
8.89
8.89
85348 00
Pathology
0.14
0.14
9.32
9.32
85360 00
Pathology
0.26
0.26
17.47
17.47
85362 00
Pathology
0.21
0.21
14.31
14.31
85366 00
Pathology
2.46
2.46
167.09
167.09
85370 00
Pathology
0.38
0.38
25.81
25.81
85378 00
Pathology
0.30
0.30
20.19
20.19
85379 00
Pathology
0.31
0.31
21.14
21.14
85380 00
Pathology
0.31
0.31
21.14
21.14
85384 00
Pathology
0.30
0.30
20.19
20.19
85385 00
Pathology
0.44
0.44
30.03
30.03
85390 00
Pathology
0.47
0.47
32.15
32.15
85390 26
Pathology
1.06
1.06
72.08
72.08
85396 00
Pathology
0.57
0.57
38.76
38.76
85397 00
Pathology
0.94
0.94
64.09
64.09
85400 00
Pathology
0.24
0.24
16.01
16.01
85410 00
Pathology
0.24
0.24
16.01
16.01
85415 00
Pathology
0.52
0.52
35.70
35.70
85420 00
Pathology
0.20
0.20
13.56
13.56
85421 00
Pathology
0.31
0.31
21.14
21.14
85441 00
Pathology
0.13
0.13
8.72
8.72
85445 00
Pathology
0.21
0.21
14.16
14.16
85460 00
Pathology
0.24
0.24
16.05
16.05
85461 00
Pathology
0.29
0.29
19.44
19.44
85475 00
Pathology
0.27
0.27
18.42
18.42
85520 00
Pathology
0.40
0.40
27.18
27.18
85525 00
Pathology
0.36
0.36
24.59
24.59
85530 00
Pathology
0.40
0.40
27.18
27.18
85536 00
Pathology
0.21
0.21
14.29
14.29
85540 00
Pathology
0.26
0.26
17.86
17.86
85547 00
Pathology
0.26
0.26
17.86
17.86
85549 00
Pathology
0.57
0.57
38.94
38.94
85555 00
Pathology
0.23
0.23
15.51
15.51
85557 00
Pathology
0.41
0.41
27.74
27.74
85576 00
Pathology
0.76
0.76
51.73
51.73
85576 26
Pathology
0.52
0.52
35.36
35.36
85597 00
Pathology
0.55
0.55
37.34
37.34
85598 00
Pathology
0.55
0.55
37.34
37.34
85610 00
Pathology
0.13
0.13
8.91
8.91
85611 00
Pathology
0.12
0.12
8.18
8.18
85612 00
Pathology
0.53
0.53
36.32
36.32
85613 00
Pathology
0.29
0.29
19.89
19.89
85635 00
Pathology
0.30
0.30
20.46
20.46
85651 00
Pathology
0.13
0.13
8.87
8.87
85652 00
Pathology
0.08
0.08
5.61
5.61
85660 00
Pathology
0.17
0.17
11.44
11.44
85670 00
Pathology
0.18
0.18
11.98
11.98
85675 00
Pathology
0.21
0.21
14.23
14.23
85705 00
Pathology
0.29
0.29
20.00
20.00
85730 00
Pathology
0.18
0.18
12.48
12.48
85732 00
Pathology
0.20
0.20
13.44
13.44
85810 00
Pathology
0.36
0.36
24.24
24.24
85999 00
Pathology
0.00
0.00
BR
BR
86000 00
Pathology
0.21
0.21
14.50
14.50
86001 00
Pathology
0.24
0.24
16.24
16.24
86003 00
Pathology
0.16
0.16
10.84
10.84
86005 00
Pathology
0.24
0.24
16.55
16.55
86008 00
Pathology
0.55
0.55
37.24
37.24
86015 00
Pathology
0.37
0.37
25.02
25.02
86021 00
Pathology
0.46
0.46
31.25
31.25
86022 00
Pathology
0.56
0.56
38.15
38.15
86023 00
Pathology
0.38
0.38
25.88
25.88
86036 00
Pathology
0.37
0.37
25.02
25.02
86037 00
Pathology
0.37
0.37
25.02
25.02
86038 00
Pathology
0.37
0.37
25.11
25.11
86039 00
Pathology
0.34
0.34
23.18
23.18
86041 00
Pathology
0.56
0.56
38.21
38.21
86042 00
Pathology
0.56
0.56
38.21
38.21
86043 00
Pathology
0.37
0.37
25.02
25.02
86051 00
Pathology
0.35
0.35
23.94
23.94
86052 00
Pathology
0.37
0.37
25.02
25.02
86053 00
Pathology
1.15
1.15
78.35
78.35
86060 00
Pathology
0.22
0.22
15.16
15.16
86063 00
Pathology
0.18
0.18
11.98
11.98
86077 00
Pathology
1.58
1.44
107.44
97.92
86078 00
Pathology
1.58
1.44
107.44
97.92
86079 00
Pathology
1.58
1.44
107.44
97.92
86140 00
Pathology
0.16
0.16
10.76
10.76
86141 00
Pathology
0.40
0.40
26.89
26.89
86146 00
Pathology
0.78
0.78
52.85
52.85
86147 00
Pathology
0.78
0.78
52.85
52.85
86148 00
Pathology
0.49
0.49
33.37
33.37
86152 00
Pathology
7.66
7.66
520.80
520.80
86153 26
Pathology
0.98
0.98
66.64
66.64
86155 00
Pathology
0.49
0.49
33.21
33.21
86156 00
Pathology
0.25
0.25
16.76
16.76
86157 00
Pathology
0.25
0.25
16.74
16.74
86160 00
Pathology
0.37
0.37
24.92
24.92
86161 00
Pathology
0.37
0.37
24.92
24.92
86162 00
Pathology
0.62
0.62
42.20
42.20
86171 00
Pathology
0.31
0.31
20.79
20.79
86200 00
Pathology
0.40
0.40
26.89
26.89
86215 00
Pathology
0.40
0.40
27.52
27.52
86225 00
Pathology
0.42
0.42
28.53
28.53
86226 00
Pathology
0.37
0.37
25.15
25.15
86231 00
Pathology
0.37
0.37
25.11
25.11
86235 00
Pathology
0.55
0.55
37.24
37.24
86255 00
Pathology
0.37
0.37
25.02
25.02
86255 26
Pathology
0.52
0.52
35.36
35.36
86256 00
Pathology
0.37
0.37
25.02
25.02
86256 26
Pathology
0.52
0.52
35.36
35.36
86258 00
Pathology
0.37
0.37
25.02
25.02
86277 00
Pathology
0.48
0.48
32.69
32.69
86280 00
Pathology
0.25
0.25
17.01
17.01
86294 00
Pathology
0.78
0.78
53.10
53.10
86300 00
Pathology
0.64
0.64
43.22
43.22
86301 00
Pathology
0.64
0.64
43.22
43.22
86304 00
Pathology
0.64
0.64
43.22
43.22
86305 00
Pathology
0.64
0.64
43.22
43.22
86308 00
Pathology
0.16
0.16
10.76
10.76
86309 00
Pathology
0.20
0.20
13.44
13.44
86310 00
Pathology
0.23
0.23
15.31
15.31
86316 00
Pathology
0.64
0.64
43.22
43.22
86317 00
Pathology
0.46
0.46
31.13
31.13
86318 00
Pathology
0.55
0.55
37.57
37.57
86320 00
Pathology
0.91
0.91
62.13
62.13
86320 26
Pathology
0.52
0.52
35.36
35.36
86325 00
Pathology
0.71
0.71
48.03
48.03
86325 26
Pathology
0.52
0.52
35.36
35.36
86327 00
Pathology
0.91
0.91
62.13
62.13
86327 26
Pathology
0.63
0.63
42.84
42.84
86328 00
Pathology
1.38
1.38
94.03
94.03
86329 00
Pathology
0.43
0.43
29.18
29.18
86331 00
Pathology
0.37
0.37
24.88
24.88
86332 00
Pathology
0.74
0.74
50.61
50.61
86334 00
Pathology
0.68
0.68
46.39
46.39
86334 26
Pathology
0.52
0.52
35.36
35.36
86335 00
Pathology
0.90
0.90
60.95
60.95
86335 26
Pathology
0.52
0.52
35.36
35.36
86336 00
Pathology
0.48
0.48
32.38
32.38
86337 00
Pathology
0.65
0.65
44.46
44.46
86340 00
Pathology
0.46
0.46
31.32
31.32
86341 00
Pathology
0.72
0.72
48.95
48.95
86343 00
Pathology
0.38
0.38
25.88
25.88
86344 00
Pathology
0.32
0.32
21.58
21.58
86352 00
Pathology
4.15
4.15
282.14
282.14
86353 00
Pathology
1.50
1.50
101.82
101.82
86355 00
Pathology
1.15
1.15
78.35
78.35
86356 00
Pathology
0.82
0.82
55.61
55.61
86357 00
Pathology
1.15
1.15
78.35
78.35
86359 00
Pathology
1.15
1.15
78.35
78.35
86360 00
Pathology
1.43
1.43
97.56
97.56
86361 00
Pathology
0.82
0.82
55.61
55.61
86362 00
Pathology
0.37
0.37
25.02
25.02
86363 00
Pathology
1.15
1.15
78.35
78.35
86364 00
Pathology
0.35
0.35
23.94
23.94
86366 00
Pathology
0.56
0.56
38.21
38.21
86367 00
Pathology
2.38
2.38
161.53
161.53
86376 00
Pathology
0.44
0.44
30.22
30.22
86381 00
Pathology
0.78
0.78
52.85
52.85
86382 00
Pathology
0.52
0.52
35.12
35.12
86384 00
Pathology
0.42
0.42
28.26
28.26
86386 00
Pathology
0.67
0.67
45.23
45.23
86403 00
Pathology
0.35
0.35
23.97
23.97
86406 00
Pathology
0.32
0.32
22.10
22.10
86408 00
Pathology
1.29
1.29
87.49
87.49
86409 00
Pathology
-
-
349.52
349.52
86413 00
Pathology
-
-
170.68
170.68
86430 00
Pathology
0.19
0.19
12.75
12.75
86431 00
Pathology
0.17
0.17
11.77
11.77
86480 00
Pathology
1.89
1.89
128.71
128.71
86481 00
Pathology
3.05
3.05
207.67
207.67
86485 00
Pathology
-
-
66.64
66.64
86486 00
Pathology
0.19
0.19
12.92
12.92
86490 00
Pathology
2.29
2.29
155.72
155.72
86510 00
Pathology
0.23
0.23
15.64
15.64
86580 00
Pathology
0.31
0.31
21.08
21.08
86590 00
Pathology
0.39
0.39
26.29
26.29
86592 00
Pathology
0.13
0.13
8.87
8.87
86593 00
Pathology
0.13
0.13
9.14
9.14
86596 00
Pathology
0.37
0.37
25.02
25.02
86602 00
Pathology
0.31
0.31
21.14
21.14
86603 00
Pathology
0.39
0.39
26.73
26.73
86606 00
Pathology
0.46
0.46
31.25
31.25
86609 00
Pathology
0.39
0.39
26.75
26.75
86611 00
Pathology
0.31
0.31
21.14
21.14
86612 00
Pathology
0.39
0.39
26.79
26.79
86615 00
Pathology
0.40
0.40
27.39
27.39
86617 00
Pathology
0.47
0.47
32.17
32.17
86618 00
Pathology
0.52
0.52
35.37
35.37
86619 00
Pathology
0.41
0.41
27.79
27.79
86622 00
Pathology
0.27
0.27
18.54
18.54
86625 00
Pathology
0.40
0.40
27.25
27.25
86628 00
Pathology
0.37
0.37
24.94
24.94
86631 00
Pathology
0.36
0.36
24.55
24.55
86632 00
Pathology
0.39
0.39
26.33
26.33
86635 00
Pathology
0.35
0.35
23.82
23.82
86638 00
Pathology
0.37
0.37
25.17
25.17
86641 00
Pathology
0.44
0.44
29.93
29.93
86644 00
Pathology
0.44
0.44
29.88
29.88
86645 00
Pathology
0.51
0.51
34.99
34.99
86648 00
Pathology
0.46
0.46
31.59
31.59
86651 00
Pathology
0.40
0.40
27.39
27.39
86652 00
Pathology
0.40
0.40
27.39
27.39
86653 00
Pathology
0.40
0.40
27.39
27.39
86654 00
Pathology
0.40
0.40
27.39
27.39
86658 00
Pathology
0.40
0.40
27.06
27.06
86663 00
Pathology
0.40
0.40
27.25
27.25
86664 00
Pathology
0.47
0.47
31.75
31.75
86665 00
Pathology
0.55
0.55
37.67
37.67
86666 00
Pathology
0.31
0.31
21.14
21.14
86668 00
Pathology
0.43
0.43
29.41
29.41
86671 00
Pathology
0.37
0.37
25.44
25.44
86674 00
Pathology
0.45
0.45
30.57
30.57
86677 00
Pathology
0.51
0.51
34.99
34.99
86682 00
Pathology
0.40
0.40
27.02
27.02
86684 00
Pathology
0.48
0.48
32.89
32.89
86687 00
Pathology
0.28
0.28
18.88
18.88
86688 00
Pathology
0.43
0.43
29.07
29.07
86689 00
Pathology
0.59
0.59
40.18
40.18
86692 00
Pathology
0.52
0.52
35.64
35.64
86694 00
Pathology
0.44
0.44
29.88
29.88
86695 00
Pathology
0.40
0.40
27.39
27.39
86696 00
Pathology
0.59
0.59
40.18
40.18
86698 00
Pathology
0.42
0.42
28.64
28.64
86701 00
Pathology
0.27
0.27
18.46
18.46
86702 00
Pathology
0.41
0.41
28.08
28.08
86703 00
Pathology
0.42
0.42
28.47
28.47
86704 00
Pathology
0.37
0.37
25.02
25.02
86705 00
Pathology
0.36
0.36
24.44
24.44
86706 00
Pathology
0.33
0.33
22.30
22.30
86707 00
Pathology
0.35
0.35
24.03
24.03
86708 00
Pathology
0.38
0.38
25.73
25.73
86709 00
Pathology
0.34
0.34
23.38
23.38
86710 00
Pathology
0.41
0.41
28.14
28.14
86711 00
Pathology
0.52
0.52
35.08
35.08
86713 00
Pathology
0.47
0.47
31.77
31.77
86717 00
Pathology
0.37
0.37
25.44
25.44
86720 00
Pathology
0.49
0.49
33.64
33.64
86723 00
Pathology
0.40
0.40
27.39
27.39
86727 00
Pathology
0.39
0.39
26.73
26.73
86732 00
Pathology
0.46
0.46
31.15
31.15
86735 00
Pathology
0.40
0.40
27.10
27.10
86738 00
Pathology
0.40
0.40
27.50
27.50
86741 00
Pathology
0.40
0.40
27.39
27.39
86744 00
Pathology
0.49
0.49
33.21
33.21
86747 00
Pathology
0.46
0.46
31.21
31.21
86750 00
Pathology
0.40
0.40
27.39
27.39
86753 00
Pathology
0.38
0.38
25.73
25.73
86756 00
Pathology
0.49
0.49
33.00
33.00
86757 00
Pathology
0.59
0.59
40.18
40.18
86759 00
Pathology
0.56
0.56
37.86
37.86
86762 00
Pathology
0.44
0.44
29.88
29.88
86765 00
Pathology
0.39
0.39
26.75
26.75
86768 00
Pathology
0.40
0.40
27.39
27.39
86769 00
Pathology
1.29
1.29
87.49
87.49
86771 00
Pathology
0.75
0.75
50.84
50.84
86774 00
Pathology
0.45
0.45
30.74
30.74
86777 00
Pathology
0.44
0.44
29.88
29.88
86778 00
Pathology
0.44
0.44
29.93
29.93
86780 00
Pathology
0.40
0.40
27.50
27.50
86784 00
Pathology
0.38
0.38
26.08
26.08
86787 00
Pathology
0.39
0.39
26.75
26.75
86788 00
Pathology
0.51
0.51
34.99
34.99
86789 00
Pathology
0.44
0.44
29.88
29.88
86790 00
Pathology
0.39
0.39
26.75
26.75
86793 00
Pathology
0.40
0.40
27.39
27.39
86794 00
Pathology
0.51
0.51
34.99
34.99
86800 00
Pathology
0.49
0.49
33.04
33.04
86803 00
Pathology
0.44
0.44
29.63
29.63
86804 00
Pathology
0.47
0.47
32.17
32.17
86805 00
Pathology
5.79
5.79
393.56
393.56
86806 00
Pathology
1.45
1.45
98.83
98.83
86807 00
Pathology
2.40
2.40
163.33
163.33
86808 00
Pathology
0.91
0.91
61.64
61.64
86812 00
Pathology
0.79
0.79
53.60
53.60
86813 00
Pathology
1.77
1.77
120.45
120.45
86816 00
Pathology
0.92
0.92
62.65
62.65
86817 00
Pathology
3.24
3.24
220.42
220.42
86821 00
Pathology
1.12
1.12
75.92
75.92
86825 00
Pathology
3.34
3.34
227.38
227.38
86826 00
Pathology
1.12
1.12
75.86
75.86
86828 00
Pathology
1.96
1.96
133.30
133.30
86829 00
Pathology
1.96
1.96
133.30
133.30
86830 00
Pathology
2.92
2.92
198.37
198.37
86831 00
Pathology
2.50
2.50
170.04
170.04
86832 00
Pathology
9.89
9.89
672.33
672.33
86833 00
Pathology
9.95
9.95
676.59
676.59
86834 00
Pathology
10.92
10.92
742.55
742.55
86835 00
Pathology
9.86
9.86
670.69
670.69
86849 00
Pathology
0.00
0.00
BR
BR
86850 00
Pathology
0.30
0.30
20.29
20.29
86860 00
Pathology
-
-
234.60
234.60
86870 00
Pathology
-
-
174.08
174.08
86880 00
Pathology
0.16
0.16
11.19
11.19
86885 00
Pathology
0.17
0.17
11.88
11.88
86886 00
Pathology
0.16
0.16
10.76
10.76
86890 00
Pathology
-
-
246.84
246.84
86891 00
Pathology
-
-
1243.04
1243.04
86900 00
Pathology
0.09
0.09
6.21
6.21
86901 00
Pathology
0.09
0.09
6.21
6.21
86902 00
Pathology
0.19
0.19
13.19
13.19
86904 00
Pathology
0.50
0.50
33.93
33.93
86905 00
Pathology
0.12
0.12
7.95
7.95
86906 00
Pathology
0.24
0.24
16.09
16.09
86910 00
Pathology
0.00
0.00
BR
BR
86911 00
Pathology
0.00
0.00
BR
BR
86920 00
Pathology
-
-
129.20
129.20
86921 00
Pathology
-
-
124.44
124.44
86922 00
Pathology
-
-
157.76
157.76
86923 00
Pathology
-
-
36.72
36.72
86927 00
Pathology
-
-
23.12
23.12
86930 00
Pathology
0.00
0.00
BR
BR
86931 00
Pathology
0.00
0.00
BR
BR
86932 00
Pathology
0.00
0.00
BR
BR
86940 00
Pathology
0.27
0.27
18.21
18.21
86941 00
Pathology
0.37
0.37
25.15
25.15
86945 00
Pathology
-
-
76.84
76.84
86950 00
Pathology
0.00
0.00
BR
BR
86960 00
Pathology
-
-
99.28
99.28
86965 00
Pathology
-
-
742.56
742.56
86970 00
Pathology
-
-
305.32
305.32
86971 00
Pathology
-
-
74.80
74.80
86972 00
Pathology
-
-
174.08
174.08
86975 00
Pathology
0.00
0.00
BR
BR
86976 00
Pathology
-
-
127.84
127.84
86977 00
Pathology
0.00
0.00
BR
BR
86978 00
Pathology
-
-
218.96
218.96
86985 00
Pathology
-
-
132.60
132.60
86999 00
Pathology
0.00
0.00
BR
BR
87003 00
Pathology
0.51
0.51
34.97
34.97
87015 00
Pathology
0.20
0.20
13.87
13.87
87040 00
Pathology
0.32
0.32
21.43
21.43
87045 00
Pathology
0.29
0.29
19.60
19.60
87046 00
Pathology
0.29
0.29
19.60
19.60
87070 00
Pathology
0.26
0.26
17.90
17.90
87071 00
Pathology
0.30
0.30
20.54
20.54
87073 00
Pathology
0.30
0.30
20.06
20.06
87075 00
Pathology
0.29
0.29
19.67
19.67
87076 00
Pathology
0.25
0.25
16.78
16.78
87077 00
Pathology
0.25
0.25
16.78
16.78
87081 00
Pathology
0.20
0.20
13.77
13.77
87084 00
Pathology
0.83
0.83
56.22
56.22
87086 00
Pathology
0.25
0.25
16.76
16.76
87088 00
Pathology
0.25
0.25
16.80
16.80
87101 00
Pathology
0.24
0.24
16.01
16.01
87102 00
Pathology
0.26
0.26
17.47
17.47
87103 00
Pathology
0.62
0.62
42.49
42.49
87106 00
Pathology
0.32
0.32
21.43
21.43
87107 00
Pathology
0.32
0.32
21.43
21.43
87109 00
Pathology
0.47
0.47
31.96
31.96
87110 00
Pathology
0.60
0.60
40.70
40.70
87116 00
Pathology
0.33
0.33
22.43
22.43
87118 00
Pathology
0.45
0.45
30.34
30.34
87140 00
Pathology
0.17
0.17
11.57
11.57
87143 00
Pathology
0.38
0.38
26.00
26.00
87147 00
Pathology
0.16
0.16
10.76
10.76
87149 00
Pathology
0.61
0.61
41.64
41.64
87150 00
Pathology
1.07
1.07
72.87
72.87
87152 00
Pathology
0.24
0.24
16.07
16.07
87153 00
Pathology
3.52
3.52
239.57
239.57
87154 00
Pathology
6.66
6.66
452.85
452.85
87158 00
Pathology
0.24
0.24
16.07
16.07
87164 00
Pathology
0.33
0.33
22.30
22.30
87164 26
Pathology
0.56
0.56
38.08
38.08
87166 00
Pathology
0.35
0.35
23.47
23.47
87168 00
Pathology
0.13
0.13
8.87
8.87
87169 00
Pathology
0.13
0.13
8.95
8.95
87172 00
Pathology
0.13
0.13
8.87
8.87
87176 00
Pathology
0.18
0.18
12.21
12.21
87177 00
Pathology
0.27
0.27
18.48
18.48
87181 00
Pathology
0.15
0.15
9.86
9.86
87184 00
Pathology
0.23
0.23
15.53
15.53
87185 00
Pathology
0.15
0.15
9.86
9.86
87186 00
Pathology
0.26
0.26
17.96
17.96
87187 00
Pathology
1.23
1.23
83.42
83.42
87188 00
Pathology
0.20
0.20
13.79
13.79
87190 00
Pathology
0.22
0.22
15.18
15.18
87197 00
Pathology
0.46
0.46
31.19
31.19
87205 00
Pathology
0.13
0.13
8.87
8.87
87206 00
Pathology
0.16
0.16
11.19
11.19
87207 00
Pathology
0.18
0.18
12.44
12.44
87207 26
Pathology
0.52
0.52
35.36
35.36
87209 00
Pathology
0.55
0.55
37.34
37.34
87210 00
Pathology
0.18
0.18
12.09
12.09
87220 00
Pathology
0.13
0.13
8.87
8.87
87230 00
Pathology
0.60
0.60
40.99
40.99
87250 00
Pathology
0.60
0.60
40.62
40.62
87252 00
Pathology
0.80
0.80
54.14
54.14
87253 00
Pathology
0.62
0.62
41.95
41.95
87254 00
Pathology
0.60
0.60
40.62
40.62
87255 00
Pathology
1.03
1.03
70.32
70.32
87260 00
Pathology
0.44
0.44
29.97
29.97
87265 00
Pathology
0.37
0.37
24.88
24.88
87267 00
Pathology
0.41
0.41
27.87
27.87
87269 00
Pathology
0.42
0.42
28.26
28.26
87270 00
Pathology
0.37
0.37
24.88
24.88
87271 00
Pathology
0.41
0.41
27.87
27.87
87272 00
Pathology
0.37
0.37
24.88
24.88
87273 00
Pathology
0.37
0.37
24.88
24.88
87274 00
Pathology
0.37
0.37
24.88
24.88
87275 00
Pathology
0.37
0.37
25.44
25.44
87276 00
Pathology
0.49
0.49
33.37
33.37
87278 00
Pathology
0.48
0.48
32.40
32.40
87279 00
Pathology
0.50
0.50
34.12
34.12
87280 00
Pathology
0.41
0.41
27.87
27.87
87281 00
Pathology
0.37
0.37
24.88
24.88
87283 00
Pathology
1.86
1.86
126.26
126.26
87285 00
Pathology
0.37
0.37
25.29
25.29
87290 00
Pathology
0.41
0.41
27.87
27.87
87299 00
Pathology
0.49
0.49
33.43
33.43
87300 00
Pathology
0.37
0.37
24.88
24.88
87301 00
Pathology
0.37
0.37
24.88
24.88
87305 00
Pathology
0.37
0.37
24.88
24.88
87320 00
Pathology
0.46
0.46
31.15
31.15
87324 00
Pathology
0.37
0.37
24.88
24.88
87327 00
Pathology
0.41
0.41
27.87
27.87
87328 00
Pathology
0.42
0.42
28.70
28.70
87329 00
Pathology
0.37
0.37
24.88
24.88
87332 00
Pathology
0.37
0.37
24.88
24.88
87335 00
Pathology
0.39
0.39
26.29
26.29
87336 00
Pathology
0.49
0.49
33.23
33.23
87337 00
Pathology
0.37
0.37
24.88
24.88
87338 00
Pathology
0.44
0.44
29.86
29.86
87339 00
Pathology
0.49
0.49
33.23
33.23
87340 00
Pathology
0.32
0.32
21.45
21.45
87341 00
Pathology
0.32
0.32
21.45
21.45
87350 00
Pathology
0.35
0.35
23.94
23.94
87380 00
Pathology
0.56
0.56
38.13
38.13
87385 00
Pathology
0.40
0.40
27.52
27.52
87389 00
Pathology
0.74
0.74
50.01
50.01
87390 00
Pathology
0.73
0.73
49.97
49.97
87391 00
Pathology
0.67
0.67
45.48
45.48
87400 00
Pathology
0.43
0.43
29.34
29.34
87420 00
Pathology
0.42
0.42
28.89
28.89
87425 00
Pathology
0.37
0.37
24.88
24.88
87426 00
Pathology
1.08
1.08
73.37
73.37
87427 00
Pathology
0.37
0.37
24.88
24.88
87428 00
Pathology
2.15
2.15
145.97
145.97
87430 00
Pathology
0.51
0.51
34.91
34.91
87449 00
Pathology
0.37
0.37
24.88
24.88
87451 00
Pathology
0.32
0.32
21.83
21.83
87467 00
Pathology
-
-
30.20
30.20
87468 00
Pathology
1.07
1.07
72.87
72.87
87469 00
Pathology
1.07
1.07
72.87
72.87
87471 00
Pathology
1.07
1.07
72.87
72.87
87472 00
Pathology
1.31
1.31
88.97
88.97
87475 00
Pathology
0.61
0.61
41.64
41.64
87476 00
Pathology
1.07
1.07
72.87
72.87
87478 00
Pathology
1.07
1.07
72.87
72.87
87480 00
Pathology
0.61
0.61
41.64
41.64
87481 00
Pathology
1.07
1.07
72.87
72.87
87482 00
Pathology
1.70
1.70
115.76
115.76
87483 00
Pathology
12.73
12.73
865.53
865.53
87484 00
Pathology
1.07
1.07
72.87
72.87
87485 00
Pathology
0.61
0.61
41.64
41.64
87486 00
Pathology
1.07
1.07
72.87
72.87
87487 00
Pathology
1.31
1.31
88.97
88.97
87490 00
Pathology
0.69
0.69
47.25
47.25
87491 00
Pathology
1.07
1.07
72.87
72.87
87492 00
Pathology
1.63
1.63
111.04
111.04
87493 00
Pathology
1.14
1.14
77.40
77.40
87495 00
Pathology
0.92
0.92
62.36
62.36
87496 00
Pathology
1.07
1.07
72.87
72.87
87497 00
Pathology
1.31
1.31
88.97
88.97
87498 00
Pathology
1.07
1.07
72.87
72.87
87500 00
Pathology
1.07
1.07
72.87
72.87
87501 00
Pathology
1.57
1.57
106.56
106.56
87502 00
Pathology
2.93
2.93
198.95
198.95
87503 00
Pathology
0.89
0.89
60.68
60.68
87505 00
Pathology
3.92
3.92
266.42
266.42
87506 00
Pathology
8.03
8.03
546.15
546.15
87507 00
Pathology
12.73
12.73
865.53
865.53
87510 00
Pathology
0.61
0.61
41.64
41.64
87511 00
Pathology
1.07
1.07
72.87
72.87
87512 00
Pathology
1.28
1.28
86.72
86.72
87516 00
Pathology
1.07
1.07
72.87
72.87
87517 00
Pathology
1.31
1.31
88.97
88.97
87520 00
Pathology
0.95
0.95
64.83
64.83
87521 00
Pathology
1.07
1.07
72.87
72.87
87522 00
Pathology
1.31
1.31
88.97
88.97
87523 00
Pathology
1.31
1.31
88.97
88.97
87525 00
Pathology
0.91
0.91
61.89
61.89
87526 00
Pathology
1.20
1.20
81.53
81.53
87527 00
Pathology
1.28
1.28
86.72
86.72
87528 00
Pathology
0.61
0.61
41.64
41.64
87529 00
Pathology
1.07
1.07
72.87
72.87
87530 00
Pathology
1.31
1.31
88.97
88.97
87531 00
Pathology
1.77
1.77
120.45
120.45
87532 00
Pathology
1.07
1.07
72.87
72.87
87533 00
Pathology
1.28
1.28
86.72
86.72
87534 00
Pathology
0.67
0.67
45.52
45.52
87535 00
Pathology
1.07
1.07
72.87
72.87
87536 00
Pathology
2.60
2.60
176.73
176.73
87537 00
Pathology
0.67
0.67
45.52
45.52
87538 00
Pathology
1.07
1.07
72.87
72.87
87539 00
Pathology
1.79
1.79
121.74
121.74
87540 00
Pathology
0.61
0.61
41.64
41.64
87541 00
Pathology
1.07
1.07
72.87
72.87
87542 00
Pathology
1.28
1.28
86.72
86.72
87550 00
Pathology
0.61
0.61
41.64
41.64
87551 00
Pathology
1.47
1.47
100.18
100.18
87552 00
Pathology
1.31
1.31
88.97
88.97
87555 00
Pathology
0.82
0.82
55.82
55.82
87556 00
Pathology
1.27
1.27
86.56
86.56
87557 00
Pathology
1.31
1.31
88.97
88.97
87560 00
Pathology
0.83
0.83
56.67
56.67
87561 00
Pathology
1.07
1.07
72.87
72.87
87562 00
Pathology
1.31
1.31
88.97
88.97
87563 00
Pathology
1.07
1.07
72.87
72.87
87580 00
Pathology
0.61
0.61
41.64
41.64
87581 00
Pathology
1.07
1.07
72.87
72.87
87582 00
Pathology
9.24
9.24
628.45
628.45
87590 00
Pathology
0.82
0.82
55.82
55.82
87591 00
Pathology
1.07
1.07
72.87
72.87
87592 00
Pathology
1.31
1.31
88.97
88.97
87593 00
Pathology
-
-
82.96
82.96
87623 00
Pathology
1.07
1.07
72.87
72.87
87624 00
Pathology
1.07
1.07
72.87
72.87
87625 00
Pathology
1.24
1.24
84.21
84.21
87631 00
Pathology
4.36
4.36
296.20
296.20
87632 00
Pathology
6.66
6.66
452.85
452.85
87633 00
Pathology
12.73
12.73
865.53
865.53
87634 00
Pathology
2.14
2.14
145.78
145.78
87635 00
Pathology
1.57
1.57
106.56
106.56
87636 00
Pathology
4.36
4.36
296.20
296.20
87637 00
Pathology
4.36
4.36
296.20
296.20
87640 00
Pathology
1.07
1.07
72.87
72.87
87641 00
Pathology
1.07
1.07
72.87
72.87
87650 00
Pathology
0.61
0.61
41.64
41.64
87651 00
Pathology
1.07
1.07
72.87
72.87
87652 00
Pathology
1.28
1.28
86.72
86.72
87653 00
Pathology
1.07
1.07
72.87
72.87
87660 00
Pathology
0.61
0.61
41.64
41.64
87661 00
Pathology
1.07
1.07
72.87
72.87
87662 00
Pathology
1.57
1.57
106.56
106.56
87797 00
Pathology
0.92
0.92
62.36
62.36
87798 00
Pathology
1.07
1.07
72.87
72.87
87799 00
Pathology
1.31
1.31
88.97
88.97
87800 00
Pathology
1.33
1.33
90.69
90.69
87801 00
Pathology
2.14
2.14
145.78
145.78
87802 00
Pathology
0.39
0.39
26.44
26.44
87803 00
Pathology
0.49
0.49
33.23
33.23
87804 00
Pathology
0.51
0.51
34.37
34.37
87806 00
Pathology
1.00
1.00
68.05
68.05
87807 00
Pathology
0.40
0.40
27.20
27.20
87808 00
Pathology
0.47
0.47
31.75
31.75
87809 00
Pathology
0.66
0.66
45.19
45.19
87810 00
Pathology
1.08
1.08
73.29
73.29
87811 00
Pathology
1.26
1.26
85.93
85.93
87850 00
Pathology
0.75
0.75
51.00
51.00
87880 00
Pathology
0.50
0.50
34.33
34.33
87899 00
Pathology
0.49
0.49
33.37
33.37
87900 00
Pathology
3.98
3.98
270.70
270.70
87901 00
Pathology
7.86
7.86
534.65
534.65
87902 00
Pathology
7.86
7.86
534.65
534.65
87903 00
Pathology
14.92
14.92
1014.80
1014.80
87904 00
Pathology
0.80
0.80
54.14
54.14
87905 00
Pathology
0.37
0.37
25.38
25.38
87906 00
Pathology
3.93
3.93
267.33
267.33
87910 00
Pathology
7.86
7.86
534.65
534.65
87912 00
Pathology
7.86
7.86
534.65
534.65
87913 00
Pathology
7.86
7.86
534.65
534.65
87999 00
Pathology
0.00
0.00
BR
BR
88000 00
Pathology
0.00
0.00
BR
BR
88005 00
Pathology
0.00
0.00
BR
BR
88007 00
Pathology
0.00
0.00
BR
BR
88012 00
Pathology
0.00
0.00
BR
BR
88014 00
Pathology
0.00
0.00
BR
BR
88016 00
Pathology
0.00
0.00
BR
BR
88020 00
Pathology
0.00
0.00
BR
BR
88025 00
Pathology
0.00
0.00
BR
BR
88027 00
Pathology
0.00
0.00
BR
BR
88028 00
Pathology
0.00
0.00
BR
BR
88029 00
Pathology
0.00
0.00
BR
BR
88036 00
Pathology
0.00
0.00
BR
BR
88037 00
Pathology
0.00
0.00
BR
BR
88040 00
Pathology
0.00
0.00
BR
BR
88045 00
Pathology
0.00
0.00
BR
BR
88099 00
Pathology
0.00
0.00
BR
BR
88104 00
Pathology
2.27
2.27
154.36
154.36
88104 26
Pathology
0.80
0.80
54.40
54.40
88104 TC
Pathology
1.47
1.47
99.96
99.96
88106 00
Pathology
2.14
2.14
145.52
145.52
88106 26
Pathology
0.55
0.55
37.40
37.40
88106 TC
Pathology
1.59
1.59
108.12
108.12
88108 00
Pathology
2.06
2.06
140.08
140.08
88108 26
Pathology
0.65
0.65
44.20
44.20
88108 TC
Pathology
1.41
1.41
95.88
95.88
88112 00
Pathology
2.04
2.04
138.72
138.72
88112 26
Pathology
0.80
0.80
54.40
54.40
88112 TC
Pathology
1.24
1.24
84.32
84.32
88120 00
Pathology
17.39
17.39
1182.52
1182.52
88120 26
Pathology
1.68
1.68
114.24
114.24
88120 TC
Pathology
15.71
15.71
1068.28
1068.28
88121 00
Pathology
12.58
12.58
855.44
855.44
88121 26
Pathology
1.40
1.40
95.20
95.20
88121 TC
Pathology
11.18
11.18
760.24
760.24
88125 00
Pathology
0.86
0.86
58.48
58.48
88125 26
Pathology
0.40
0.40
27.20
27.20
88125 TC
Pathology
0.46
0.46
31.28
31.28
88130 00
Pathology
0.55
0.55
37.34
37.34
88140 00
Pathology
0.24
0.24
16.59
16.59
88141 00
Pathology
0.72
0.72
48.96
48.96
88142 00
Pathology
0.62
0.62
42.07
42.07
88143 00
Pathology
0.70
0.70
47.85
47.85
88147 00
Pathology
1.54
1.54
105.00
105.00
88148 00
Pathology
0.54
0.54
36.88
36.88
88150 00
Pathology
0.54
0.54
36.88
36.88
88152 00
Pathology
0.84
0.84
57.40
57.40
88153 00
Pathology
0.73
0.73
49.90
49.90
88155 00
Pathology
0.45
0.45
30.42
30.42
88160 00
Pathology
2.39
2.39
162.52
162.52
88160 26
Pathology
0.74
0.74
50.32
50.32
88160 TC
Pathology
1.65
1.65
112.20
112.20
88161 00
Pathology
2.44
2.44
165.92
165.92
88161 26
Pathology
0.73
0.73
49.64
49.64
88161 TC
Pathology
1.71
1.71
116.28
116.28
88162 00
Pathology
3.86
3.86
262.48
262.48
88162 26
Pathology
1.14
1.14
77.52
77.52
88162 TC
Pathology
2.72
2.72
184.96
184.96
88164 00
Pathology
0.54
0.54
36.88
36.88
88165 00
Pathology
1.29
1.29
87.68
87.68
88166 00
Pathology
0.54
0.54
36.88
36.88
88167 00
Pathology
0.54
0.54
36.88
36.88
88172 00
Pathology
1.67
1.67
113.56
113.56
88172 26
Pathology
1.02
1.02
69.36
69.36
88172 TC
Pathology
0.65
0.65
44.20
44.20
88173 00
Pathology
5.02
5.02
341.36
341.36
88173 26
Pathology
2.02
2.02
137.36
137.36
88173 TC
Pathology
3.00
3.00
204.00
204.00
88174 00
Pathology
0.77
0.77
52.69
52.69
88175 00
Pathology
0.81
0.81
55.26
55.26
88177 00
Pathology
0.88
0.88
59.84
59.84
88177 26
Pathology
0.63
0.63
42.84
42.84
88177 TC
Pathology
0.25
0.25
17.00
17.00
88182 00
Pathology
5.01
5.01
340.68
340.68
88182 26
Pathology
1.11
1.11
75.48
75.48
88182 TC
Pathology
3.90
3.90
265.20
265.20
88184 00
Pathology
2.34
2.34
159.12
159.12
88185 00
Pathology
0.71
0.71
48.28
48.28
88187 00
Pathology
1.05
1.05
71.40
71.40
88188 00
Pathology
1.81
1.81
123.08
123.08
88189 00
Pathology
2.45
2.45
166.60
166.60
88199 00
Pathology
0.00
0.00
BR
BR
88199 26
Pathology
0.00
0.00
BR
BR
88199 TC
Pathology
0.00
0.00
BR
BR
88230 00
Pathology
3.56
3.56
241.92
241.92
88233 00
Pathology
4.30
4.30
292.25
292.25
88235 00
Pathology
4.59
4.59
312.13
312.13
88237 00
Pathology
4.39
4.39
298.53
298.53
88239 00
Pathology
4.51
4.51
306.36
306.36
88240 00
Pathology
0.40
0.40
27.14
27.14
88241 00
Pathology
0.37
0.37
25.11
25.11
88245 00
Pathology
5.29
5.29
359.62
359.62
88248 00
Pathology
5.29
5.29
359.62
359.62
88249 00
Pathology
5.29
5.29
359.62
359.62
88261 00
Pathology
8.07
8.07
548.96
548.96
88262 00
Pathology
3.83
3.83
260.61
260.61
88263 00
Pathology
4.59
4.59
312.11
312.11
88264 00
Pathology
4.42
4.42
300.31
300.31
88267 00
Pathology
5.76
5.76
391.60
391.60
88269 00
Pathology
5.30
5.30
360.64
360.64
88271 00
Pathology
0.65
0.65
44.48
44.48
88272 00
Pathology
1.24
1.24
84.52
84.52
88273 00
Pathology
1.06
1.06
72.29
72.29
88274 00
Pathology
1.29
1.29
88.01
88.01
88275 00
Pathology
1.56
1.56
106.31
106.31
88280 00
Pathology
1.02
1.02
69.51
69.51
88283 00
Pathology
2.10
2.10
142.46
142.46
88285 00
Pathology
0.82
0.82
55.88
55.88
88289 00
Pathology
1.05
1.05
71.50
71.50
88291 00
Pathology
1.00
1.00
68.00
68.00
88299 00
Pathology
0.00
0.00
BR
BR
88300 00
Pathology
0.49
0.49
33.32
33.32
88300 26
Pathology
0.13
0.13
8.84
8.84
88300 TC
Pathology
0.36
0.36
24.48
24.48
88302 00
Pathology
1.00
1.00
68.00
68.00
88302 26
Pathology
0.20
0.20
13.60
13.60
88302 TC
Pathology
0.80
0.80
54.40
54.40
88304 00
Pathology
1.29
1.29
87.72
87.72
88304 26
Pathology
0.33
0.33
22.44
22.44
88304 TC
Pathology
0.96
0.96
65.28
65.28
88305 00
Pathology
2.15
2.15
146.20
146.20
88305 26
Pathology
1.08
1.08
73.44
73.44
88305 TC
Pathology
1.07
1.07
72.76
72.76
88307 00
Pathology
8.64
8.64
587.52
587.52
88307 26
Pathology
2.37
2.37
161.16
161.16
88307 TC
Pathology
6.27
6.27
426.36
426.36
88309 00
Pathology
12.98
12.98
882.64
882.64
88309 26
Pathology
4.18
4.18
284.24
284.24
88309 TC
Pathology
8.80
8.80
598.40
598.40
88311 00
Pathology
0.61
0.61
41.48
41.48
88311 26
Pathology
0.35
0.35
23.80
23.80
88311 TC
Pathology
0.26
0.26
17.68
17.68
88312 00
Pathology
3.38
3.38
229.84
229.84
88312 26
Pathology
0.77
0.77
52.36
52.36
88312 TC
Pathology
2.61
2.61
177.48
177.48
88313 00
Pathology
2.49
2.49
169.32
169.32
88313 26
Pathology
0.35
0.35
23.80
23.80
88313 TC
Pathology
2.14
2.14
145.52
145.52
88314 00
Pathology
2.66
2.66
180.88
180.88
88314 26
Pathology
0.59
0.59
40.12
40.12
88314 TC
Pathology
2.07
2.07
140.76
140.76
88319 00
Pathology
4.10
4.10
278.80
278.80
88319 26
Pathology
0.78
0.78
53.04
53.04
88319 TC
Pathology
3.32
3.32
225.76
225.76
88321 00
Pathology
2.89
2.44
196.52
165.92
88323 00
Pathology
3.45
3.45
234.60
234.60
88323 26
Pathology
2.56
2.56
174.08
174.08
88323 TC
Pathology
0.89
0.89
60.52
60.52
88325 00
Pathology
4.63
3.92
314.84
266.56
88329 00
Pathology
1.65
1.03
112.20
70.04
88331 00
Pathology
3.03
3.03
206.04
206.04
88331 26
Pathology
1.79
1.79
121.72
121.72
88331 TC
Pathology
1.24
1.24
84.32
84.32
88332 00
Pathology
1.63
1.63
110.84
110.84
88332 26
Pathology
0.88
0.88
59.84
59.84
88332 TC
Pathology
0.75
0.75
51.00
51.00
88333 00
Pathology
2.74
2.74
186.32
186.32
88333 26
Pathology
1.78
1.78
121.04
121.04
88333 TC
Pathology
0.96
0.96
65.28
65.28
88334 00
Pathology
1.66
1.66
112.88
112.88
88334 26
Pathology
1.08
1.08
73.44
73.44
88334 TC
Pathology
0.58
0.58
39.44
39.44
88341 00
Pathology
2.72
2.72
184.96
184.96
88341 26
Pathology
0.81
0.81
55.08
55.08
88341 TC
Pathology
1.91
1.91
129.88
129.88
88342 00
Pathology
3.18
3.18
216.24
216.24
88342 26
Pathology
1.01
1.01
68.68
68.68
88342 TC
Pathology
2.17
2.17
147.56
147.56
88344 00
Pathology
5.19
5.19
352.92
352.92
88344 26
Pathology
1.11
1.11
75.48
75.48
88344 TC
Pathology
4.08
4.08
277.44
277.44
88346 00
Pathology
4.50
4.50
306.00
306.00
88346 26
Pathology
1.04
1.04
70.72
70.72
88346 TC
Pathology
3.46
3.46
235.28
235.28
88348 00
Pathology
14.53
14.53
988.04
988.04
88348 26
Pathology
2.23
2.23
151.64
151.64
88348 TC
Pathology
12.30
12.30
836.40
836.40
88350 00
Pathology
3.42
3.42
232.56
232.56
88350 26
Pathology
0.84
0.84
57.12
57.12
88350 TC
Pathology
2.58
2.58
175.44
175.44
88355 00
Pathology
3.79
3.79
257.72
257.72
88355 26
Pathology
2.21
2.21
150.28
150.28
88355 TC
Pathology
1.58
1.58
107.44
107.44
88356 00
Pathology
7.06
7.06
480.08
480.08
88356 26
Pathology
3.55
3.55
241.40
241.40
88356 TC
Pathology
3.51
3.51
238.68
238.68
88358 00
Pathology
4.10
4.10
278.80
278.80
88358 26
Pathology
1.43
1.43
97.24
97.24
88358 TC
Pathology
2.67
2.67
181.56
181.56
88360 00
Pathology
3.61
3.61
245.48
245.48
88360 26
Pathology
1.20
1.20
81.60
81.60
88360 TC
Pathology
2.41
2.41
163.88
163.88
88361 00
Pathology
3.58
3.58
243.44
243.44
88361 26
Pathology
1.26
1.26
85.68
85.68
88361 TC
Pathology
2.32
2.32
157.76
157.76
88362 00
Pathology
6.87
6.87
467.16
467.16
88362 26
Pathology
3.22
3.22
218.96
218.96
88362 TC
Pathology
3.65
3.65
248.20
248.20
88363 00
Pathology
0.69
0.56
46.92
38.08
88364 00
Pathology
4.00
4.00
272.00
272.00
88364 26
Pathology
0.98
0.98
66.64
66.64
88364 TC
Pathology
3.02
3.02
205.36
205.36
88365 00
Pathology
5.32
5.32
361.76
361.76
88365 26
Pathology
1.24
1.24
84.32
84.32
88365 TC
Pathology
4.08
4.08
277.44
277.44
88366 00
Pathology
8.15
8.15
554.20
554.20
88366 26
Pathology
1.78
1.78
121.04
121.04
88366 TC
Pathology
6.37
6.37
433.16
433.16
88367 00
Pathology
3.35
3.35
227.80
227.80
88367 26
Pathology
0.96
0.96
65.28
65.28
88367 TC
Pathology
2.39
2.39
162.52
162.52
88368 00
Pathology
4.44
4.44
301.92
301.92
88368 26
Pathology
1.22
1.22
82.96
82.96
88368 TC
Pathology
3.22
3.22
218.96
218.96
88369 00
Pathology
3.85
3.85
261.80
261.80
88369 26
Pathology
0.97
0.97
65.96
65.96
88369 TC
Pathology
2.88
2.88
195.84
195.84
88371 00
Pathology
0.68
0.68
46.17
46.17
88371 26
Pathology
0.56
0.56
38.08
38.08
88372 00
Pathology
0.80
0.80
54.45
54.45
88372 26
Pathology
0.52
0.52
35.36
35.36
88373 00
Pathology
2.03
2.03
138.04
138.04
88373 26
Pathology
0.73
0.73
49.64
49.64
88373 TC
Pathology
1.30
1.30
88.40
88.40
88374 00
Pathology
8.63
8.63
586.84
586.84
88374 26
Pathology
1.22
1.22
82.96
82.96
88374 TC
Pathology
7.41
7.41
503.88
503.88
88375 00
Pathology
1.40
1.40
95.20
95.20
88377 00
Pathology
11.86
11.86
806.48
806.48
88377 26
Pathology
1.85
1.85
125.80
125.80
88377 TC
Pathology
10.01
10.01
680.68
680.68
88380 00
Pathology
3.73
3.73
253.64
253.64
88380 26
Pathology
1.52
1.52
103.36
103.36
88380 TC
Pathology
2.21
2.21
150.28
150.28
88381 00
Pathology
6.04
6.04
410.72
410.72
88381 26
Pathology
0.68
0.68
46.24
46.24
88381 TC
Pathology
5.36
5.36
364.48
364.48
88387 00
Pathology
0.99
0.99
67.32
67.32
88387 26
Pathology
0.77
0.77
52.36
52.36
88387 TC
Pathology
0.22
0.22
14.96
14.96
88388 00
Pathology
1.08
1.08
73.44
73.44
88388 26
Pathology
0.68
0.68
46.24
46.24
88388 TC
Pathology
0.40
0.40
27.20
27.20
88399 00
Pathology
0.00
0.00
BR
BR
88399 26
Pathology
0.00
0.00
BR
BR
88399 TC
Pathology
0.00
0.00
BR
BR
88720 00
Pathology
0.15
0.15
10.43
10.43
88738 00
Pathology
0.15
0.15
10.43
10.43
88740 00
Pathology
0.29
0.29
19.46
19.46
88741 00
Pathology
0.29
0.29
19.46
19.46
88749 00
Pathology
0.00
0.00
BR
BR
89049 00
Pathology
8.57
1.82
582.76
123.76
89050 00
Pathology
0.14
0.14
9.80
9.80
89051 00
Pathology
0.17
0.17
11.63
11.63
89055 00
Pathology
0.13
0.13
8.87
8.87
89060 00
Pathology
0.22
0.22
15.22
15.22
89060 26
Pathology
0.52
0.52
35.36
35.36
89125 00
Pathology
0.18
0.18
12.21
12.21
89160 00
Pathology
0.15
0.15
10.07
10.07
89190 00
Pathology
0.18
0.18
12.02
12.02
89220 00
Pathology
0.58
0.58
39.44
39.44
89230 00
Pathology
0.09
0.09
6.12
6.12
89240 00
Pathology
0.00
0.00
BR
BR
89250 00
Pathology
-
-
3315.68
3315.68
89251 00
Pathology
-
-
2486.76
2486.76
89253 00
Pathology
-
-
1657.84
1657.84
89254 00
Pathology
-
-
1339.60
1339.60
89255 00
Pathology
-
-
994.84
994.84
89257 00
Pathology
-
-
994.84
994.84
89258 00
Pathology
-
-
1989.00
1989.00
89259 00
Pathology
-
-
515.44
515.44
89260 00
Pathology
-
-
429.08
429.08
89261 00
Pathology
-
-
488.92
488.92
89264 00
Pathology
-
-
1077.80
1077.80
89268 00
Pathology
-
-
1357.96
1357.96
89272 00
Pathology
-
-
2536.40
2536.40
89280 00
Pathology
-
-
3542.80
3542.80
89281 00
Pathology
-
-
3201.44
3201.44
89290 00
Pathology
-
-
3389.80
3389.80
89291 00
Pathology
-
-
4144.60
4144.60
89300 00
Pathology
0.30
0.30
20.43
20.43
89310 00
Pathology
0.26
0.26
17.88
17.88
89320 00
Pathology
0.38
0.38
25.56
25.56
89321 00
Pathology
0.37
0.37
25.02
25.02
89322 00
Pathology
0.47
0.47
32.19
32.19
89325 00
Pathology
0.33
0.33
22.16
22.16
89329 00
Pathology
0.60
0.60
40.68
40.68
89330 00
Pathology
0.32
0.32
21.56
21.56
89331 00
Pathology
0.60
0.60
40.68
40.68
89335 00
Pathology
-
-
663.00
663.00
89337 00
Pathology
-
-
7874.40
7874.40
89342 00
Pathology
-
-
1243.04
1243.04
89343 00
Pathology
-
-
1094.12
1094.12
89344 00
Pathology
-
-
994.84
994.84
89346 00
Pathology
-
-
1300.84
1300.84
89352 00
Pathology
-
-
1044.48
1044.48
89353 00
Pathology
-
-
331.84
331.84
89354 00
Pathology
-
-
497.08
497.08
89356 00
Pathology
-
-
994.84
994.84
89398 00
Pathology
0.00
0.00
BR
BR
G0480 00
Pathology
3.49
3.49
237.64
237.64
G0481 00
Pathology
4.78
4.78
325.19
325.19
G0482 00
Pathology
6.07
6.07
412.72
412.72
G0483 00
Pathology
7.54
7.54
512.78
512.78
G0659 00
Pathology
1.90
1.90
129.05
129.05
MEDICINE GUIDELINES
Information regarding publications incorporated by reference
				  is found in the Introduction Section of the Fee Schedule.
The following Commission guidelines are in addition to the
				  CPT® guidelines and represent additional
				  guidance from the Commission relative to unit values for these services. To the
				  extent that a conflict may exist between an incorporated portion of the
				  CPT® publication or HCPCS codes and a code,
				  guideline, identifier, or modifier unique to Arizona, then the Arizona code,
				  guideline, identifier, or modifier shall control. Codes that are unique to
				  Arizona are preceded by an AZ identifier and numbered in the following format:
				  AZxxx.
A. MATERIALS SUPPLIED BY A HEALTHCARE PROVIDER: A healthcare
				  provider may charge for materials and supplies as described in the HCPCS
				  Section of the Physician's Fee Schedule.
B. COMPLIANCE WITH THE AMERICANS WITH DISABILITIES ACT:
				  CPT® Code 99199 can be used to bill for the
				  services of an interpreter when they are used to comply with the provisions of
				  "The Americans With Disabilities Act",
i.e.
, interpreters for
				  the hearing impaired.
C. ADD-ON CODES: Some of the listed procedures are commonly
				  carried out in addition to the primary procedure performed. All add-on codes
				  found in the CPT® codebook are exempt from the
				  multiple procedure concept. They are exempt from the use of modifier 51.
D. SEPARATE PROCEDURES: Some of the procedures or services
				  listed in the CPT® codebook that are commonly
				  carried out as an integral component of a total service or procedure have been
				  identified by the inclusion of the term "separate procedure". The codes
				  designated as a "separate procedure" should not be reported in addition to the
				  code for the total procedure or service of which it is considered an integral
				  component.
When a procedure or service is carried out independently or
				  considered to be unrelated or distinct from other procedures/services provided
				  at that time, it may be reported by itself, or in addition to other
				  procedures/services by appending modifier 59 to the specific "separate
				  procedure" code to indicate that the procedure is not considered to be a
				  component of another procedure, but is a distinct, independent
				  procedure.
E. BUNDLED CODES: Indicates that the service is always
				  bundled in a payment for another service. If these services are covered,
				  payment for them is subsumed by the payment for the services to which they are
				  incident (
e.g
., a telephone call from a hospital nurse
				  regarding the care of a patient).
F. MODERATE SEDATION: Codes specific to the provider
				  performing the services (e.g., CPT® codes 99151,
				  99152, and 99153) are used when the physician performing the procedure provides
				  the sedation whereas CPT® codes 99155, 99156,
				  and 99157 are used when sedation is provided by a healthcare professional other
				  than the physician performing the procedure.
ARIZONA PHYSICIANS' FEE
							 SCHEDULE
Medicine Codes
							 2024
Medicine Conversion Factor
							 $68.00
Code
Category
FY24 NF
							 RVU
FY24 FAC
							 RVU
FY24 NF RBRVS Rate
FY24 FAC RBRVS
							 Rate
90281 00
Medicine
-
-
101.32
101.32
90283 00
Medicine
-
-
30.60
30.60
90284 00
Medicine
0.00
0.00
BR
BR
90287 00
Medicine
0.00
0.00
BR
BR
90288 00
Medicine
0.00
0.00
BR
BR
90291 00
Medicine
-
-
114.92
114.92
90296 00
Medicine
0.00
0.00
BR
BR
90371 00
Medicine
-
-
286.28
286.28
90375 00
Medicine
-
-
602.48
602.48
90376 00
Medicine
-
-
996.20
996.20
90377 00
Medicine
-
-
532.44
532.44
90378 00
Medicine
-
-
1885.64
1885.64
90380 00
Medicine
0.00
0.00
BR
BR
90381 00
Medicine
0.00
0.00
BR
BR
90384 00
Medicine
-
-
133.96
133.96
90385 00
Medicine
-
-
63.92
63.92
90386 00
Medicine
-
-
84.32
84.32
90389 00
Medicine
-
-
101.32
101.32
90393 00
Medicine
-
-
34.00
34.00
90396 00
Medicine
-
-
149.60
149.60
90399 00
Medicine
0.00
0.00
BR
BR
90460 00
Medicine
0.69
0.69
46.92
46.92
90461 00
Medicine
0.26
0.26
17.68
17.68
90471 00
Medicine
0.62
0.62
42.16
42.16
90472 00
Medicine
0.44
0.44
29.92
29.92
90473 00
Medicine
0.50
0.50
34.00
34.00
90474 00
Medicine
0.36
0.36
24.48
24.48
90476 00
Medicine
-
-
47.60
47.60
90477 00
Medicine
0.00
0.00
BR
BR
90480 00
Medicine
-
-
51.00
51.00
90581 00
Medicine
0.00
0.00
BR
BR
90584 00
Medicine
0.00
0.00
BR
BR
90585 00
Medicine
-
-
31.28
31.28
90586 00
Medicine
-
-
299.88
299.88
90587 00
Medicine
0.00
0.00
BR
BR
90589 00
Medicine
0.00
0.00
BR
BR
90611 00
Medicine
-
-
27.20
27.20
90619 00
Medicine
-
-
152.32
152.32
90620 00
Medicine
-
-
201.96
201.96
90621 00
Medicine
-
-
166.60
166.60
90622 00
Medicine
-
-
23.80
23.80
90623 00
Medicine
0.00
0.00
BR
BR
90625 00
Medicine
-
-
267.24
267.24
90626 00
Medicine
-
-
334.56
334.56
90627 00
Medicine
-
-
283.56
283.56
90630 00
Medicine
-
-
34.00
34.00
90632 00
Medicine
-
-
146.20
146.20
90633 00
Medicine
-
-
48.96
48.96
90634 00
Medicine
-
-
70.04
70.04
90636 00
Medicine
-
-
124.44
124.44
90644 00
Medicine
-
-
52.36
52.36
90647 00
Medicine
-
-
42.16
42.16
90648 00
Medicine
-
-
37.40
37.40
90649 00
Medicine
-
-
174.76
174.76
90650 00
Medicine
-
-
178.16
178.16
90651 00
Medicine
-
-
242.08
242.08
90653 00
Medicine
-
-
55.76
55.76
90654 00
Medicine
-
-
25.84
25.84
90655 00
Medicine
-
-
23.80
23.80
90656 00
Medicine
-
-
27.20
27.20
90657 00
Medicine
-
-
23.80
23.80
90658 00
Medicine
-
-
23.80
23.80
90660 00
Medicine
-
-
40.80
40.80
90661 00
Medicine
-
-
23.80
23.80
90662 00
Medicine
-
-
152.32
152.32
90664 00
Medicine
0.00
0.00
BR
BR
90666 00
Medicine
-
-
47.60
47.60
90667 00
Medicine
-
-
10.20
10.20
90668 00
Medicine
-
-
34.00
34.00
90670 00
Medicine
-
-
535.84
535.84
90671 00
Medicine
-
-
526.32
526.32
90672 00
Medicine
-
-
57.80
57.80
90673 00
Medicine
-
-
47.60
47.60
90674 00
Medicine
-
-
70.72
70.72
90675 00
Medicine
-
-
674.56
674.56
90676 00
Medicine
-
-
182.24
182.24
90677 00
Medicine
-
-
599.76
599.76
90678 00
Medicine
0.00
0.00
BR
BR
90679 00
Medicine
0.00
0.00
BR
BR
90680 00
Medicine
-
-
101.32
101.32
90681 00
Medicine
-
-
135.32
135.32
90682 00
Medicine
-
-
152.32
152.32
90683 00
Medicine
0.00
0.00
BR
BR
90685 00
Medicine
-
-
34.00
34.00
90686 00
Medicine
-
-
46.24
46.24
90687 00
Medicine
-
-
21.76
21.76
90688 00
Medicine
-
-
43.52
43.52
90689 00
Medicine
-
-
64.60
64.60
90690 00
Medicine
-
-
93.84
93.84
90691 00
Medicine
-
-
104.04
104.04
90694 00
Medicine
-
-
160.48
160.48
90696 00
Medicine
-
-
78.20
78.20
90697 00
Medicine
-
-
142.80
142.80
90698 00
Medicine
-
-
108.12
108.12
90700 00
Medicine
-
-
40.80
40.80
90702 00
Medicine
-
-
40.80
40.80
90707 00
Medicine
-
-
86.36
86.36
90710 00
Medicine
-
-
234.60
234.60
90713 00
Medicine
-
-
44.20
44.20
90714 00
Medicine
-
-
63.24
63.24
90715 00
Medicine
-
-
79.56
79.56
90716 00
Medicine
-
-
143.48
143.48
90717 00
Medicine
-
-
173.40
173.40
90723 00
Medicine
-
-
103.36
103.36
90732 00
Medicine
-
-
277.44
277.44
90733 00
Medicine
-
-
135.32
135.32
90734 00
Medicine
-
-
144.84
144.84
90736 00
Medicine
-
-
202.64
202.64
90738 00
Medicine
-
-
287.64
287.64
90739 00
Medicine
-
-
332.52
332.52
90740 00
Medicine
-
-
316.20
316.20
90743 00
Medicine
-
-
156.40
156.40
90744 00
Medicine
-
-
63.92
63.92
90746 00
Medicine
-
-
146.20
146.20
90747 00
Medicine
-
-
292.40
292.40
90748 00
Medicine
-
-
61.88
61.88
90749 00
Medicine
0.00
0.00
BR
BR
90750 00
Medicine
-
-
181.56
181.56
90756 00
Medicine
-
-
67.32
67.32
90758 00
Medicine
0.00
0.00
BR
BR
90759 00
Medicine
-
-
153.00
153.00
90785 00
Medicine
0.44
0.39
29.92
26.52
90791 00
Medicine
5.17
4.43
351.56
301.24
90792 00
Medicine
5.82
5.08
395.76
345.44
90832 00
Medicine
2.35
2.05
159.80
139.40
90833 00
Medicine
2.16
1.92
146.88
130.56
90834 00
Medicine
3.10
2.71
210.80
184.28
90836 00
Medicine
2.73
2.43
185.64
165.24
90837 00
Medicine
4.57
4.00
310.76
272.00
90838 00
Medicine
3.62
3.22
246.16
218.96
90839 00
Medicine
4.40
3.87
299.20
263.16
90840 00
Medicine
2.18
1.94
148.24
131.92
90845 00
Medicine
2.94
2.60
199.92
176.80
90846 00
Medicine
2.93
2.92
199.24
198.56
90847 00
Medicine
3.07
3.05
208.76
207.40
90849 00
Medicine
1.13
0.88
76.84
59.84
90853 00
Medicine
0.83
0.72
56.44
48.96
90863 00
Medicine
0.75
0.70
51.00
47.60
90865 00
Medicine
4.85
3.64
329.80
247.52
90867 00
Medicine
-
-
542.64
477.36
90868 00
Medicine
-
-
405.96
357.00
90869 00
Medicine
-
-
811.24
714.00
90870 00
Medicine
5.18
3.12
352.24
212.16
90875 00
Medicine
1.75
1.74
119.00
118.32
90876 00
Medicine
3.08
2.76
209.44
187.68
90880 00
Medicine
3.08
2.57
209.44
174.76
90882 00
Medicine
-
-
40.80
36.04
90885 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
90887 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
90889 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
90899 00
Medicine
0.00
0.00
BR
BR
90901 00
Medicine
1.23
0.57
83.64
38.76
90912 00
Medicine
2.42
1.26
164.56
85.68
90913 00
Medicine
0.96
0.71
65.28
48.28
90935 00
Medicine
2.10
2.10
142.80
142.80
90937 00
Medicine
3.02
3.02
205.36
205.36
90940 00
Medicine
-
-
38.08
38.08
90945 00
Medicine
2.54
2.54
172.72
172.72
90947 00
Medicine
3.62
3.62
246.16
246.16
90951 00
Medicine
34.74
34.74
2362.32
2362.32
90952 00
Medicine
0.00
0.00
BR
BR
90953 00
Medicine
-
-
304.64
304.64
90954 00
Medicine
29.78
29.78
2025.04
2025.04
90955 00
Medicine
15.49
15.49
1053.32
1053.32
90956 00
Medicine
10.33
10.33
702.44
702.44
90957 00
Medicine
22.80
22.80
1550.40
1550.40
90958 00
Medicine
14.84
14.84
1009.12
1009.12
90959 00
Medicine
9.68
9.68
658.24
658.24
90960 00
Medicine
10.50
10.50
714.00
714.00
90961 00
Medicine
8.72
8.72
592.96
592.96
90962 00
Medicine
6.02
6.02
409.36
409.36
90963 00
Medicine
18.00
18.00
1224.00
1224.00
90964 00
Medicine
15.43
15.43
1049.24
1049.24
90965 00
Medicine
14.81
14.81
1007.08
1007.08
90966 00
Medicine
8.72
8.72
592.96
592.96
90967 00
Medicine
0.52
0.52
35.36
35.36
90968 00
Medicine
0.51
0.51
34.68
34.68
90969 00
Medicine
0.50
0.50
34.00
34.00
90970 00
Medicine
0.28
0.28
19.04
19.04
90989 00
Medicine
-
-
608.60
608.60
90993 00
Medicine
-
-
91.12
91.12
90997 00
Medicine
2.60
2.60
176.80
176.80
90999 00
Medicine
0.00
0.00
BR
BR
91010 00
Medicine
6.63
6.63
450.84
450.84
91010 26
Medicine
1.90
1.90
129.20
129.20
91010 TC
Medicine
4.73
4.73
321.64
321.64
91013 00
Medicine
0.76
0.76
51.68
51.68
91013 26
Medicine
0.27
0.27
18.36
18.36
91013 TC
Medicine
0.49
0.49
33.32
33.32
91020 00
Medicine
8.29
8.29
563.72
563.72
91020 26
Medicine
2.13
2.13
144.84
144.84
91020 TC
Medicine
6.16
6.16
418.88
418.88
91022 00
Medicine
5.21
5.21
354.28
354.28
91022 26
Medicine
2.13
2.13
144.84
144.84
91022 TC
Medicine
3.08
3.08
209.44
209.44
91030 00
Medicine
4.36
4.36
296.48
296.48
91030 26
Medicine
1.35
1.35
91.80
91.80
91030 TC
Medicine
3.01
3.01
204.68
204.68
91034 00
Medicine
5.74
5.74
390.32
390.32
91034 26
Medicine
1.46
1.46
99.28
99.28
91034 TC
Medicine
4.28
4.28
291.04
291.04
91035 00
Medicine
13.64
13.64
927.52
927.52
91035 26
Medicine
2.39
2.39
162.52
162.52
91035 TC
Medicine
11.25
11.25
765.00
765.00
91037 00
Medicine
5.06
5.06
344.08
344.08
91037 26
Medicine
1.43
1.43
97.24
97.24
91037 TC
Medicine
3.63
3.63
246.84
246.84
91038 00
Medicine
12.08
12.08
821.44
821.44
91038 26
Medicine
1.63
1.63
110.84
110.84
91038 TC
Medicine
10.45
10.45
710.60
710.60
91040 00
Medicine
15.49
15.49
1053.32
1053.32
91040 26
Medicine
1.45
1.45
98.60
98.60
91040 TC
Medicine
14.04
14.04
954.72
954.72
91065 00
Medicine
2.22
2.22
150.96
150.96
91065 26
Medicine
0.29
0.29
19.72
19.72
91065 TC
Medicine
1.93
1.93
131.24
131.24
91110 00
Medicine
21.90
21.90
1489.20
1489.20
91110 26
Medicine
3.30
3.30
224.40
224.40
91110 TC
Medicine
18.60
18.60
1264.80
1264.80
91111 00
Medicine
26.24
26.24
1784.32
1784.32
91111 26
Medicine
1.33
1.33
90.44
90.44
91111 TC
Medicine
24.91
24.91
1693.88
1693.88
91112 00
Medicine
48.27
48.27
3282.36
3282.36
91112 26
Medicine
3.10
3.10
210.80
210.80
91112 TC
Medicine
45.17
45.17
3071.56
3071.56
91113 00
Medicine
26.81
26.81
1823.08
1823.08
91113 26
Medicine
3.56
3.56
242.08
242.08
91113 TC
Medicine
23.25
23.25
1581.00
1581.00
91117 00
Medicine
4.02
4.02
273.36
273.36
91120 00
Medicine
15.00
15.00
1020.00
1020.00
91120 26
Medicine
1.42
1.42
96.56
96.56
91120 TC
Medicine
13.58
13.58
923.44
923.44
91122 00
Medicine
8.28
8.28
563.04
563.04
91122 26
Medicine
2.58
2.58
175.44
175.44
91122 TC
Medicine
5.70
5.70
387.60
387.60
91132 00
Medicine
13.12
13.12
892.16
892.16
91132 26
Medicine
0.77
0.77
52.36
52.36
91132 TC
Medicine
12.35
12.35
839.80
839.80
91133 00
Medicine
13.79
13.79
937.72
937.72
91133 26
Medicine
0.97
0.97
65.96
65.96
91133 TC
Medicine
12.82
12.82
871.76
871.76
91200 00
Medicine
0.92
0.92
62.56
62.56
91200 26
Medicine
0.31
0.31
21.08
21.08
91200 TC
Medicine
0.61
0.61
41.48
41.48
91299 00
Medicine
0.00
0.00
BR
BR
91299 26
Medicine
0.00
0.00
BR
BR
91299 TC
Medicine
0.00
0.00
BR
BR
91304 00
Medicine
-
-
308.04
308.04
91318 00
Medicine
-
-
136.00
136.00
91319 00
Medicine
-
-
182.24
182.24
91320 00
Medicine
-
-
272.00
272.00
91321 00
Medicine
-
-
303.28
303.28
91322 00
Medicine
-
-
303.28
303.28
92002 00
Medicine
2.54
1.34
172.72
91.12
92004 00
Medicine
4.46
2.77
303.28
188.36
92012 00
Medicine
2.67
1.48
181.56
100.64
92014 00
Medicine
3.77
2.23
256.36
151.64
92015 00
Medicine
0.57
0.55
38.76
37.40
92018 00
Medicine
4.11
4.11
279.48
279.48
92019 00
Medicine
2.15
2.15
146.20
146.20
92020 00
Medicine
0.82
0.60
55.76
40.80
92025 00
Medicine
1.09
1.09
74.12
74.12
92025 26
Medicine
0.57
0.57
38.76
38.76
92025 TC
Medicine
0.52
0.52
35.36
35.36
92060 00
Medicine
1.91
1.91
129.88
129.88
92060 26
Medicine
1.09
1.09
74.12
74.12
92060 TC
Medicine
0.82
0.82
55.76
55.76
92065 00
Medicine
1.19
0.99
80.92
67.32
92066 00
Medicine
0.79
0.79
53.72
53.72
92071 00
Medicine
1.08
0.95
73.44
64.60
92072 00
Medicine
3.73
2.75
253.64
187.00
92081 00
Medicine
1.00
1.00
68.00
68.00
92081 26
Medicine
0.47
0.47
31.96
31.96
92081 TC
Medicine
0.53
0.53
36.04
36.04
92082 00
Medicine
1.41
1.41
95.88
95.88
92082 26
Medicine
0.61
0.61
41.48
41.48
92082 TC
Medicine
0.80
0.80
54.40
54.40
92083 00
Medicine
1.90
1.90
129.20
129.20
92083 26
Medicine
0.79
0.79
53.72
53.72
92083 TC
Medicine
1.11
1.11
75.48
75.48
92100 00
Medicine
2.55
0.95
173.40
64.60
92132 00
Medicine
0.94
0.94
63.92
63.92
92132 26
Medicine
0.48
0.48
32.64
32.64
92132 TC
Medicine
0.46
0.46
31.28
31.28
92133 00
Medicine
1.09
1.09
74.12
74.12
92133 26
Medicine
0.63
0.63
42.84
42.84
92133 TC
Medicine
0.46
0.46
31.28
31.28
92134 00
Medicine
1.21
1.21
82.28
82.28
92134 26
Medicine
0.73
0.73
49.64
49.64
92134 TC
Medicine
0.48
0.48
32.64
32.64
92136 00
Medicine
1.41
1.41
95.88
95.88
92136 26
Medicine
0.89
0.89
60.52
60.52
92136 TC
Medicine
0.52
0.52
35.36
35.36
92145 00
Medicine
0.39
0.39
26.52
26.52
92145 26
Medicine
0.16
0.16
10.88
10.88
92145 TC
Medicine
0.23
0.23
15.64
15.64
92201 00
Medicine
0.74
0.67
50.32
45.56
92202 00
Medicine
0.46
0.43
31.28
29.24
92227 00
Medicine
0.53
0.53
36.04
36.04
92228 00
Medicine
0.89
0.89
60.52
60.52
92228 26
Medicine
0.49
0.49
33.32
33.32
92228 TC
Medicine
0.40
0.40
27.20
27.20
92229 00
Medicine
1.23
1.23
83.64
83.64
92230 00
Medicine
4.11
1.02
279.48
69.36
92235 00
Medicine
4.87
4.87
331.16
331.16
92235 26
Medicine
1.24
1.24
84.32
84.32
92235 TC
Medicine
3.63
3.63
246.84
246.84
92240 00
Medicine
5.64
5.64
383.52
383.52
92240 26
Medicine
1.38
1.38
93.84
93.84
92240 TC
Medicine
4.26
4.26
289.68
289.68
92242 00
Medicine
8.43
8.43
573.24
573.24
92242 26
Medicine
1.59
1.59
108.12
108.12
92242 TC
Medicine
6.84
6.84
465.12
465.12
92250 00
Medicine
1.11
1.11
75.48
75.48
92250 26
Medicine
0.61
0.61
41.48
41.48
92250 TC
Medicine
0.50
0.50
34.00
34.00
92260 00
Medicine
0.58
0.32
39.44
21.76
92265 00
Medicine
2.61
2.61
177.48
177.48
92265 26
Medicine
1.34
1.34
91.12
91.12
92265 TC
Medicine
1.27
1.27
86.36
86.36
92270 00
Medicine
3.52
3.52
239.36
239.36
92270 26
Medicine
1.24
1.24
84.32
84.32
92270 TC
Medicine
2.28
2.28
155.04
155.04
92273 00
Medicine
3.78
3.78
257.04
257.04
92273 26
Medicine
1.06
1.06
72.08
72.08
92273 TC
Medicine
2.72
2.72
184.96
184.96
92274 00
Medicine
2.68
2.68
182.24
182.24
92274 26
Medicine
0.97
0.97
65.96
65.96
92274 TC
Medicine
1.71
1.71
116.28
116.28
92283 00
Medicine
1.63
1.63
110.84
110.84
92283 26
Medicine
0.25
0.25
17.00
17.00
92283 TC
Medicine
1.38
1.38
93.84
93.84
92284 00
Medicine
1.12
1.12
76.16
76.16
92285 00
Medicine
0.70
0.70
47.60
47.60
92285 26
Medicine
0.09
0.09
6.12
6.12
92285 TC
Medicine
0.61
0.61
41.48
41.48
92286 00
Medicine
1.17
1.17
79.56
79.56
92286 26
Medicine
0.63
0.63
42.84
42.84
92286 TC
Medicine
0.54
0.54
36.72
36.72
92287 00
Medicine
4.28
4.28
291.04
291.04
92287 26
Medicine
0.87
0.87
59.16
59.16
92287 TC
Medicine
3.41
3.41
231.88
231.88
92310 00
Medicine
2.99
1.69
203.32
114.92
92311 00
Medicine
3.09
1.51
210.12
102.68
92312 00
Medicine
3.69
1.80
250.92
122.40
92313 00
Medicine
2.94
1.26
199.92
85.68
92314 00
Medicine
2.60
1.00
176.80
68.00
92315 00
Medicine
2.45
0.61
166.60
41.48
92316 00
Medicine
3.03
0.92
206.04
62.56
92317 00
Medicine
2.59
0.61
176.12
41.48
92325 00
Medicine
1.23
1.23
83.64
83.64
92326 00
Medicine
1.18
1.18
80.24
80.24
92340 00
Medicine
1.04
0.53
70.72
36.04
92341 00
Medicine
1.19
0.68
80.92
46.24
92342 00
Medicine
1.27
0.77
86.36
52.36
92352 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
92353 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
92354 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
92355 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
92358 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
92370 00
Medicine
0.91
0.46
61.88
31.28
92371 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
92499 00
Medicine
0.00
0.00
BR
BR
92499 26
Medicine
0.00
0.00
BR
BR
92499 TC
Medicine
0.00
0.00
BR
BR
92502 00
Medicine
2.85
2.85
193.80
193.80
92504 00
Medicine
0.87
0.27
59.16
18.36
92507 00
Medicine
2.29
2.29
155.72
155.72
92508 00
Medicine
0.73
0.73
49.64
49.64
92511 00
Medicine
3.52
1.13
239.36
76.84
92512 00
Medicine
1.93
0.81
131.24
55.08
92516 00
Medicine
2.17
0.67
147.56
45.56
92517 00
Medicine
2.31
1.25
157.08
85.00
92518 00
Medicine
2.34
1.27
159.12
86.36
92519 00
Medicine
3.82
1.88
259.76
127.84
92520 00
Medicine
2.63
1.18
178.84
80.24
92521 00
Medicine
3.99
3.99
271.32
271.32
92522 00
Medicine
3.34
3.34
227.12
227.12
92523 00
Medicine
6.84
6.84
465.12
465.12
92524 00
Medicine
3.29
3.29
223.72
223.72
92526 00
Medicine
2.54
2.54
172.72
172.72
92531 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
92532 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
92533 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
92534 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
92537 00
Medicine
1.19
1.19
80.92
80.92
92537 26
Medicine
0.91
0.91
61.88
61.88
92537 TC
Medicine
0.28
0.28
19.04
19.04
92538 00
Medicine
0.67
0.67
45.56
45.56
92538 26
Medicine
0.47
0.47
31.96
31.96
92538 TC
Medicine
0.20
0.20
13.60
13.60
92540 00
Medicine
3.20
3.20
217.60
217.60
92540 26
Medicine
2.27
2.27
154.36
154.36
92540 TC
Medicine
0.93
0.93
63.24
63.24
92541 00
Medicine
0.75
0.75
51.00
51.00
92541 26
Medicine
0.62
0.62
42.16
42.16
92541 TC
Medicine
0.13
0.13
8.84
8.84
92542 00
Medicine
0.86
0.86
58.48
58.48
92542 26
Medicine
0.73
0.73
49.64
49.64
92542 TC
Medicine
0.13
0.13
8.84
8.84
92544 00
Medicine
0.53
0.53
36.04
36.04
92544 26
Medicine
0.42
0.42
28.56
28.56
92544 TC
Medicine
0.11
0.11
7.48
7.48
92545 00
Medicine
0.50
0.50
34.00
34.00
92545 26
Medicine
0.39
0.39
26.52
26.52
92545 TC
Medicine
0.11
0.11
7.48
7.48
92546 00
Medicine
3.98
3.98
270.64
270.64
92546 26
Medicine
0.44
0.44
29.92
29.92
92546 TC
Medicine
3.54
3.54
240.72
240.72
92547 00
Medicine
0.32
0.32
21.76
21.76
92548 00
Medicine
1.41
1.41
95.88
95.88
92548 26
Medicine
0.99
0.99
67.32
67.32
92548 TC
Medicine
0.42
0.42
28.56
28.56
92549 00
Medicine
1.93
1.93
131.24
131.24
92549 26
Medicine
1.32
1.32
89.76
89.76
92549 TC
Medicine
0.61
0.61
41.48
41.48
92550 00
Medicine
0.65
0.65
44.20
44.20
92551 00
Medicine
0.38
0.38
25.84
25.84
92552 00
Medicine
1.14
1.14
77.52
77.52
92553 00
Medicine
1.38
1.38
93.84
93.84
92555 00
Medicine
0.87
0.87
59.16
59.16
92556 00
Medicine
1.35
1.35
91.80
91.80
92557 00
Medicine
1.09
0.94
74.12
63.92
92558 00
Medicine
0.28
0.25
19.04
17.00
92562 00
Medicine
1.45
1.45
98.60
98.60
92563 00
Medicine
1.04
1.04
70.72
70.72
92565 00
Medicine
0.63
0.63
42.84
42.84
92567 00
Medicine
0.49
0.32
33.32
21.76
92568 00
Medicine
0.45
0.44
30.60
29.92
92570 00
Medicine
0.96
0.86
65.28
58.48
92571 00
Medicine
0.93
0.93
63.24
63.24
92572 00
Medicine
1.60
1.60
108.80
108.80
92575 00
Medicine
2.22
2.22
150.96
150.96
92576 00
Medicine
1.28
1.28
87.04
87.04
92577 00
Medicine
0.66
0.66
44.88
44.88
92579 00
Medicine
1.32
1.09
89.76
74.12
92582 00
Medicine
2.60
2.60
176.80
176.80
92583 00
Medicine
1.71
1.71
116.28
116.28
92584 00
Medicine
3.32
3.32
225.76
225.76
92587 00
Medicine
0.64
0.64
43.52
43.52
92587 26
Medicine
0.53
0.53
36.04
36.04
92587 TC
Medicine
0.11
0.11
7.48
7.48
92588 00
Medicine
0.99
0.99
67.32
67.32
92588 26
Medicine
0.84
0.84
57.12
57.12
92588 TC
Medicine
0.15
0.15
10.20
10.20
92590 00
Medicine
-
-
100.64
91.80
92591 00
Medicine
-
-
101.32
92.48
92592 00
Medicine
-
-
40.80
36.72
92593 00
Medicine
-
-
54.40
48.96
92594 00
Medicine
-
-
47.60
42.84
92595 00
Medicine
-
-
80.92
74.12
92596 00
Medicine
2.31
2.31
157.08
157.08
92597 00
Medicine
2.17
2.17
147.56
147.56
92601 00
Medicine
4.74
3.62
322.32
246.16
92602 00
Medicine
2.98
2.04
202.64
138.72
92603 00
Medicine
4.45
3.52
302.60
239.36
92604 00
Medicine
2.68
1.95
182.24
132.60
92605 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
92606 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
92607 00
Medicine
3.72
3.72
252.96
252.96
92608 00
Medicine
1.46
1.46
99.28
99.28
92609 00
Medicine
3.10
3.10
210.80
210.80
92610 00
Medicine
2.56
2.10
174.08
142.80
92611 00
Medicine
2.76
2.76
187.68
187.68
92612 00
Medicine
5.96
1.97
405.28
133.96
92613 00
Medicine
1.08
1.08
73.44
73.44
92614 00
Medicine
4.48
1.94
304.64
131.92
92615 00
Medicine
0.97
0.97
65.96
65.96
92616 00
Medicine
6.86
2.95
466.48
200.60
92617 00
Medicine
1.21
1.21
82.28
82.28
92618 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
92620 00
Medicine
2.64
2.34
179.52
159.12
92621 00
Medicine
0.65
0.55
44.20
37.40
92622 00
Medicine
2.37
1.96
161.16
133.28
92623 00
Medicine
0.61
0.52
41.48
35.36
92625 00
Medicine
2.01
1.80
136.68
122.40
92626 00
Medicine
2.58
2.20
175.44
149.60
92627 00
Medicine
0.61
0.52
41.48
35.36
92630 00
Medicine
-
-
118.32
107.44
92633 00
Medicine
-
-
91.12
82.96
92640 00
Medicine
3.24
2.76
220.32
187.68
92650 00
Medicine
0.81
0.81
55.08
55.08
92651 00
Medicine
2.48
2.48
168.64
168.64
92652 00
Medicine
3.36
3.36
228.48
228.48
92653 00
Medicine
2.49
2.49
169.32
169.32
92700 00
Medicine
0.00
0.00
BR
BR
92920 00
Medicine
15.45
15.45
1050.60
1050.60
92921 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
92924 00
Medicine
18.43
18.43
1253.24
1253.24
92925 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
92928 00
Medicine
17.19
17.19
1168.92
1168.92
92929 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
92933 00
Medicine
19.28
19.28
1311.04
1311.04
92934 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
92937 00
Medicine
17.19
17.19
1168.92
1168.92
92938 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
92941 00
Medicine
19.30
19.30
1312.40
1312.40
92943 00
Medicine
19.30
19.30
1312.40
1312.40
92944 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
92950 00
Medicine
9.71
5.41
660.28
367.88
92953 00
Medicine
0.03
0.03
2.04
2.04
92960 00
Medicine
4.59
3.18
312.12
216.24
92961 00
Medicine
7.16
7.16
486.88
486.88
92970 00
Medicine
5.51
5.51
374.68
374.68
92971 00
Medicine
2.93
2.93
199.24
199.24
92972 00
Medicine
4.28
4.28
291.04
291.04
92973 00
Medicine
5.15
5.15
350.20
350.20
92974 00
Medicine
4.72
4.72
320.96
320.96
92975 00
Medicine
10.98
10.98
746.64
746.64
92977 00
Medicine
1.66
1.66
112.88
112.88
92978 00
Medicine
-
-
536.52
536.52
92978 26
Medicine
2.76
2.76
187.68
187.68
92978 TC
Medicine
-
-
348.84
348.84
92979 00
Medicine
-
-
323.68
323.68
92979 26
Medicine
2.19
2.19
148.92
148.92
92979 TC
Medicine
-
-
174.76
174.76
92986 00
Medicine
38.98
38.98
2650.64
2650.64
92987 00
Medicine
40.17
40.17
2731.56
2731.56
92990 00
Medicine
32.17
32.17
2187.56
2187.56
92997 00
Medicine
18.53
18.53
1260.04
1260.04
92998 00
Medicine
9.30
9.30
632.40
632.40
93000 00
Medicine
0.43
0.43
29.24
29.24
93005 00
Medicine
0.19
0.19
12.92
12.92
93010 00
Medicine
0.24
0.24
16.32
16.32
93015 00
Medicine
2.16
2.16
146.88
146.88
93016 00
Medicine
0.62
0.62
42.16
42.16
93017 00
Medicine
1.13
1.13
76.84
76.84
93018 00
Medicine
0.41
0.41
27.88
27.88
93024 00
Medicine
3.35
3.35
227.80
227.80
93024 26
Medicine
1.61
1.61
109.48
109.48
93024 TC
Medicine
1.74
1.74
118.32
118.32
93025 00
Medicine
3.75
3.75
255.00
255.00
93025 26
Medicine
1.09
1.09
74.12
74.12
93025 TC
Medicine
2.66
2.66
180.88
180.88
93040 00
Medicine
0.39
0.39
26.52
26.52
93041 00
Medicine
0.19
0.19
12.92
12.92
93042 00
Medicine
0.20
0.20
13.60
13.60
93050 00
Medicine
0.48
0.48
32.64
32.64
93050 26
Medicine
0.24
0.24
16.32
16.32
93050 TC
Medicine
0.24
0.24
16.32
16.32
93150 00
Medicine
2.99
1.26
203.32
85.68
93151 00
Medicine
2.61
1.19
177.48
80.92
93152 00
Medicine
4.72
2.78
320.96
189.04
93153 00
Medicine
1.55
0.64
105.40
43.52
93224 00
Medicine
2.16
2.16
146.88
146.88
93225 00
Medicine
0.55
0.55
37.40
37.40
93226 00
Medicine
1.07
1.07
72.76
72.76
93227 00
Medicine
0.54
0.54
36.72
36.72
93228 00
Medicine
0.74
0.74
50.32
50.32
93229 00
Medicine
24.42
24.42
1660.56
1660.56
93241 00
Medicine
7.75
7.75
527.00
527.00
93242 00
Medicine
0.36
0.36
24.48
24.48
93243 00
Medicine
6.71
6.71
456.28
456.28
93244 00
Medicine
0.68
0.68
46.24
46.24
93245 00
Medicine
8.15
8.15
554.20
554.20
93246 00
Medicine
0.36
0.36
24.48
24.48
93247 00
Medicine
7.04
7.04
478.72
478.72
93248 00
Medicine
0.75
0.75
51.00
51.00
93260 00
Medicine
2.26
2.26
153.68
153.68
93260 26
Medicine
1.21
1.21
82.28
82.28
93260 TC
Medicine
1.05
1.05
71.40
71.40
93261 00
Medicine
2.08
2.08
141.44
141.44
93261 26
Medicine
1.04
1.04
70.72
70.72
93261 TC
Medicine
1.04
1.04
70.72
70.72
93264 00
Medicine
1.54
1.05
104.72
71.40
93268 00
Medicine
5.25
5.25
357.00
357.00
93270 00
Medicine
0.25
0.25
17.00
17.00
93271 00
Medicine
4.29
4.29
291.72
291.72
93272 00
Medicine
0.71
0.71
48.28
48.28
93278 00
Medicine
0.95
0.95
64.60
64.60
93278 26
Medicine
0.37
0.37
25.16
25.16
93278 TC
Medicine
0.58
0.58
39.44
39.44
93279 00
Medicine
2.01
2.01
136.68
136.68
93279 26
Medicine
0.91
0.91
61.88
61.88
93279 TC
Medicine
1.10
1.10
74.80
74.80
93280 00
Medicine
2.35
2.35
159.80
159.80
93280 26
Medicine
1.08
1.08
73.44
73.44
93280 TC
Medicine
1.27
1.27
86.36
86.36
93281 00
Medicine
2.50
2.50
170.00
170.00
93281 26
Medicine
1.21
1.21
82.28
82.28
93281 TC
Medicine
1.29
1.29
87.72
87.72
93282 00
Medicine
2.37
2.37
161.16
161.16
93282 26
Medicine
1.20
1.20
81.60
81.60
93282 TC
Medicine
1.17
1.17
79.56
79.56
93283 00
Medicine
2.91
2.91
197.88
197.88
93283 26
Medicine
1.63
1.63
110.84
110.84
93283 TC
Medicine
1.28
1.28
87.04
87.04
93284 00
Medicine
3.14
3.14
213.52
213.52
93284 26
Medicine
1.77
1.77
120.36
120.36
93284 TC
Medicine
1.37
1.37
93.16
93.16
93285 00
Medicine
1.79
1.79
121.72
121.72
93285 26
Medicine
0.74
0.74
50.32
50.32
93285 TC
Medicine
1.05
1.05
71.40
71.40
93286 00
Medicine
1.35
1.35
91.80
91.80
93286 26
Medicine
0.43
0.43
29.24
29.24
93286 TC
Medicine
0.92
0.92
62.56
62.56
93287 00
Medicine
1.56
1.56
106.08
106.08
93287 26
Medicine
0.63
0.63
42.84
42.84
93287 TC
Medicine
0.93
0.93
63.24
63.24
93288 00
Medicine
1.68
1.68
114.24
114.24
93288 26
Medicine
0.60
0.60
40.80
40.80
93288 TC
Medicine
1.08
1.08
73.44
73.44
93289 00
Medicine
2.15
2.15
146.20
146.20
93289 26
Medicine
1.06
1.06
72.08
72.08
93289 TC
Medicine
1.09
1.09
74.12
74.12
93290 00
Medicine
1.59
1.59
108.12
108.12
93290 26
Medicine
0.61
0.61
41.48
41.48
93290 TC
Medicine
0.98
0.98
66.64
66.64
93291 00
Medicine
1.46
1.46
99.28
99.28
93291 26
Medicine
0.52
0.52
35.36
35.36
93291 TC
Medicine
0.94
0.94
63.92
63.92
93292 00
Medicine
1.53
1.53
104.04
104.04
93292 26
Medicine
0.61
0.61
41.48
41.48
93292 TC
Medicine
0.92
0.92
62.56
62.56
93293 00
Medicine
1.32
1.32
89.76
89.76
93293 26
Medicine
0.42
0.42
28.56
28.56
93293 TC
Medicine
0.90
0.90
61.20
61.20
93294 00
Medicine
0.87
0.87
59.16
59.16
93295 00
Medicine
1.08
1.08
73.44
73.44
93296 00
Medicine
0.64
0.64
43.52
43.52
93297 00
Medicine
1.81
1.81
123.08
123.08
93297 26
Medicine
0.73
0.73
49.64
49.64
93297 TC
Medicine
1.08
1.08
73.44
73.44
93298 00
Medicine
3.05
3.05
207.40
207.40
93298 26
Medicine
0.73
0.73
49.64
49.64
93298 TC
Medicine
2.32
2.32
157.76
157.76
93303 00
Medicine
6.58
6.58
447.44
447.44
93303 26
Medicine
1.80
1.80
122.40
122.40
93303 TC
Medicine
4.78
4.78
325.04
325.04
93304 00
Medicine
4.66
4.66
316.88
316.88
93304 26
Medicine
1.05
1.05
71.40
71.40
93304 TC
Medicine
3.61
3.61
245.48
245.48
93306 00
Medicine
5.89
5.89
400.52
400.52
93306 26
Medicine
2.02
2.02
137.36
137.36
93306 TC
Medicine
3.87
3.87
263.16
263.16
93307 00
Medicine
4.09
4.09
278.12
278.12
93307 26
Medicine
1.27
1.27
86.36
86.36
93307 TC
Medicine
2.82
2.82
191.76
191.76
93308 00
Medicine
2.96
2.96
201.28
201.28
93308 26
Medicine
0.73
0.73
49.64
49.64
93308 TC
Medicine
2.23
2.23
151.64
151.64
93312 00
Medicine
7.06
7.06
480.08
480.08
93312 26
Medicine
3.11
3.11
211.48
211.48
93312 TC
Medicine
3.95
3.95
268.60
268.60
93313 00
Medicine
0.33
0.33
22.44
22.44
93314 00
Medicine
6.77
6.77
460.36
460.36
93314 26
Medicine
2.60
2.60
176.80
176.80
93314 TC
Medicine
4.17
4.17
283.56
283.56
93315 00
Medicine
-
-
557.60
557.60
93315 26
Medicine
3.69
3.69
250.92
250.92
93315 TC
Medicine
-
-
306.68
306.68
93316 00
Medicine
0.76
0.76
51.68
51.68
93317 00
Medicine
-
-
499.12
499.12
93317 26
Medicine
2.57
2.57
174.76
174.76
93317 TC
Medicine
-
-
324.36
324.36
93318 00
Medicine
-
-
577.32
577.32
93318 26
Medicine
2.97
2.97
201.96
201.96
93318 TC
Medicine
-
-
375.36
375.36
93319 00
Medicine
1.66
0.69
112.88
46.92
93320 00
Medicine
1.52
1.52
103.36
103.36
93320 26
Medicine
0.52
0.52
35.36
35.36
93320 TC
Medicine
1.00
1.00
68.00
68.00
93321 00
Medicine
0.75
0.75
51.00
51.00
93321 26
Medicine
0.21
0.21
14.28
14.28
93321 TC
Medicine
0.54
0.54
36.72
36.72
93325 00
Medicine
0.70
0.70
47.60
47.60
93325 26
Medicine
0.09
0.09
6.12
6.12
93325 TC
Medicine
0.61
0.61
41.48
41.48
93350 00
Medicine
5.56
5.56
378.08
378.08
93350 26
Medicine
2.02
2.02
137.36
137.36
93350 TC
Medicine
3.54
3.54
240.72
240.72
93351 00
Medicine
6.96
6.96
473.28
473.28
93351 26
Medicine
2.42
2.42
164.56
164.56
93351 TC
Medicine
4.54
4.54
308.72
308.72
93352 00
Medicine
1.04
1.04
70.72
70.72
93355 00
Medicine
6.58
6.58
447.44
447.44
93356 00
Medicine
1.11
0.34
75.48
23.12
93451 00
Medicine
25.50
25.50
1734.00
1734.00
93451 26
Medicine
3.81
3.81
259.08
259.08
93451 TC
Medicine
21.69
21.69
1474.92
1474.92
93452 00
Medicine
26.52
26.52
1803.36
1803.36
93452 26
Medicine
6.89
6.89
468.52
468.52
93452 TC
Medicine
19.63
19.63
1334.84
1334.84
93453 00
Medicine
33.84
33.84
2301.12
2301.12
93453 26
Medicine
9.20
9.20
625.60
625.60
93453 TC
Medicine
24.64
24.64
1675.52
1675.52
93454 00
Medicine
26.74
26.74
1818.32
1818.32
93454 26
Medicine
6.96
6.96
473.28
473.28
93454 TC
Medicine
19.78
19.78
1345.04
1345.04
93455 00
Medicine
29.80
29.80
2026.40
2026.40
93455 26
Medicine
8.11
8.11
551.48
551.48
93455 TC
Medicine
21.69
21.69
1474.92
1474.92
93456 00
Medicine
33.27
33.27
2262.36
2262.36
93456 26
Medicine
9.07
9.07
616.76
616.76
93456 TC
Medicine
24.20
24.20
1645.60
1645.60
93457 00
Medicine
36.26
36.26
2465.68
2465.68
93457 26
Medicine
10.18
10.18
692.24
692.24
93457 TC
Medicine
26.08
26.08
1773.44
1773.44
93458 00
Medicine
30.76
30.76
2091.68
2091.68
93458 26
Medicine
8.59
8.59
584.12
584.12
93458 TC
Medicine
22.17
22.17
1507.56
1507.56
93459 00
Medicine
33.09
33.09
2250.12
2250.12
93459 26
Medicine
9.73
9.73
661.64
661.64
93459 TC
Medicine
23.36
23.36
1588.48
1588.48
93460 00
Medicine
36.71
36.71
2496.28
2496.28
93460 26
Medicine
10.88
10.88
739.84
739.84
93460 TC
Medicine
25.83
25.83
1756.44
1756.44
93461 00
Medicine
40.50
40.50
2754.00
2754.00
93461 26
Medicine
12.03
12.03
818.04
818.04
93461 TC
Medicine
28.47
28.47
1935.96
1935.96
93462 00
Medicine
6.06
6.06
412.08
412.08
93463 00
Medicine
2.86
2.86
194.48
194.48
93464 00
Medicine
6.53
6.53
444.04
444.04
93464 26
Medicine
2.59
2.59
176.12
176.12
93464 TC
Medicine
3.94
3.94
267.92
267.92
93503 00
Medicine
2.57
2.57
174.76
174.76
93505 00
Medicine
19.13
19.13
1300.84
1300.84
93505 26
Medicine
6.63
6.63
450.84
450.84
93505 TC
Medicine
12.50
12.50
850.00
850.00
93563 00
Medicine
1.51
1.51
102.68
102.68
93564 00
Medicine
1.62
1.62
110.16
110.16
93565 00
Medicine
0.79
0.79
53.72
53.72
93566 00
Medicine
0.76
0.76
51.68
51.68
93567 00
Medicine
1.10
1.10
74.80
74.80
93568 00
Medicine
1.36
1.36
92.48
92.48
93569 00
Medicine
1.11
1.11
75.48
75.48
93571 00
Medicine
-
-
408.00
408.00
93571 26
Medicine
2.10
2.10
142.80
142.80
93571 TC
Medicine
-
-
265.20
265.20
93572 00
Medicine
-
-
221.68
221.68
93572 26
Medicine
1.53
1.53
104.04
104.04
93572 TC
Medicine
-
-
117.64
117.64
93573 00
Medicine
1.84
1.84
125.12
125.12
93574 00
Medicine
2.05
2.05
139.40
139.40
93575 00
Medicine
2.72
2.72
184.96
184.96
93580 00
Medicine
28.52
28.52
1939.36
1939.36
93581 00
Medicine
38.70
38.70
2631.60
2631.60
93582 00
Medicine
19.32
19.32
1313.76
1313.76
93583 00
Medicine
21.68
21.68
1474.24
1474.24
93584 00
Medicine
1.73
1.73
117.64
117.64
93585 00
Medicine
1.63
1.63
110.84
110.84
93586 00
Medicine
2.06
2.06
140.08
140.08
93587 00
Medicine
3.04
3.04
206.72
206.72
93588 00
Medicine
3.07
3.07
208.76
208.76
93590 00
Medicine
31.26
31.26
2125.68
2125.68
93591 00
Medicine
25.70
25.70
1747.60
1747.60
93592 00
Medicine
11.26
11.26
765.68
765.68
93593 00
Medicine
0.00
0.00
BR
BR
93593 26
Medicine
5.51
5.51
374.68
374.68
93593 TC
Medicine
0.00
0.00
BR
BR
93594 00
Medicine
-
-
943.16
924.12
93594 26
Medicine
8.37
8.37
569.16
569.16
93594 TC
Medicine
-
-
374.00
354.96
93595 00
Medicine
0.00
0.00
BR
BR
93595 26
Medicine
7.59
7.59
516.12
516.12
93595 TC
Medicine
0.00
0.00
BR
BR
93596 00
Medicine
-
-
1029.52
1009.12
93596 26
Medicine
9.44
9.44
641.92
641.92
93596 TC
Medicine
-
-
387.60
367.20
93597 00
Medicine
-
-
1372.92
1345.72
93597 26
Medicine
12.33
12.33
838.44
838.44
93597 TC
Medicine
-
-
534.48
507.28
93598 00
Medicine
0.00
0.00
BR
BR
93598 26
Medicine
1.95
1.95
132.60
132.60
93598 TC
Medicine
0.00
0.00
BR
BR
93600 00
Medicine
-
-
382.84
382.84
93600 26
Medicine
3.38
3.38
229.84
229.84
93600 TC
Medicine
-
-
153.00
153.00
93602 00
Medicine
-
-
313.48
313.48
93602 26
Medicine
3.32
3.32
225.76
225.76
93602 TC
Medicine
-
-
87.72
87.72
93603 00
Medicine
-
-
358.36
358.36
93603 26
Medicine
3.32
3.32
225.76
225.76
93603 TC
Medicine
-
-
132.60
132.60
93609 00
Medicine
-
-
748.68
748.68
93609 26
Medicine
7.93
7.93
539.24
539.24
93609 TC
Medicine
-
-
209.44
209.44
93610 00
Medicine
-
-
425.00
425.00
93610 26
Medicine
4.69
4.69
318.92
318.92
93610 TC
Medicine
-
-
106.08
106.08
93612 00
Medicine
-
-
436.56
436.56
93612 26
Medicine
4.62
4.62
314.16
314.16
93612 TC
Medicine
-
-
122.40
122.40
93613 00
Medicine
8.52
8.52
579.36
579.36
93615 00
Medicine
-
-
96.56
96.56
93615 26
Medicine
1.05
1.05
71.40
71.40
93615 TC
Medicine
-
-
25.16
25.16
93616 00
Medicine
-
-
195.84
195.84
93616 26
Medicine
1.70
1.70
115.60
115.60
93616 TC
Medicine
-
-
80.24
80.24
93618 00
Medicine
-
-
710.60
710.60
93618 26
Medicine
6.27
6.27
426.36
426.36
93618 TC
Medicine
-
-
284.24
284.24
93619 00
Medicine
-
-
1336.20
1336.20
93619 26
Medicine
11.20
11.20
761.60
761.60
93619 TC
Medicine
-
-
574.60
574.60
93620 00
Medicine
-
-
1939.36
1939.36
93620 26
Medicine
17.97
17.97
1221.96
1221.96
93620 TC
Medicine
-
-
717.40
717.40
93621 00
Medicine
-
-
706.52
706.52
93621 26
Medicine
2.39
2.39
162.52
162.52
93621 TC
Medicine
-
-
544.00
544.00
93622 00
Medicine
-
-
1396.72
1396.72
93622 26
Medicine
4.93
4.93
335.24
335.24
93622 TC
Medicine
-
-
1061.48
1061.48
93623 00
Medicine
-
-
384.88
384.88
93623 26
Medicine
1.98
1.98
134.64
134.64
93623 TC
Medicine
-
-
250.24
250.24
93624 00
Medicine
-
-
607.92
607.92
93624 26
Medicine
6.97
6.97
473.96
473.96
93624 TC
Medicine
-
-
138.72
138.72
93631 00
Medicine
-
-
1662.60
1662.60
93631 26
Medicine
11.49
11.49
781.32
781.32
93631 TC
Medicine
-
-
881.28
881.28
93640 00
Medicine
-
-
872.44
872.44
93640 26
Medicine
5.13
5.13
348.84
348.84
93640 TC
Medicine
-
-
523.60
523.60
93641 00
Medicine
-
-
1150.56
1150.56
93641 26
Medicine
8.97
8.97
609.96
609.96
93641 TC
Medicine
-
-
540.60
540.60
93642 00
Medicine
9.77
9.77
664.36
664.36
93642 26
Medicine
7.32
7.32
497.76
497.76
93642 TC
Medicine
2.45
2.45
166.60
166.60
93644 00
Medicine
5.69
5.69
386.92
386.92
93644 26
Medicine
4.17
4.17
283.56
283.56
93644 TC
Medicine
1.52
1.52
103.36
103.36
93650 00
Medicine
17.00
17.00
1156.00
1156.00
93653 00
Medicine
24.42
24.42
1660.56
1660.56
93654 00
Medicine
29.42
29.42
2000.56
2000.56
93655 00
Medicine
8.95
8.95
608.60
608.60
93656 00
Medicine
27.69
27.69
1882.92
1882.92
93657 00
Medicine
8.96
8.96
609.28
609.28
93660 00
Medicine
4.86
4.86
330.48
330.48
93660 26
Medicine
2.67
2.67
181.56
181.56
93660 TC
Medicine
2.19
2.19
148.92
148.92
93662 00
Medicine
-
-
324.36
324.36
93662 26
Medicine
2.05
2.05
139.40
139.40
93662 TC
Medicine
-
-
184.96
184.96
93668 00
Medicine
0.44
0.44
29.92
29.92
93701 00
Medicine
0.81
0.81
55.08
55.08
93702 00
Medicine
3.67
3.67
249.56
249.56
93724 00
Medicine
8.28
8.28
563.04
563.04
93724 26
Medicine
6.89
6.89
468.52
468.52
93724 TC
Medicine
1.39
1.39
94.52
94.52
93740 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
93745 00
Medicine
0.00
0.00
BR
BR
93745 26
Medicine
0.00
0.00
BR
BR
93745 TC
Medicine
0.00
0.00
BR
BR
93750 00
Medicine
1.52
1.18
103.36
80.24
93770 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
93784 00
Medicine
1.38
1.38
93.84
93.84
93786 00
Medicine
0.68
0.68
46.24
46.24
93788 00
Medicine
0.17
0.17
11.56
11.56
93790 00
Medicine
0.53
0.53
36.04
36.04
93792 00
Medicine
2.11
2.11
143.48
143.48
93793 00
Medicine
0.34
0.34
23.12
23.12
93797 00
Medicine
0.51
0.26
34.68
17.68
93798 00
Medicine
0.77
0.40
52.36
27.20
93799 00
Medicine
0.00
0.00
BR
BR
93799 26
Medicine
0.00
0.00
BR
BR
93799 TC
Medicine
0.00
0.00
BR
BR
93880 00
Medicine
5.70
5.70
387.60
387.60
93880 26
Medicine
1.12
1.12
76.16
76.16
93880 TC
Medicine
4.58
4.58
311.44
311.44
93882 00
Medicine
3.74
3.74
254.32
254.32
93882 26
Medicine
0.70
0.70
47.60
47.60
93882 TC
Medicine
3.04
3.04
206.72
206.72
93886 00
Medicine
8.23
8.23
559.64
559.64
93886 26
Medicine
1.36
1.36
92.48
92.48
93886 TC
Medicine
6.87
6.87
467.16
467.16
93888 00
Medicine
4.79
4.79
325.72
325.72
93888 26
Medicine
0.73
0.73
49.64
49.64
93888 TC
Medicine
4.06
4.06
276.08
276.08
93890 00
Medicine
8.52
8.52
579.36
579.36
93890 26
Medicine
1.50
1.50
102.00
102.00
93890 TC
Medicine
7.02
7.02
477.36
477.36
93892 00
Medicine
9.82
9.82
667.76
667.76
93892 26
Medicine
1.74
1.74
118.32
118.32
93892 TC
Medicine
8.08
8.08
549.44
549.44
93893 00
Medicine
12.09
12.09
822.12
822.12
93893 26
Medicine
1.76
1.76
119.68
119.68
93893 TC
Medicine
10.33
10.33
702.44
702.44
93895 00
Medicine
-
-
287.64
287.64
93895 26
Medicine
0.00
0.00
BR
BR
93895 TC
Medicine
-
-
287.64
287.64
93922 00
Medicine
2.47
2.47
167.96
167.96
93922 26
Medicine
0.35
0.35
23.80
23.80
93922 TC
Medicine
2.12
2.12
144.16
144.16
93923 00
Medicine
3.91
3.91
265.88
265.88
93923 26
Medicine
0.64
0.64
43.52
43.52
93923 TC
Medicine
3.27
3.27
222.36
222.36
93924 00
Medicine
4.80
4.80
326.40
326.40
93924 26
Medicine
0.70
0.70
47.60
47.60
93924 TC
Medicine
4.10
4.10
278.80
278.80
93925 00
Medicine
7.21
7.21
490.28
490.28
93925 26
Medicine
1.11
1.11
75.48
75.48
93925 TC
Medicine
6.10
6.10
414.80
414.80
93926 00
Medicine
4.32
4.32
293.76
293.76
93926 26
Medicine
0.68
0.68
46.24
46.24
93926 TC
Medicine
3.64
3.64
247.52
247.52
93930 00
Medicine
5.94
5.94
403.92
403.92
93930 26
Medicine
1.12
1.12
76.16
76.16
93930 TC
Medicine
4.82
4.82
327.76
327.76
93931 00
Medicine
3.71
3.71
252.28
252.28
93931 26
Medicine
0.69
0.69
46.92
46.92
93931 TC
Medicine
3.02
3.02
205.36
205.36
93970 00
Medicine
5.61
5.61
381.48
381.48
93970 26
Medicine
0.97
0.97
65.96
65.96
93970 TC
Medicine
4.64
4.64
315.52
315.52
93971 00
Medicine
3.57
3.57
242.76
242.76
93971 26
Medicine
0.62
0.62
42.16
42.16
93971 TC
Medicine
2.95
2.95
200.60
200.60
93975 00
Medicine
7.93
7.93
539.24
539.24
93975 26
Medicine
1.62
1.62
110.16
110.16
93975 TC
Medicine
6.31
6.31
429.08
429.08
93976 00
Medicine
4.76
4.76
323.68
323.68
93976 26
Medicine
1.12
1.12
76.16
76.16
93976 TC
Medicine
3.64
3.64
247.52
247.52
93978 00
Medicine
5.41
5.41
367.88
367.88
93978 26
Medicine
1.12
1.12
76.16
76.16
93978 TC
Medicine
4.29
4.29
291.72
291.72
93979 00
Medicine
3.54
3.54
240.72
240.72
93979 26
Medicine
0.70
0.70
47.60
47.60
93979 TC
Medicine
2.84
2.84
193.12
193.12
93980 00
Medicine
3.51
3.51
238.68
238.68
93980 26
Medicine
1.76
1.76
119.68
119.68
93980 TC
Medicine
1.75
1.75
119.00
119.00
93981 00
Medicine
2.12
2.12
144.16
144.16
93981 26
Medicine
0.62
0.62
42.16
42.16
93981 TC
Medicine
1.50
1.50
102.00
102.00
93985 00
Medicine
7.43
7.43
505.24
505.24
93985 26
Medicine
1.11
1.11
75.48
75.48
93985 TC
Medicine
6.32
6.32
429.76
429.76
93986 00
Medicine
4.37
4.37
297.16
297.16
93986 26
Medicine
0.69
0.69
46.92
46.92
93986 TC
Medicine
3.68
3.68
250.24
250.24
93990 00
Medicine
4.41
4.41
299.88
299.88
93990 26
Medicine
0.69
0.69
46.92
46.92
93990 TC
Medicine
3.72
3.72
252.96
252.96
93998 00
Medicine
0.00
0.00
BR
BR
94002 00
Medicine
2.70
2.70
183.60
183.60
94003 00
Medicine
1.90
1.90
129.20
129.20
94004 00
Medicine
1.41
1.41
95.88
95.88
94005 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
94010 00
Medicine
0.82
0.82
55.76
55.76
94010 26
Medicine
0.24
0.24
16.32
16.32
94010 TC
Medicine
0.58
0.58
39.44
39.44
94011 00
Medicine
2.51
2.51
170.68
170.68
94012 00
Medicine
4.10
4.10
278.80
278.80
94013 00
Medicine
0.55
0.55
37.40
37.40
94014 00
Medicine
1.68
1.68
114.24
114.24
94015 00
Medicine
0.96
0.96
65.28
65.28
94016 00
Medicine
0.72
0.72
48.96
48.96
94060 00
Medicine
1.17
1.17
79.56
79.56
94060 26
Medicine
0.30
0.30
20.40
20.40
94060 TC
Medicine
0.87
0.87
59.16
59.16
94070 00
Medicine
1.89
1.89
128.52
128.52
94070 26
Medicine
0.81
0.81
55.08
55.08
94070 TC
Medicine
1.08
1.08
73.44
73.44
94150 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
94150 26
Medicine
0.00
0.00
Bundled Code
Bundled Code
94150 TC
Medicine
0.00
0.00
Bundled Code
Bundled Code
94200 00
Medicine
0.45
0.45
30.60
30.60
94200 26
Medicine
0.08
0.08
5.44
5.44
94200 TC
Medicine
0.37
0.37
25.16
25.16
94375 00
Medicine
1.17
1.17
79.56
79.56
94375 26
Medicine
0.42
0.42
28.56
28.56
94375 TC
Medicine
0.75
0.75
51.00
51.00
94450 00
Medicine
2.39
2.39
162.52
162.52
94450 26
Medicine
0.57
0.57
38.76
38.76
94450 TC
Medicine
1.82
1.82
123.76
123.76
94452 00
Medicine
1.51
1.51
102.68
102.68
94452 26
Medicine
0.41
0.41
27.88
27.88
94452 TC
Medicine
1.10
1.10
74.80
74.80
94453 00
Medicine
2.01
2.01
136.68
136.68
94453 26
Medicine
0.54
0.54
36.72
36.72
94453 TC
Medicine
1.47
1.47
99.96
99.96
94610 00
Medicine
1.67
1.67
113.56
113.56
94617 00
Medicine
2.67
2.67
181.56
181.56
94617 26
Medicine
0.93
0.93
63.24
63.24
94617 TC
Medicine
1.74
1.74
118.32
118.32
94618 00
Medicine
1.02
1.02
69.36
69.36
94618 26
Medicine
0.65
0.65
44.20
44.20
94618 TC
Medicine
0.37
0.37
25.16
25.16
94619 00
Medicine
1.95
1.95
132.60
132.60
94619 26
Medicine
0.63
0.63
42.84
42.84
94619 TC
Medicine
1.32
1.32
89.76
89.76
94621 00
Medicine
4.64
4.64
315.52
315.52
94621 26
Medicine
1.99
1.99
135.32
135.32
94621 TC
Medicine
2.65
2.65
180.20
180.20
94625 00
Medicine
2.22
0.55
150.96
37.40
94626 00
Medicine
2.41
0.81
163.88
55.08
94640 00
Medicine
0.24
0.24
16.32
16.32
94642 00
Medicine
-
-
78.20
76.16
94644 00
Medicine
1.79
1.79
121.72
121.72
94645 00
Medicine
0.49
0.49
33.32
33.32
94660 00
Medicine
1.94
1.10
131.92
74.80
94662 00
Medicine
1.03
1.03
70.04
70.04
94664 00
Medicine
0.54
0.54
36.72
36.72
94667 00
Medicine
0.75
0.75
51.00
51.00
94668 00
Medicine
1.18
1.18
80.24
80.24
94669 00
Medicine
0.62
0.62
42.16
42.16
94680 00
Medicine
1.62
1.62
110.16
110.16
94680 26
Medicine
0.37
0.37
25.16
25.16
94680 TC
Medicine
1.25
1.25
85.00
85.00
94681 00
Medicine
1.44
1.44
97.92
97.92
94681 26
Medicine
0.28
0.28
19.04
19.04
94681 TC
Medicine
1.16
1.16
78.88
78.88
94690 00
Medicine
1.46
1.46
99.28
99.28
94690 26
Medicine
0.11
0.11
7.48
7.48
94690 TC
Medicine
1.35
1.35
91.80
91.80
94726 00
Medicine
1.68
1.68
114.24
114.24
94726 26
Medicine
0.35
0.35
23.80
23.80
94726 TC
Medicine
1.33
1.33
90.44
90.44
94727 00
Medicine
1.34
1.34
91.12
91.12
94727 26
Medicine
0.35
0.35
23.80
23.80
94727 TC
Medicine
0.99
0.99
67.32
67.32
94728 00
Medicine
1.33
1.33
90.44
90.44
94728 26
Medicine
0.36
0.36
24.48
24.48
94728 TC
Medicine
0.97
0.97
65.96
65.96
94729 00
Medicine
1.70
1.70
115.60
115.60
94729 26
Medicine
0.26
0.26
17.68
17.68
94729 TC
Medicine
1.44
1.44
97.92
97.92
94760 00
Medicine
0.08
0.08
5.44
5.44
94761 00
Medicine
0.12
0.12
8.16
8.16
94762 00
Medicine
0.76
0.76
51.68
51.68
94772 00
Medicine
-
-
422.28
410.04
94772 26
Medicine
-
-
169.32
163.88
94772 TC
Medicine
-
-
252.96
246.16
94774 00
Medicine
0.00
0.00
BR
BR
94775 00
Medicine
0.00
0.00
BR
BR
94776 00
Medicine
0.00
0.00
BR
BR
94777 00
Medicine
-
-
125.80
122.40
94780 00
Medicine
1.60
0.69
108.80
46.92
94781 00
Medicine
0.64
0.24
43.52
16.32
94799 00
Medicine
0.00
0.00
BR
BR
94799 26
Medicine
0.00
0.00
BR
BR
94799 TC
Medicine
0.00
0.00
BR
BR
95004 00
Medicine
0.11
0.11
7.48
7.48
95012 00
Medicine
0.57
0.57
38.76
38.76
95017 00
Medicine
0.26
0.11
17.68
7.48
95018 00
Medicine
0.60
0.21
40.80
14.28
95024 00
Medicine
0.24
0.03
16.32
2.04
95027 00
Medicine
0.15
0.15
10.20
10.20
95028 00
Medicine
0.38
0.38
25.84
25.84
95044 00
Medicine
0.15
0.15
10.20
10.20
95052 00
Medicine
0.19
0.19
12.92
12.92
95056 00
Medicine
1.57
1.57
106.76
106.76
95060 00
Medicine
1.18
1.18
80.24
80.24
95065 00
Medicine
0.87
0.87
59.16
59.16
95070 00
Medicine
1.05
1.05
71.40
71.40
95076 00
Medicine
3.70
2.18
251.60
148.24
95079 00
Medicine
2.56
2.01
174.08
136.68
95115 00
Medicine
0.31
0.31
21.08
21.08
95117 00
Medicine
0.37
0.37
25.16
25.16
95120 00
Medicine
-
-
37.40
22.44
95125 00
Medicine
-
-
40.80
24.48
95130 00
Medicine
-
-
34.68
21.08
95131 00
Medicine
-
-
54.40
33.32
95132 00
Medicine
-
-
70.72
43.52
95133 00
Medicine
-
-
116.28
70.72
95134 00
Medicine
-
-
148.24
90.44
95144 00
Medicine
0.50
0.10
34.00
6.80
95145 00
Medicine
1.09
0.09
74.12
6.12
95146 00
Medicine
2.03
0.09
138.04
6.12
95147 00
Medicine
1.95
0.09
132.60
6.12
95148 00
Medicine
2.90
0.09
197.20
6.12
95149 00
Medicine
3.86
0.09
262.48
6.12
95165 00
Medicine
0.44
0.10
29.92
6.80
95170 00
Medicine
0.33
0.09
22.44
6.12
95180 00
Medicine
4.15
3.03
282.20
206.04
95199 00
Medicine
0.00
0.00
BR
BR
95249 00
Medicine
1.96
1.96
133.28
133.28
95250 00
Medicine
4.43
4.43
301.24
301.24
95251 00
Medicine
1.03
1.03
70.04
70.04
95700 00
Medicine
-
-
538.56
528.36
95705 00
Medicine
-
-
799.00
783.36
95706 00
Medicine
-
-
337.96
331.16
95707 00
Medicine
-
-
2186.88
2142.68
95708 00
Medicine
-
-
675.92
662.32
95709 00
Medicine
-
-
1622.48
1590.52
95710 00
Medicine
-
-
743.92
728.96
95711 00
Medicine
-
-
675.92
662.32
95712 00
Medicine
-
-
1217.20
1192.72
95713 00
Medicine
-
-
1014.56
994.16
95714 00
Medicine
-
-
678.64
665.04
95715 00
Medicine
-
-
2028.44
1987.64
95716 00
Medicine
-
-
3981.40
3901.84
95717 00
Medicine
3.18
3.13
216.24
212.84
95718 00
Medicine
4.04
3.97
274.72
269.96
95719 00
Medicine
4.82
4.74
327.76
322.32
95720 00
Medicine
6.22
6.11
422.96
415.48
95721 00
Medicine
6.22
6.10
422.96
414.80
95722 00
Medicine
7.54
7.40
512.72
503.20
95723 00
Medicine
7.54
7.40
512.72
503.20
95724 00
Medicine
9.48
9.31
644.64
633.08
95725 00
Medicine
8.75
8.54
595.00
580.72
95726 00
Medicine
12.17
11.93
827.56
811.24
95782 00
Medicine
29.38
29.38
1997.84
1997.84
95782 26
Medicine
3.63
3.63
246.84
246.84
95782 TC
Medicine
25.75
25.75
1751.00
1751.00
95783 00
Medicine
31.15
31.15
2118.20
2118.20
95783 26
Medicine
3.96
3.96
269.28
269.28
95783 TC
Medicine
27.19
27.19
1848.92
1848.92
95800 00
Medicine
4.08
4.08
277.44
277.44
95800 26
Medicine
1.16
1.16
78.88
78.88
95800 TC
Medicine
2.92
2.92
198.56
198.56
95801 00
Medicine
2.92
2.92
198.56
198.56
95801 26
Medicine
1.20
1.20
81.60
81.60
95801 TC
Medicine
1.72
1.72
116.96
116.96
95803 00
Medicine
4.06
4.06
276.08
276.08
95803 26
Medicine
1.23
1.23
83.64
83.64
95803 TC
Medicine
2.83
2.83
192.44
192.44
95805 00
Medicine
12.96
12.96
881.28
881.28
95805 26
Medicine
1.68
1.68
114.24
114.24
95805 TC
Medicine
11.28
11.28
767.04
767.04
95806 00
Medicine
2.83
2.83
192.44
192.44
95806 26
Medicine
1.29
1.29
87.72
87.72
95806 TC
Medicine
1.54
1.54
104.72
104.72
95807 00
Medicine
12.30
12.30
836.40
836.40
95807 26
Medicine
1.74
1.74
118.32
118.32
95807 TC
Medicine
10.56
10.56
718.08
718.08
95808 00
Medicine
15.37
15.37
1045.16
1045.16
95808 26
Medicine
2.44
2.44
165.92
165.92
95808 TC
Medicine
12.93
12.93
879.24
879.24
95810 00
Medicine
18.72
18.72
1272.96
1272.96
95810 26
Medicine
3.47
3.47
235.96
235.96
95810 TC
Medicine
15.25
15.25
1037.00
1037.00
95811 00
Medicine
19.57
19.57
1330.76
1330.76
95811 26
Medicine
3.61
3.61
245.48
245.48
95811 TC
Medicine
15.96
15.96
1085.28
1085.28
95812 00
Medicine
10.52
10.52
715.36
715.36
95812 26
Medicine
1.67
1.67
113.56
113.56
95812 TC
Medicine
8.85
8.85
601.80
601.80
95813 00
Medicine
13.30
13.30
904.40
904.40
95813 26
Medicine
2.52
2.52
171.36
171.36
95813 TC
Medicine
10.78
10.78
733.04
733.04
95816 00
Medicine
11.85
11.85
805.80
805.80
95816 26
Medicine
1.67
1.67
113.56
113.56
95816 TC
Medicine
10.18
10.18
692.24
692.24
95819 00
Medicine
13.65
13.65
928.20
928.20
95819 26
Medicine
1.67
1.67
113.56
113.56
95819 TC
Medicine
11.98
11.98
814.64
814.64
95822 00
Medicine
12.40
12.40
843.20
843.20
95822 26
Medicine
1.67
1.67
113.56
113.56
95822 TC
Medicine
10.73
10.73
729.64
729.64
95824 00
Medicine
-
-
198.56
198.56
95824 26
Medicine
1.14
1.14
77.52
77.52
95824 TC
Medicine
-
-
121.04
121.04
95829 00
Medicine
53.09
53.09
3610.12
3610.12
95829 26
Medicine
9.67
9.67
657.56
657.56
95829 TC
Medicine
43.42
43.42
2952.56
2952.56
95830 00
Medicine
20.62
2.71
1402.16
184.28
95836 00
Medicine
3.13
3.13
212.84
212.84
95851 00
Medicine
0.65
0.23
44.20
15.64
95852 00
Medicine
0.54
0.16
36.72
10.88
95857 00
Medicine
1.91
0.84
129.88
57.12
95860 00
Medicine
3.37
3.37
229.16
229.16
95860 26
Medicine
1.49
1.49
101.32
101.32
95860 TC
Medicine
1.88
1.88
127.84
127.84
95861 00
Medicine
4.78
4.78
325.04
325.04
95861 26
Medicine
2.38
2.38
161.84
161.84
95861 TC
Medicine
2.40
2.40
163.20
163.20
95863 00
Medicine
6.21
6.21
422.28
422.28
95863 26
Medicine
2.90
2.90
197.20
197.20
95863 TC
Medicine
3.31
3.31
225.08
225.08
95864 00
Medicine
6.94
6.94
471.92
471.92
95864 26
Medicine
3.09
3.09
210.12
210.12
95864 TC
Medicine
3.85
3.85
261.80
261.80
95865 00
Medicine
4.46
4.46
303.28
303.28
95865 26
Medicine
2.42
2.42
164.56
164.56
95865 TC
Medicine
2.04
2.04
138.72
138.72
95866 00
Medicine
3.67
3.67
249.56
249.56
95866 26
Medicine
1.86
1.86
126.48
126.48
95866 TC
Medicine
1.81
1.81
123.08
123.08
95867 00
Medicine
3.19
3.19
216.92
216.92
95867 26
Medicine
1.22
1.22
82.96
82.96
95867 TC
Medicine
1.97
1.97
133.96
133.96
95868 00
Medicine
4.15
4.15
282.20
282.20
95868 26
Medicine
1.83
1.83
124.44
124.44
95868 TC
Medicine
2.32
2.32
157.76
157.76
95869 00
Medicine
2.85
2.85
193.80
193.80
95869 26
Medicine
0.58
0.58
39.44
39.44
95869 TC
Medicine
2.27
2.27
154.36
154.36
95870 00
Medicine
2.49
2.49
169.32
169.32
95870 26
Medicine
0.58
0.58
39.44
39.44
95870 TC
Medicine
1.91
1.91
129.88
129.88
95872 00
Medicine
5.63
5.63
382.84
382.84
95872 26
Medicine
4.36
4.36
296.48
296.48
95872 TC
Medicine
1.27
1.27
86.36
86.36
95873 00
Medicine
2.11
2.11
143.48
143.48
95873 26
Medicine
0.57
0.57
38.76
38.76
95873 TC
Medicine
1.54
1.54
104.72
104.72
95874 00
Medicine
2.28
2.28
155.04
155.04
95874 26
Medicine
0.57
0.57
38.76
38.76
95874 TC
Medicine
1.71
1.71
116.28
116.28
95875 00
Medicine
3.66
3.66
248.88
248.88
95875 26
Medicine
1.72
1.72
116.96
116.96
95875 TC
Medicine
1.94
1.94
131.92
131.92
95885 00
Medicine
1.85
1.85
125.80
125.80
95885 26
Medicine
0.54
0.54
36.72
36.72
95885 TC
Medicine
1.31
1.31
89.08
89.08
95886 00
Medicine
2.88
2.88
195.84
195.84
95886 26
Medicine
1.32
1.32
89.76
89.76
95886 TC
Medicine
1.56
1.56
106.08
106.08
95887 00
Medicine
2.48
2.48
168.64
168.64
95887 26
Medicine
1.08
1.08
73.44
73.44
95887 TC
Medicine
1.40
1.40
95.20
95.20
95905 00
Medicine
1.01
1.01
68.68
68.68
95905 26
Medicine
0.08
0.08
5.44
5.44
95905 TC
Medicine
0.93
0.93
63.24
63.24
95907 00
Medicine
2.70
2.70
183.60
183.60
95907 26
Medicine
1.55
1.55
105.40
105.40
95907 TC
Medicine
1.15
1.15
78.20
78.20
95908 00
Medicine
3.35
3.35
227.80
227.80
95908 26
Medicine
1.94
1.94
131.92
131.92
95908 TC
Medicine
1.41
1.41
95.88
95.88
95909 00
Medicine
4.02
4.02
273.36
273.36
95909 26
Medicine
2.32
2.32
157.76
157.76
95909 TC
Medicine
1.70
1.70
115.60
115.60
95910 00
Medicine
5.25
5.25
357.00
357.00
95910 26
Medicine
3.09
3.09
210.12
210.12
95910 TC
Medicine
2.16
2.16
146.88
146.88
95911 00
Medicine
6.33
6.33
430.44
430.44
95911 26
Medicine
3.86
3.86
262.48
262.48
95911 TC
Medicine
2.47
2.47
167.96
167.96
95912 00
Medicine
7.40
7.40
503.20
503.20
95912 26
Medicine
4.61
4.61
313.48
313.48
95912 TC
Medicine
2.79
2.79
189.72
189.72
95913 00
Medicine
8.54
8.54
580.72
580.72
95913 26
Medicine
5.45
5.45
370.60
370.60
95913 TC
Medicine
3.09
3.09
210.12
210.12
95919 00
Medicine
0.47
0.47
31.96
31.96
95919 26
Medicine
0.29
0.29
19.72
19.72
95919 TC
Medicine
0.18
0.18
12.24
12.24
95921 00
Medicine
2.63
2.63
178.84
178.84
95921 26
Medicine
1.30
1.30
88.40
88.40
95921 TC
Medicine
1.33
1.33
90.44
90.44
95922 00
Medicine
2.84
2.84
193.12
193.12
95922 26
Medicine
1.35
1.35
91.80
91.80
95922 TC
Medicine
1.49
1.49
101.32
101.32
95923 00
Medicine
3.66
3.66
248.88
248.88
95923 26
Medicine
1.31
1.31
89.08
89.08
95923 TC
Medicine
2.35
2.35
159.80
159.80
95924 00
Medicine
4.53
4.53
308.04
308.04
95924 26
Medicine
2.55
2.55
173.40
173.40
95924 TC
Medicine
1.98
1.98
134.64
134.64
95925 00
Medicine
5.28
5.28
359.04
359.04
95925 26
Medicine
0.82
0.82
55.76
55.76
95925 TC
Medicine
4.46
4.46
303.28
303.28
95926 00
Medicine
4.73
4.73
321.64
321.64
95926 26
Medicine
0.80
0.80
54.40
54.40
95926 TC
Medicine
3.93
3.93
267.24
267.24
95927 00
Medicine
5.47
5.47
371.96
371.96
95927 26
Medicine
0.80
0.80
54.40
54.40
95927 TC
Medicine
4.67
4.67
317.56
317.56
95928 00
Medicine
7.22
7.22
490.96
490.96
95928 26
Medicine
2.32
2.32
157.76
157.76
95928 TC
Medicine
4.90
4.90
333.20
333.20
95929 00
Medicine
7.30
7.30
496.40
496.40
95929 26
Medicine
2.31
2.31
157.08
157.08
95929 TC
Medicine
4.99
4.99
339.32
339.32
95930 00
Medicine
2.02
2.02
137.36
137.36
95930 26
Medicine
0.54
0.54
36.72
36.72
95930 TC
Medicine
1.48
1.48
100.64
100.64
95933 00
Medicine
2.47
2.47
167.96
167.96
95933 26
Medicine
0.92
0.92
62.56
62.56
95933 TC
Medicine
1.55
1.55
105.40
105.40
95937 00
Medicine
3.12
3.12
212.16
212.16
95937 26
Medicine
1.01
1.01
68.68
68.68
95937 TC
Medicine
2.11
2.11
143.48
143.48
95938 00
Medicine
11.25
11.25
765.00
765.00
95938 26
Medicine
1.33
1.33
90.44
90.44
95938 TC
Medicine
9.92
9.92
674.56
674.56
95939 00
Medicine
16.74
16.74
1138.32
1138.32
95939 26
Medicine
3.47
3.47
235.96
235.96
95939 TC
Medicine
13.27
13.27
902.36
902.36
95940 00
Medicine
0.95
0.95
64.60
64.60
95941 00
Medicine
-
-
1828.52
1791.80
95954 00
Medicine
11.81
11.81
803.08
803.08
95954 26
Medicine
3.30
3.30
224.40
224.40
95954 TC
Medicine
8.51
8.51
578.68
578.68
95955 00
Medicine
5.71
5.71
388.28
388.28
95955 26
Medicine
1.56
1.56
106.08
106.08
95955 TC
Medicine
4.15
4.15
282.20
282.20
95957 00
Medicine
8.80
8.80
598.40
598.40
95957 26
Medicine
2.99
2.99
203.32
203.32
95957 TC
Medicine
5.81
5.81
395.08
395.08
95958 00
Medicine
21.01
21.01
1428.68
1428.68
95958 26
Medicine
6.58
6.58
447.44
447.44
95958 TC
Medicine
14.43
14.43
981.24
981.24
95961 00
Medicine
9.85
9.85
669.80
669.80
95961 26
Medicine
4.76
4.76
323.68
323.68
95961 TC
Medicine
5.09
5.09
346.12
346.12
95962 00
Medicine
8.35
8.35
567.80
567.80
95962 26
Medicine
5.07
5.07
344.76
344.76
95962 TC
Medicine
3.28
3.28
223.04
223.04
95965 00
Medicine
-
-
3283.04
3283.04
95965 26
Medicine
12.07
12.07
820.76
820.76
95965 TC
Medicine
-
-
2462.28
2462.28
95966 00
Medicine
-
-
1978.80
1978.80
95966 26
Medicine
5.82
5.82
395.76
395.76
95966 TC
Medicine
-
-
1583.04
1583.04
95967 00
Medicine
-
-
1183.88
1183.88
95967 26
Medicine
5.05
5.05
343.40
343.40
95967 TC
Medicine
-
-
840.48
840.48
95970 00
Medicine
0.56
0.54
38.08
36.72
95971 00
Medicine
1.44
1.15
97.92
78.20
95972 00
Medicine
1.70
1.19
115.60
80.92
95976 00
Medicine
1.17
1.15
79.56
78.20
95977 00
Medicine
1.56
1.53
106.08
104.04
95980 00
Medicine
1.34
1.34
91.12
91.12
95981 00
Medicine
1.17
0.53
79.56
36.04
95982 00
Medicine
1.78
1.08
121.04
73.44
95983 00
Medicine
1.49
1.46
101.32
99.28
95984 00
Medicine
1.30
1.28
88.40
87.04
95990 00
Medicine
2.71
2.71
184.28
184.28
95991 00
Medicine
3.32
1.18
225.76
80.24
95992 00
Medicine
1.27
1.06
86.36
72.08
95999 00
Medicine
0.00
0.00
BR
BR
96000 00
Medicine
2.46
2.46
167.28
167.28
96001 00
Medicine
3.26
3.26
221.68
221.68
96002 00
Medicine
0.63
0.63
42.84
42.84
96003 00
Medicine
0.49
0.49
33.32
33.32
96004 00
Medicine
3.19
3.19
216.92
216.92
96020 00
Medicine
-
-
314.16
314.16
96020 26
Medicine
4.62
4.62
314.16
314.16
96020 TC
Medicine
0.00
0.00
BR
BR
96040 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
96105 00
Medicine
2.88
2.88
195.84
195.84
96110 00
Medicine
0.35
0.35
23.80
23.80
96112 00
Medicine
3.72
3.69
252.96
250.92
96113 00
Medicine
1.80
1.69
122.40
114.92
96116 00
Medicine
2.76
2.37
187.68
161.16
96121 00
Medicine
2.25
1.97
153.00
133.96
96125 00
Medicine
3.07
3.07
208.76
208.76
96127 00
Medicine
0.14
0.14
9.52
9.52
96130 00
Medicine
3.60
3.25
244.80
221.00
96131 00
Medicine
2.57
2.25
174.76
153.00
96132 00
Medicine
3.85
3.14
261.80
213.52
96133 00
Medicine
2.92
2.26
198.56
153.68
96136 00
Medicine
1.25
0.69
85.00
46.92
96137 00
Medicine
1.13
0.53
76.84
36.04
96138 00
Medicine
1.03
1.03
70.04
70.04
96139 00
Medicine
1.06
1.06
72.08
72.08
96146 00
Medicine
0.07
0.07
4.76
4.76
96156 00
Medicine
2.97
2.63
201.96
178.84
96158 00
Medicine
2.01
1.76
136.68
119.68
96159 00
Medicine
0.68
0.59
46.24
40.12
96160 00
Medicine
0.09
0.09
6.12
6.12
96161 00
Medicine
0.09
0.09
6.12
6.12
96164 00
Medicine
0.31
0.28
21.08
19.04
96165 00
Medicine
0.14
0.12
9.52
8.16
96167 00
Medicine
2.12
1.86
144.16
126.48
96168 00
Medicine
0.76
0.66
51.68
44.88
96170 00
Medicine
2.32
2.17
157.76
147.56
96171 00
Medicine
0.83
0.78
56.44
53.04
96202 00
Medicine
0.71
0.63
48.28
42.84
96203 00
Medicine
0.17
0.17
11.56
11.56
96360 00
Medicine
0.97
0.97
65.96
65.96
96361 00
Medicine
0.37
0.37
25.16
25.16
96365 00
Medicine
1.88
1.88
127.84
127.84
96366 00
Medicine
0.61
0.61
41.48
41.48
96367 00
Medicine
0.85
0.85
57.80
57.80
96368 00
Medicine
0.59
0.59
40.12
40.12
96369 00
Medicine
4.24
4.24
288.32
288.32
96370 00
Medicine
0.48
0.48
32.64
32.64
96371 00
Medicine
1.81
1.81
123.08
123.08
96372 00
Medicine
0.43
0.43
29.24
29.24
96373 00
Medicine
0.56
0.56
38.08
38.08
96374 00
Medicine
1.10
1.10
74.80
74.80
96375 00
Medicine
0.46
0.46
31.28
31.28
96376 00
Medicine
-
-
68.00
59.84
96377 00
Medicine
0.55
0.55
37.40
37.40
96379 00
Medicine
0.00
0.00
BR
BR
96380 00
Medicine
0.68
0.68
46.24
46.24
96381 00
Medicine
0.59
0.59
40.12
40.12
96401 00
Medicine
2.15
2.15
146.20
146.20
96402 00
Medicine
1.06
1.06
72.08
72.08
96405 00
Medicine
2.49
0.85
169.32
57.80
96406 00
Medicine
3.89
1.32
264.52
89.76
96409 00
Medicine
3.00
3.00
204.00
204.00
96411 00
Medicine
1.63
1.63
110.84
110.84
96413 00
Medicine
3.88
3.88
263.84
263.84
96415 00
Medicine
0.83
0.83
56.44
56.44
96416 00
Medicine
3.82
3.82
259.76
259.76
96417 00
Medicine
1.91
1.91
129.88
129.88
96420 00
Medicine
3.06
3.06
208.08
208.08
96422 00
Medicine
4.68
4.68
318.24
318.24
96423 00
Medicine
2.18
2.18
148.24
148.24
96425 00
Medicine
5.05
5.05
343.40
343.40
96440 00
Medicine
22.38
4.01
1521.84
272.68
96446 00
Medicine
4.79
0.61
325.72
41.48
96450 00
Medicine
4.85
2.26
329.80
153.68
96521 00
Medicine
3.72
3.72
252.96
252.96
96522 00
Medicine
3.53
3.53
240.04
240.04
96523 00
Medicine
0.75
0.75
51.00
51.00
96542 00
Medicine
3.92
1.25
266.56
85.00
96547 00
Medicine
0.00
0.00
BR
BR
96548 00
Medicine
0.00
0.00
BR
BR
96549 00
Medicine
0.00
0.00
BR
BR
96567 00
Medicine
4.11
4.11
279.48
279.48
96570 00
Medicine
1.49
1.49
101.32
101.32
96571 00
Medicine
0.74
0.74
50.32
50.32
96573 00
Medicine
6.80
6.80
462.40
462.40
96574 00
Medicine
8.33
8.33
566.44
566.44
96900 00
Medicine
0.75
0.75
51.00
51.00
96902 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
96904 00
Medicine
2.06
2.06
140.08
140.08
96910 00
Medicine
3.56
3.56
242.08
242.08
96912 00
Medicine
3.03
3.03
206.04
206.04
96913 00
Medicine
4.59
4.59
312.12
312.12
96920 00
Medicine
4.67
1.88
317.56
127.84
96921 00
Medicine
5.12
2.13
348.16
144.84
96922 00
Medicine
6.97
3.43
473.96
233.24
96931 00
Medicine
5.09
5.09
346.12
346.12
96932 00
Medicine
3.81
3.81
259.08
259.08
96933 00
Medicine
1.28
1.28
87.04
87.04
96934 00
Medicine
3.53
3.53
240.04
240.04
96935 00
Medicine
2.32
2.32
157.76
157.76
96936 00
Medicine
1.21
1.21
82.28
82.28
96999 00
Medicine
0.00
0.00
BR
BR
99000 00
Medicine
-
-
13.60
13.60
99001 00
Medicine
-
-
22.44
22.44
99002 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
99024 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
99026 00
Medicine
-
-
80.92
80.92
99027 00
Medicine
0.00
0.00
BR
BR
99050 00
Medicine
-
-
34.00
34.00
99051 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
99053 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
99056 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
99058 00
Medicine
-
-
42.84
42.84
99060 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
99070 00
Medicine
0.00
0.00
BR
BR
99071 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
99072 00
Medicine
0.00
0.00
BR
BR
99075 00
Medicine
0.00
0.00
BR
BR
99078 00
Medicine
0.00
0.00
Bundled Code
Bundled Code
99080 00
Medicine
0.00
0.00
BR
BR
99082 00
Medicine
0.00
0.00
BR
BR
99091 00
Medicine
1.61
1.61
109.48
109.48
99151 00
Medicine
1.82
0.71
123.76
48.28
99152 00
Medicine
1.51
0.36
102.68
24.48
99153 00
Medicine
0.35
0.35
23.80
23.80
99155 00
Medicine
2.45
2.45
166.60
166.60
99156 00
Medicine
2.22
2.22
150.96
150.96
99157 00
Medicine
1.76
1.76
119.68
119.68
99170 00
Medicine
4.95
2.51
336.60
170.68
99172 00
Medicine
-
-
34.00
31.28
99173 00
Medicine
0.10
0.10
6.80
6.80
99174 00
Medicine
0.19
0.19
12.92
12.92
99175 00
Medicine
0.90
0.90
61.20
61.20
99177 00
Medicine
0.15
0.15
10.20
10.20
99183 00
Medicine
3.14
3.14
213.52
213.52
99184 00
Medicine
6.34
6.34
431.12
431.12
99188 00
Medicine
0.35
0.29
23.80
19.72
99190 00
Medicine
-
-
567.80
528.36
99191 00
Medicine
-
-
439.28
408.68
99192 00
Medicine
-
-
291.04
270.64
99195 00
Medicine
2.87
2.87
195.16
195.16
99199 00
Medicine
0.00
0.00
BR
BR
99500 00
Medicine
-
-
BR
BR
99501 00
Medicine
-
-
BR
BR
99502 00
Medicine
-
-
BR
BR
99503 00
Medicine
-
-
BR
BR
99504 00
Medicine
-
-
BR
BR
99505 00
Medicine
-
-
BR
BR
99506 00
Medicine
-
-
BR
BR
99507 00
Medicine
-
-
BR
BR
99509 00
Medicine
-
-
BR
BR
99510 00
Medicine
-
-
BR
BR
99511 00
Medicine
-
-
BR
BR
99512 00
Medicine
-
-
BR
BR
99600 00
Medicine
0.00
0.00
BR
BR
99601 00
Medicine
-
-
BR
BR
99602 00
Medicine
-
-
BR
BR
99605 00
Medicine
-
-
40.80
40.80
99606 00
Medicine
-
-
38.08
38.08
99607 00
Medicine
-
-
38.08
38.08
PHYSICAL MEDICINE AND REHABILITATION GUIDELINES
Information regarding publications incorporated by reference
				  is found in the Introduction Section of the Fee Schedule.
The following Commission guidelines are in addition to the
				  CPT® guidelines and represent additional
				  guidance from the Commission relative to physical medicine and rehabilitation
				  services. To the extent that a conflict may exist between an incorporated
				  portion of the CPT® and a code, guideline,
				  identifier, or modifier unique to Arizona, then the Arizona code, guideline,
				  identifier or modifier shall control. Codes that are unique to Arizona are
				  preceded by an AZ identifier and numbered in the following format:
				  AZxxx.
General requirements on reporting services are found in the
				  Introduction of the Fee Schedule. In addition to the definitions and
				  commonalities preceding the coded medical procedures, several other
				  requirements unique to this Section (Physical Medicine and Rehabilitation) are
				  defined or identified as follows:
A. Physical therapy (PT) evaluation codes (97161-97163) and
				  occupational therapy (OT) evaluation codes (97165-97167) are billed at the
				  initial visit and a re-evaluation code (97164 for PT, 97168 for OT) may be
				  billed once every two calendar weeks following an initial evaluation.
				  Additional billing for PT and OT evaluation services may be allowed when
				  specific additional services are warranted. Approval of the payer must be
				  obtained prior to performing additional services. Criteria to select the
				  appropriate evaluation and re-evaluation codes are outlined in the current
				  CPT® publication.
Note:
These limitations do
not
apply to referring healthcare providers or to providers who treat patients once
				  per month.
B. When multiple modalities (untimed 97012-97028 and/or
				  time-based 97032-97036) are performed, the first modality (or the first unit of
				  a time-based modality) is reported as listed. The second modality (or the
				  second unit of a timebased modality) is identified by adding modifier -51 to
				  the code number. The second and each subsequent modality (or unit(s) of a
				  time-based modality) should be valued at 50% of its listed value.
First modality reported or first unit of a time-based
							 modality
-100%
Second, third, and additional approved modality or
							 unit(s)
- 50%
Any more than three modalities or more than three units of a
				  time-based modality or any combination of time-based and untimed modalities
				  equaling three billed units per body part being treated must have prior
				  approval from the payer. The time a healthcare provider bills for a time-based
				  modality (97032-97036) does not count towards the total timed therapeutic
				  procedure maximum of four units or 67 minutes. However, the time spent
				  performing time-based modalities counts towards the total treatment time and
				  should be used to determine the number of units a provider bills
				  (
see
Section E and Example 5).
The amount of time spent
				  performing each specific procedure or modality provided to the patient is not
				  required to be documented in the treatment notes
(
see
Section G)
.
Note:
97010 is a bundled service and not
				  separately reportable.
Example:
During a visit, a patient receives the following
				  services:
45 minutes therapeutic exercise 97110
15 minutes mechanical traction 97012
15 minutes unattended electrical stimulation 97014
10 minutes ultrasound 97035
15 minutes moist heat 97010 while receiving the electric
				  stimulation
Under the multiple modality rule, the healthcare provider
				  would bill:
97110 3 units at 100% of value (therapeutic procedure, timed
				  code)
97012 1 unit at 100% of value (modality, untimed code)
97014 1 unit at 50% of value (modality, untimed code)
97035 1 unit at 50% of value (modality, timed code)
97010 is bundled into the above services and not paid as a
				  separate service. The total time spent performing time-based codes (97110 and
				  97035) is 55 minutes and justifies billing four units of time-based services
				  (
see
Section E).
C. CPT® codes describing
				  therapeutic procedures (97110-97150 and 97530-97546) are not subject to the
				  multiple modality rule and shall be paid at 100% of their listed value. When
				  performing therapeutic procedure(s), (excluding work hardening/conditioning,
				  97545-97546, and physical test or measures for functional capacity evaluation,
				  97750), a maximum of four units or 67 minutes is allowed each day. Approval
				  must be obtained from the payer prior to performing therapeutic procedures in
				  excess of this maximum (
e.g
. when multiple body parts are
				  treated in a single visit).
D. The values for the codes in this section include the time
				  and work of the provider, the equipment required to provide the service, and
				  the cost of the healthcare provider's liability insurance. Medications and
				  disposable electrodes used in these procedures should be considered supplies
				  and managed in accordance with the HCPCS Section of this Fee Schedule.
E. Time-Based Physical Medicine and Rehabilitation
				  CPT® codes are billed according to guidance from
				  the Centers for Medicare and Medicaid Services (CMS), as published in the
				  Medicare Claims Processing Manual, Chapter 5, Section 20.2, C. Counting Minutes
				  for Timed Codes in 15 Minute Units.
When only one service is provided in a day, healthcare
				  providers should not bill for services provided for less than 8 minutes. For
				  any single 15-minute timed CPT® code in the same
				  day, healthcare providers bill a single 15-minute unit for treatment of greater
				  than or equal to 8 minutes through and including 22 minutes. If the duration of
				  a single procedure in a day is greater than or equal to 23 minutes through and
				  including 37 minutes, two units should be billed. Please refer to the table
				  below, which outlines how to bill for up to four units or 67 minutes, without
				  payer approval.
Units
Number of Minutes
0
[LESS THAN] 8 minutes
1
[GREATER THAN EQUAL TO] 8 minutes and [LESS THAN
							 EQUAL TO] 22 minutes
2
[GREATER THAN EQUAL TO] 23 minutes and [LESS THAN
							 EQUAL TO] 37 minutes
3
[GREATER THAN EQUAL TO] 38 minutes and [LESS THAN
							 EQUAL TO] 52 minutes
4
[GREATER THAN EQUAL TO] 53 minutes and [LESS THAN
							 EQUAL TO] 67 minutes
If additional therapeutic procedures and/or time-based
				  modalities are approved by the payer, the pattern for determining time/units is
				  continued.
When more than one service represented by 15-minute timed
				  codes is performed in a single day, the total number of minutes of service
				  determines the number of timed units billed (as noted in the chart above). For
				  any service represented by a 15-minute timed code that is performed for 7
				  minutes or less on the same day as another service also represented by a
				  15-minute timed code performed for 7 minutes or less, and the total time of
				  these two services is 8 minutes or greater, the provider may bill one unit of
				  service that was performed for the most minutes. The same logic is applied if
				  three or more different services are performed on the same day for 7 minutes or
				  less.
The expectation, based on the work values assigned to these
				  codes, is that a provider's direct patient contact time for each unit will
				  average 15 minutes in length. If more than one 15-minute timed
				  CPT® code is billed during a single calendar
				  day, the total number of units billed is constrained by the total treatment
				  time for that day.
When documenting to support the billing of timed
				  CPT® codes, the provider should
document
				  the total number of timed minutes and the total time of the treatment provided
				  that day.
Total treatment time includes the minutes for timed code
				  treatment and untimed code treatment. Total treatment time does not include
				  time for services that are not billable (
e.g
., rest periods).
The amount of time for each specific intervention/modality provided to
				  the patient is not required to be documented in the treatment
				  note.
It is important that the total number of timed treatment
				  minutes support the billing of units on the invoice and that the total
				  treatment time also reflects the services billed as untimed codes. The billing
				  and the total timed code treatment minutes documented must be consistent.
				  Additional guidance for documentation of timed codes is found in the CMS
				  Benefit Policy Manual, Chapter 15, 220.3, E. Treatment Note
Examples of how to count the appropriate number of minutes
				  for the total therapy minutes provided:
Example 1
During a visit, the patient receives the following
				  services:
45 minutes therapeutic exercise 97110
5 minutes manual therapy 97140
7 minutes therapeutic activities 97530
Total Timed Codes: 57 minutes
The healthcare provider would bill: 4 units
97110
3 units
97530
1 unit
Since the total time spent providing manual therapy and
				  therapeutic exercises is greater than 8 minutes, one unit is billed for the
				  service which was performed for more time.
Example 2
During a visit, the patient receives the following
				  services:
24 minutes neuromuscular reeducation 97112
23 minutes therapeutic exercise 97110
Total Timed Codes: 47 minutes
The healthcare provider would bill: 3 units
97112
2 units
97110
1 unit
Each service is provided for more than 15 minutes, so at
				  least one unit is appropriate for each. Two units are billed for Neuromuscular
				  reeducation since that service was performed for more time.
Example 3
During a visit, the patient receives the following
				  services:
20 minutes therapeutic activities 97530
20 minutes therapeutic exercise 97110
Total Timed Codes: 40 minutes
The healthcare provider would bill: 3 units
97530
2 units
97110
1 unit
OR
97110
2 units
97530
1 unit
Each service was provided for 20 minutes, which would allow
				  for one unit for each service. However, the total time of 40 minutes allows for
				  three units to be billed. Since the time for each service is the same, the
				  provider can choose which code to bill for two units and which code to bill for
				  one unit.
Example 4
During a visit, the patient receives the following
				  services:
33 minutes therapeutic exercise 97110
7 minutes manual therapy 97140
Total Timed Codes: 40 minutes
The healthcare provider would bill: 3 units
97110
2 units
97140
1 unit
The first 30 minutes of therapeutic exercise is 2 units. The
				  remaining 3 minutes is added to the 7 minutes of manual therapy and then is
				  billed for one unit of manual therapy. The time for manual therapy is greater
				  than the remaining time from the therapeutic exercise.
Example 5
During a visit, the patient receives the following
				  services:
18 minutes therapeutic exercise 97110
13 minutes manual therapy 97140
10 minutes gait training 97116
8 minutes ultrasound 97035
Total Timed Codes: 49 minutes
The healthcare provider would bill: 3 units
97110
1 unit
97140
1 unit
97116
1 unit
Bill the procedures that the most time was spent performing.
				  One unit each of 97110, 97140, and 97116. Although the ultrasound should be
				  documented, it cannot be billed, as the healthcare provider is constrained by
				  the total timed codes minutes. Since the total for the timed codes is 49
				  minutes, only three units would be billed.
F. A work hardening program is limited to 6 1/2 hours per
				  day, not to exceed a 6 week period of time.
G. The payer has the right to require documentation to
				  establish that a modality or therapeutic procedure was performed. Inasmuch as
				  these Guidelines allow for re-evaluations to be performed every two weeks, it
				  is at that time the healthcare provider should address and document the status
				  of the treatment protocol.
It is not appropriate for the payer on a per billing basis to
				  require a healthcare provider to provide unnecessarily detailed documentation
				  to justify payment. A healthcare provider is required to comply with A.R.S.
				  §
									23-1062.01 when submitting a bill.
				  For example, the purpose of modalities like hot and cold packs, paraffin baths,
				  and whirlpools is straightforward. Modalities are utilized as a sub-element of
				  the overall treatment protocol to prepare the injured worker for therapy or to
				  minimize the impact of the therapy on the injured worker. Other than a
				  statement that certain modalities were performed, any additional documentation
				  such as the purpose of the application of modalities, resulting flexibility or
				  comfort is unnecessary. Additionally, listing the amount of weight an
				  individual is lifting, repetitions, and sets is, again, unnecessary. During a
				  re-evaluation visit, the healthcare provider should provide documentation
				  regarding changes in strength, stamina, and flexibility.
Documentation of each treatment shall include the following
				  elements:
* Date of treatment.
* Identification of each specific intervention/modality
				  provided and billed, both timed and untimed services in a manner that it can be
				  compared with the billing record to verify correct coding.
* Total timed code treatment minutes and total treatment time
				  in minutes (the amount of time for each specific intervention/modality provided
				  is not required).
* Signatures (written or electronic) and professional
				  designation of the qualified healthcare provider who furnished or supervised
				  the services provided.
ARIZONA PHYSICIANS' FEE SCHEDULE
Physical Medicine Codes 2024
Physical Medicine Conversion Factor
				  $68.00
Code
Category
FY24 NF
							 RVU
FY24 FAC
							 RVU
FY24 NF RBRVS Rate
FY24 FAC RBRVS
							 Rate
97010 00
Physical Medicine
0.19
0.19
12.92
12.92
97012 00
Physical Medicine
0.42
0.42
28.56
28.56
97014 00
Physical Medicine
0.37
0.37
25.16
25.16
97016 00
Physical Medicine
0.35
0.35
23.80
23.80
97018 00
Physical Medicine
0.17
0.17
11.56
11.56
97022 00
Physical Medicine
0.51
0.51
34.68
34.68
97024 00
Physical Medicine
0.22
0.22
14.96
14.96
97026 00
Physical Medicine
0.20
0.20
13.60
13.60
97028 00
Physical Medicine
0.25
0.25
17.00
17.00
97032 00
Physical Medicine
0.43
0.43
29.24
29.24
97033 00
Physical Medicine
0.58
0.58
39.44
39.44
97034 00
Physical Medicine
0.42
0.42
28.56
28.56
97035 00
Physical Medicine
0.42
0.42
28.56
28.56
97036 00
Physical Medicine
1.05
1.05
71.40
71.40
97037 00
Physical Medicine
0.00
0.00
BR
BR
97039 00
Physical Medicine
0.00
0.00
BR
BR
97110 00
Physical Medicine
0.88
0.88
59.84
59.84
97112 00
Physical Medicine
1.01
1.01
68.68
68.68
97113 00
Physical Medicine
1.10
1.10
74.80
74.80
97116 00
Physical Medicine
0.88
0.88
59.84
59.84
97124 00
Physical Medicine
0.91
0.91
61.88
61.88
97129 00
Physical Medicine
0.67
0.66
45.56
44.88
97130 00
Physical Medicine
0.64
0.63
43.52
42.84
97139 00
Physical Medicine
0.00
0.00
BR
BR
97140 00
Physical Medicine
0.81
0.81
55.08
55.08
97150 00
Physical Medicine
0.54
0.54
36.72
36.72
97151 00
Physical Medicine
-
-
30.60
30.60
97152 00
Physical Medicine
-
-
22.44
22.44
97153 00
Physical Medicine
-
-
20.40
20.40
97154 00
Physical Medicine
-
-
17.00
17.00
97155 00
Physical Medicine
-
-
27.20
27.20
97156 00
Physical Medicine
-
-
23.80
23.80
97157 00
Physical Medicine
-
-
21.76
21.76
97158 00
Physical Medicine
-
-
16.32
16.32
97161 00
Physical Medicine
3.01
3.01
204.68
204.68
97162 00
Physical Medicine
3.01
3.01
204.68
204.68
97163 00
Physical Medicine
3.01
3.01
204.68
204.68
97164 00
Physical Medicine
2.09
2.09
142.12
142.12
97165 00
Physical Medicine
3.04
3.04
206.72
206.72
97166 00
Physical Medicine
3.04
3.04
206.72
206.72
97167 00
Physical Medicine
3.04
3.04
206.72
206.72
97168 00
Physical Medicine
2.10
2.10
142.80
142.80
97169 00
Physical Medicine
-
-
67.32
60.52
97170 00
Physical Medicine
-
-
118.32
106.76
97171 00
Physical Medicine
-
-
236.64
212.84
97172 00
Physical Medicine
-
-
84.32
76.16
97530 00
Physical Medicine
1.10
1.10
74.80
74.80
97533 00
Physical Medicine
1.87
1.87
127.16
127.16
97535 00
Physical Medicine
0.98
0.98
66.64
66.64
97537 00
Physical Medicine
0.95
0.95
64.60
64.60
97542 00
Physical Medicine
0.95
0.95
64.60
64.60
97545 00
Physical Medicine
-
-
169.32
152.32
97546 00
Physical Medicine
-
-
84.32
75.48
97550 00
Physical Medicine
1.59
1.59
108.12
108.12
97551 00
Physical Medicine
0.79
0.73
53.72
49.64
97552 00
Physical Medicine
0.67
0.67
45.56
45.56
97597 00
Physical Medicine
3.03
1.05
206.04
71.40
97598 00
Physical Medicine
1.35
0.73
91.80
49.64
97602 00
Physical Medicine
-
-
68.68
61.88
97605 00
Physical Medicine
1.29
0.72
87.72
48.96
97606 00
Physical Medicine
1.53
0.79
104.04
53.72
97607 00
Physical Medicine
10.45
0.63
710.60
42.84
97608 00
Physical Medicine
10.81
0.74
735.08
50.32
97610 00
Physical Medicine
12.83
0.53
872.44
36.04
97750 00
Physical Medicine
1.02
1.02
69.36
69.36
97755 00
Physical Medicine
1.15
1.15
78.20
78.20
97760 00
Physical Medicine
1.43
1.43
97.24
97.24
97761 00
Physical Medicine
1.25
1.25
85.00
85.00
97763 00
Physical Medicine
1.57
1.57
106.76
106.76
97799 00
Physical Medicine
0.00
0.00
BR
BR
97802 00
Physical Medicine
1.09
0.95
74.12
64.60
97803 00
Physical Medicine
0.95
0.81
64.60
55.08
97804 00
Physical Medicine
0.50
0.46
34.00
31.28
97810 00
Physical Medicine
1.15
0.91
78.20
61.88
97811 00
Physical Medicine
0.85
0.76
57.80
51.68
97813 00
Physical Medicine
1.36
0.99
92.48
67.32
97814 00
Physical Medicine
1.10
0.84
74.80
57.12
98925 00
Physical Medicine
0.94
0.68
63.92
46.24
98926 00
Physical Medicine
1.35
1.03
91.80
70.04
98927 00
Physical Medicine
1.76
1.37
119.68
93.16
98928 00
Physical Medicine
2.15
1.73
146.20
117.64
98929 00
Physical Medicine
2.53
2.07
172.04
140.76
98940 00
Physical Medicine
0.82
0.65
55.76
44.20
98941 00
Physical Medicine
1.18
1.00
80.24
68.00
98942 00
Physical Medicine
1.52
1.34
103.36
91.12
98943 00
Physical Medicine
0.77
0.67
52.36
45.56
98960 00
Physical Medicine
0.92
0.92
62.56
62.56
98961 00
Physical Medicine
0.44
0.44
29.92
29.92
98962 00
Physical Medicine
0.33
0.33
22.44
22.44
98966 00
Physical Medicine
0.39
0.34
26.52
23.12
98967 00
Physical Medicine
0.72
0.66
48.96
44.88
98968 00
Physical Medicine
0.99
0.92
67.32
62.56
98970 00
Physical Medicine
0.35
0.35
23.80
23.80
98971 00
Physical Medicine
0.62
0.62
42.16
42.16
98972 00
Physical Medicine
0.92
0.91
62.56
61.88
98975 00
Physical Medicine
0.60
0.60
40.80
40.80
98976 00
Physical Medicine
1.42
1.42
96.56
96.56
98977 00
Physical Medicine
1.42
1.42
96.56
96.56
98978 00
Physical Medicine
0.00
0.00
BR
BR
98980 00
Physical Medicine
1.52
0.91
103.36
61.88
98981 00
Physical Medicine
1.20
0.90
81.60
61.20
EVALUATION AND MANAGEMENT GUIDELINES
Information regarding publications incorporated by reference
				  is found in the Introduction of the Fee Schedule.
The evaluation and management guidelines incorporated by
				  reference may be found in the CPT® published by
				  the AMA and is reprinted, in part, below with permission. To the extent that a
				  conflict may exist between an incorporated portion of the
				  CPT® publication or HCPCS code and a code,
				  guideline, identifier or modifier unique to Arizona, then the Arizona code,
				  guideline, identifier or modifier shall control. Codes that are unique to
				  Arizona are preceded by an AZ identifier and numbered in the following format:
				  AZxxx.
Documentation and review of records, when required, is
				  inclusive to the performance of the appropriate E/M service. A health care
				  provider shall only be reimbursed for time that is not accounted for in the E/M
				  service code by billing prolonged services codes 99415, 99416, 99417, or 99418.
				  Proper documentation must justify the use of these codes and accompany the
				  invoice.
Impairment Examinations
Impairment examinations shall be billed using
				  CPT® 99455, work related or medical disability
				  examination by the treating physician, or CPT®
				  99456, work related or medical disability examination by other than the
				  treating physician. Physicians may bill one unit of these codes for the initial
				  hour and an additional unit for each 30-minute increment after the initial
				  hour. Each 30 minute increment commences the minute following the end of the
				  previous time interval. The physician shall include documentation that
				  demonstrates the complexity of the case and the time spent on the service to
				  justify billing each additional unit. Reimbursement for
				  CPT® codes 99455 and 99456 shall be made at 100%
				  of the listed reimbursement value for the initial unit and then 50% of the
				  listed reimbursement value for each additional unit.
Example:
A physician spends 72 minutes performing a work related
				  disability examination on a patient they previously treated.
The physician would bill two units of 99455 and be reimbursed
				  at 1.5 times the listed reimbursement value for
				  CPT® 99455.
Remote Monitoring
Two HCPCS codes are included in this section of the 2024/2025
				  Fee Schedule for remote monitoring:
G2010 - Remote evaluation of recorded video and/or images
				  submitted by an established patient (
e.g
., store and forward),
				  including interpretation with follow-up with the patient within 24 business
				  hours, not originating from a related E/M service provided within the previous
				  7 days nor leading to an E/M service or procedure within the next 24 hours or
				  soonest available appointment.
G2012 - Brief communication technology-based service,
e.g.
, virtual check-in, by a physician or other qualified
				  health care professional who can report evaluation and management services,
				  provided to an established patient, not originating from a related E/M service
				  provided within the previous 7 days nor leading to an E/M service or procedure
				  within the next 24 hours or soonest available appointment: 5-10 minutes of
				  medical discussion.
A. CLASSIFICATION OF EVALUATION AND MANAGEMENT (E/M)
				  SERVICES.
The E/M section is divided into broad categories such as
				  office visits, hospital inpatient or observation care visits, and
				  consultations. Most of the categories are further divided into two or more
				  subcategories of E/M services. For example, there are two subcategories of
				  office visits (new patient and established patient) and there are two
				  subcategories of hospital inpatient and observation care visits (initial and
				  subsequent). The subcategories of E/M services are further classified into
				  levels of E/M services that are identified by specific codes.
The basic format of the levels of E/M services based on
				  medical decision making (MDM) or time is the same. First, a unique code number
				  is listed. Second, the place and/or type of service is specified,
				  (
e.g
., office or other outpatient visit). Third, the content
				  of the service is defined. Fourth, time is specified. (A detailed discussion of
				  time is provided in the Guidelines for Selecting Level of Service Based on
				  Time.)
The place of service and service type are defined by the
				  location where the face-to-face encounter with the patient and/or
				  family/caregiver occurs. For example, service provided to a nursing facility
				  resident brought to the office is reported with an office or other outpatient
				  code.
New and Established Patients
Solely for the purposes of distinguishing between new and
				  established patients, professional services are those face-to-face services
				  rendered by physicians and other qualified health care professionals who may
				  report evaluation and management services. A new patient is one who has not
				  received any professional services from the physician or other qualified health
				  care professional or another physician or other qualified health care
				  professional of the exact same specialty and subspecialty who belongs to the
				  same group practice, within the past three years.
An established patient is one who has received professional
				  services from the physician or other qualified health care professional or
				  another physician or other qualified health care professional of the exact same
				  specialty and subspecialty who belongs to the same group practice, within the
				  past three years. In the instance where a physician or other qualified health
				  care professional is on call for or covering for another physician or other
				  qualified health care professional, the patient's encounter will be classified
				  as it would have been by the physician or other qualified health care
				  professional who is not available. When advanced practice nurses and physician
				  assistants are working with physicians, they are considered as working in the
				  exact same specialty and subspecialty as the physician.
No distinction is made between new and established patients
				  in the emergency department. E/M services in the emergency department category
				  may be reported for any new or established patient who presents for treatment
				  in the emergency department.
Initial and Subsequent Services
Some categories apply to both new and established patients
				  (e.g., hospital inpatient or observation care). These categories differentiate
				  services by whether the service is the initial service or a subsequent service.
				  For the purpose of distinguishing between initial or subsequent visits,
				  professional services are those face-to-face services rendered by physicians
				  and other qualified health care professionals who may report evaluation and
				  management services. An initial service is when the patient has not received
				  any professional services from the physician or other qualified health care
				  professional or another physician or other qualified health care professional
				  of the exact same specialty and subspecialty who belongs to the same group
				  practice, during the inpatient, observation, or nursing facility admission and
				  stay.
A subsequent service is when the patient has received
				  professional service(s) from the physician or other qualified health care
				  professional or another physician or other qualified health care professional
				  of the exact same specialty and subspecialty who belongs to the same group
				  practice, during the admission and stay.
In the instance when a physician or other qualified health
				  care professional is on call for or covering for another physician or other
				  qualified health care professional, the patient's encounter will be classified
				  as it would have been by the physician or other qualified health care
				  professional who is not available. When advanced practice nurses and physician
				  assistants are working with physicians, they are considered as working in the
				  exact same specialty and subspecialty as the physician.
For reporting hospital inpatient or observation care
				  services, a stay that includes a transition from observation to inpatient is a
				  single stay. For reporting nursing facility services, a stay that includes
				  transition(s) between skilled nursing facility and nursing facility level of
				  care is the same stay.
Split or Shared Visits
Physician(s) and other qualified health care professionals(s)
				  (QHP[s]) may act as a team in providing care for the patient, working together
				  during a single E/M service. The split or shared visits guidelines are applied
				  to determine which professional may report the service. If the physician or
				  other QHP performs a substantive portion of the encounter, the physician or
				  other QHP may report the service. If code selection is based on total time on
				  the date of the encounter, the service is reported by the professional who
				  spent the majority of the face-to-face or non-face-to-face time performing the
				  service. For the purpose of reporting E/M services within the context of
				  team-based care, performance of a substantive part of the MDM requires that the
				  physician'(s) or other QHP(s) made or approved the management plan for the
				  number and complexity of problems addressed at the encounter and takes
				  responsibility for that plan with its inherent risk of complications and/or
				  morbidity or mortality of patient management. By doing so, a physician or other
				  QHP has performed two of the three elements used in the selection of the code
				  level based on MDM. If the amount and/or complexity of data to be reviewed and
				  analyzed is used by the physician or other QHP to determine the reported code
				  level, assessing an independent historian's narrative and the ordering or
				  review of tests or documents do not have to be personally performed by the
				  physician or other QHP, because the relevant items would be considered in
				  formulating the management plan. Independent interpretation of tests and
				  discussion of management plan or test interpretation must be personally
				  performed by the physician or other QHP if these are used to determine the
				  reported code level by the physician or other QHP.
Multiple Evaluation and Management Services on the Same
				  Date
The following guidelines apply to services that a patient may
				  receive for hospital inpatient care, observation care, or nursing facility
				  care. For instructions regarding transitions to these settings from the office
				  or outpatient, home or residence, or emergency department setting, see
				  guidelines for Hospital Inpatient and Observation Care Services or Nursing
				  Facility Services.
A patient may receive E/M services in more than one setting
				  on a calendar date. A patient may also have more than one visit in the same
				  setting on a calendar date. The guidelines for multiple E/M services on the
				  same date address circumstances in which the patient has received multiple
				  visits or services from the same physician or other QHP or another physician or
				  QHP of the exact same specialty and subspecialty who belongs to the same group
				  practice.
Per day: The hospital inpatient and observation care services
				  and the nursing facility services are "per day" services. When multiple visits
				  occur over the course of a single calendar date in the same setting, a single
				  service is reported. When using MDM for code level selection, use the
				  aggregated MDM over the course of the calendar date. When using time for code
				  level selection, sum the time over the course of the day using the guidelines
				  for reporting time.
Multiple encounters in different settings or facilities: A
				  patient may be seen and treated in different facilities (e.g., a
				  hospital-to-hospital transfer). When more than one primary E/M service is
				  reported and time is used to select the code level for either service, only the
				  time spent providing that individual service may be allocated to the code level
				  selected for reporting that service. No time may be counted twice when
				  reporting more than one E/M service. Prolonged services are also based on the
				  same allocation and their relationship to the primary service. The designation
				  of the facility may be defined by licensure or regulation. Transfer from a
				  hospital bed to a nursing facility bed in a hospital with nursing facility beds
				  is considered as two services in two facilities because there is a discharge
				  from one type of designation to another. An intra-facility transfer for a
				  different level of care (e.g., from a routine unit to a critical care unit)
				  does not constitute a new stay, nor does it constitute a transfer to a
				  different facility.
Emergency department (ED) and services in other settings
				  (same or different facilities): Time spent in an ED by a physician or other QHP
				  who provides subsequent E/M services may be included in calculating total time
				  on the date of the encounter when ED services are not reported and another E/M
				  service is reported (e.g., hospital inpatient and observation care
				  services).
Discharge services and services in other facilities: Each
				  service may be reported separately as long as any time spent on the discharge
				  service is not counted towards the total time of a subsequent service in which
				  code level selection for the subsequent service is based on time. This includes
				  any hospital inpatient or observation care services (including admission and
				  discharge services) time (99234, 99235, 99236) because these services may be
				  selected based on MDM or time. When these services are reported with another
				  E/M service on the same calendar date, time related to the hospital inpatient
				  or observation care service (including admission and discharge services) may
				  not be used for code selection of the subsequent service.
Discharge Services and services in the same facility: If the
				  patient is discharged and readmitted to the same facility on the same calendar
				  date, report a subsequent care service instead of a discharge or initial
				  service. For the purpose of E/M reporting, this is a single stay.
Discharge services and services in a different facility: If
				  the patient is admitted to another facility, for the purpose of E/M reporting,
				  this is considered a different stay. Discharge and initial services may be
				  reported as long as time spent on the discharge service is not counted towards
				  the total time of the subsequent service reported when code level selection is
				  based on time.
Critical care services (including neonatal intensive care
				  services and pediatric and neonatal critical care): Reporting guidelines for
				  intensive and critical care services that are performed on the same calendar
				  date as another E/M service are described in the service specific section
				  guidelines.
Transitions between office or other outpatient, home or
				  residence, or emergency department and hospital inpatient or observation or
				  nursing facility: See the guidelines for Hospital Inpatient and Observation
				  Care Services or Nursing Facility Services. If the patient is seen in two
				  settings and only one service is reported, the total time on the date of the
				  encounter of the aggregated MDM is used for determining the level of the single
				  reported service. If prolonged services are reported, use the prolonged
				  services code that is appropriate for the primary service reported, regardless
				  of where the patient was located when the prolonged services time threshold was
				  met. The choice of the primary service is at the discretion of the reporting
				  physician or other QHP.
Services Reported Separately
Any specifically identifiable procedure or service (i.e.,
				  identified with a specific CPT code) performed on the date of E/M services may
				  be reported separately.
The ordering and actual performance and/or interpretation of
				  diagnostic tests/studies during a patient encounter are not included in
				  determining the levels of E/M services when the professional interpretation of
				  those tests/studies is reported separately by the physician or other qualified
				  health care professional reporting the E/M service. Tests that do not require
				  separate interpretation (e.g., tests that are results only) and are analyzed as
				  part of MDM do not count as an independent interpretation, but may be counted
				  as ordered or reviewed for selecting an MDM level. The performance of
				  diagnostic tests/studies for which specific CPT codes are available may be
				  reported separately, in addition to the appropriate E/M code. The
				  interpretation of the results of diagnostic tests/studies (i.e., professional
				  component) with preparation of a separate distinctly identifiable signed
				  written report may also be reported separately, using the appropriate CPT code
				  and, if required, with modifier 26 appended. The physician or other qualified
				  health care professional may need to indicate that on the day a procedure or
				  service identified by a CPT code was performed, the patient's condition
				  required a significant separately identifiable E/M service. The E/M service may
				  be caused or prompted by the symptoms or condition for which the procedure
				  and/or service was provided. This circumstance may be reported by adding
				  modifier 25 to the appropriate level of E/M service. As such, different
				  diagnoses are not required for reporting of the procedure and the E/M services
				  on the same date.
History and/or Examination
E/M codes that have levels of services include a medically
				  appropriate history and/or physical examination, when performed. The nature and
				  extent of the history and/or physical examination are determined by the
				  treating physician or other qualified health care professional reporting the
				  service. The care team may collect information, and the patient or caregiver
				  may supply information directly (e.g., by electronic health record [EHR] portal
				  or questionnaire) that is reviewed by the reporting physician or other
				  qualified health care professional. The extent of history and physical
				  examination is not an element in the selection of the level of these E/M
				  service codes.
B. LEVELS OF E/M SERVICES.
Select the appropriate level of E/M services based on the
				  following:
1. The level of the MDM as defined for each service,
or
2. The total time for E/M services performed on the date of
				  the encounter.
Within each category or subcategory of E/M service based on
				  MDM or time, there are three to five levels of E/M services available for
				  reporting purposes. Levels of E/M services are NOT interchangeable among the
				  different categories or subcategories of service. For example, the first level
				  of E/M services in the subcategory of office visit, new patient, does not have
				  the same definition as the first level of E/M services in the subcategory of
				  office visit, established patient. Each level of E/M services may be used by
				  all physicians or other qualified health care professionals.
Guidelines for Selecting Level of Service Based on
				  Medical Decision Making
Four types of MDM are recognized: straightforward, low,
				  moderate, and high. The concept of the level of MDM does not apply to CPT codes
				  99211 and 99281.
MDM includes establishing diagnoses, assessing the status of
				  a condition, and/or selecting a management option. MDM is defined by three
				  elements. The elements are:
* The number and complexity of problem(s) that are addressed
				  during the encounter.
* The amount and/or complexity of data to be reviewed and
				  analyzed. These data include medical records, tests, and/or other information
				  that must be obtained, ordered, reviewed, and analyzed for the encounter. This
				  includes information obtained from multiple sources or interprofessional
				  communications that are not reported separately and interpretation of tests
				  that are not reported separately. Ordering a test is included in the category
				  of test result(s) and the review of the test result is part of the encounter
				  and not a subsequent encounter. Ordering a test may include those considered
				  but not selected after shared decision making. For example, a patient may
				  request diagnostic imaging that is not necessary for their condition and
				  discussion of the lack of benefit may be required. Alternatively, a test may
				  normally be performed, but due to the risk for a specific patient it is not
				  ordered. These considerations must be documented. Data are divided into three
				  categories:
1. Tests, documents, orders, or independent historian(s).
				  (Each unique test, order, or document is counted to meet a threshold
				  number.)
2. Independent interpretation of tests (not separately
				  reported).
3. Discussion of management or test interpretation with an
				  external physician or other qualified health care professional or appropriate
				  source (not separately reported).
* The risk of complications and/or morbidity or mortality of
				  patient management. This includes decisions made at the encounter, associated
				  with diagnostic procedure(s), and treatment(s). This includes the possible
				  management options selected and those considered but not selected after shared
				  decision making with the patient and/or family. For example, a decision about
				  hospitalization includes considerations of alternative levels of care. Examples
				  may include a psychiatric patient with a sufficient degree of support in the
				  outpatient setting or the decision to not hospitalize a patient with advanced
				  dementia with an acute condition that would generally warrant inpatient care,
				  but for whom the goal is palliative treatment.
Shared decision making involves eliciting patient and/or
				  family preferences, patient and/or family education, and explaining risks and
				  benefits of management options.
MDM may be impacted by role and management
				  responsibility.
When the physician or other qualified health care
				  professional is reporting a separate CPT® code that includes interpretation
				  and/or report, the interpretation and/or report is not counted toward the MDM
				  when selecting a level of E/M services. When the physician or other qualified
				  health care professional is reporting a separate service for discussion of
				  management with a physician or another qualified health care professional, the
				  discussion is not counted toward the MDM when selecting a level of outpatient
				  E/M services.
The Levels of Medical Decision Making (MDM) table (Table 1)
				  is a guide to assist in selecting the level of MDM for reporting an E/M
				  services code. The table includes the four levels of MDM
				  (
i.e
., straightforward, low, moderate, high) and the three
				  elements of MDM (
i.e
., number and complexity of problems
				  addressed at the encounter, amount and/or complexity of data reviewed and
				  analyzed, and risk of complications and/or morbidity or mortality of patient
				  management). To qualify for a particular level of MDM, two of the three
				  elements for that level of MDM must be met or exceeded.
Examples in the table may be more or less applicable to
				  specific settings of care. For example, the decision to hospitalize applies to
				  the outpatient or nursing facility encounters, whereas the decision to escalate
				  hospital level of care (e.g., transfer to ICU) applies to the hospitalized or
				  observation care patient. See also the introductory guidelines of each code
				  family section.
The elements listed in Table 1, Levels of Medical Decision
				  Making, are defined in the guidelines for number and complexity of problems
				  addressed at the encounter, amount and/or complexity of data to be reviewed and
				  analyzed, and risk of complications and/or morbidity or mortality of patient
				  management.
Table 1: Levels of Medical Decision Making
				  (MDM)
Elements of Medical Decision
							 Making
Level of MDM
(Based on 2 out of 3 Elements of MDM)
Number and Complexity of Problems Addressed at
							 the Encounter
Amount and/or Complexity of Data to Be Reviewed
							 and Analyzed
*Each unique test, order, or document
							 contributes to the combination of 2 or combination of 3 in Category 1
							 below.
Risk of Complications and/or Morbidity or
							 Mortality of Patient Management
Straightforward
Minimal
1 self-limited or minor problem
Minimal or none
Minimal risk of morbidity from additional
							 diagnostic testing or treatment
Low
Low
*
2
or more selflimited or minor
							 problems;
or
*
1
stable, chronic illness;
or
*
1
acute, uncomplicated illness or
							 injury;
or
*
1
stable, acute illness;
or
*
1
acute, uncomplicated illness or
							 injury requiring hospital inpatient or observation level of
							 care
Limited
(Must meet the requirements of at least 1 out of 2
							 categories)
Category 1: Tests and documents
*
Any combination of 2 from the
							 following:
* Review of prior external note(s) from each unique
							 source*;
* Review of the result(s) of each unique
							 test*;\
* Ordering of each unique test*
or
Category 2: Assessment requiring an independent
							 historian(s)
(For the categories of independent
							 interpretation of tests and discussion of management or test interpretation,
							 see moderate or high)
Low risk or morbidity from additional
							 diagnostic testing or treatment
Moderate
Moderate
*
1
or more chronic illnesses with
							 exacerbation, progression, or side effects of treatment;
or
*
2
or more stable, chronic
							 illnesses;
or
*
1
undiagnosed new problem with
							 uncertain prognosis;
or
*
1
acute illness with systemic
							 symptoms;
or
* 1 acute, complicated injury
Moderate
(Must meet the requirements of at least 1 out
							 of 3 categories)
Category 1: Tests, documents, or independent
							 historian(s)
* Any combination of 3 from the following:
* Review of prior external note(s) from each unique
							 source*;
* Review of the result(s) of each unique
							 test*;
* Ordering of each unique test*;
* Assessment requiring an independent
							 historian(s)
or
Category 2: Independent interpretation of
							 tests
* Independent interpretation of a test performed by
							 another physician /other qualified health care professional (not separately
							 reported);
or
Category 3: Discussion of management or test
							 interpretation
* Discussion of management or test interpretation
							 with external physician/other qualified health care professional/appropriate
							 source (not separately reported)
Moderate risk of morbidity from additional
							 diagnostic testing or treatment
Examples only:
* Prescription drug management
* Decision regarding minor surgery with identified
							 patient or procedure risk factors
* Decision regarding elective major surgery without
							 identified patient or procedure risk factors
* Diagnosis or treatment significantly limited by
							 social determinants of health.
High
High
Extensive
High risk of morbidity from
*
1
or more chronic illnesses with
							 severe exacerbation, progression, or side effects of treatment;
or
*
1
acute or chronic illness or injury
							 that poses a threat to life or bodily function
(Must meet the requirements of at least 2 out
							 of 3 categories)
Category 1: Tests, documents or independent
							 historian(s)
Any combination of 3 from the
							 following:
* Review of prior external note(s) from each unique
							 source*;
* Review of the result(s) of each unique
							 test*;
* Ordering of each unique test*;
* Assessment requiring an independent
							 historian(s)
or
Category 2: Independent interpretation of
							 tests
* Independent interpretation of a test performed by
							 another physician/other qualified healthcare professional (not separately
							 reported);
or
Category 3: Discussion of management or test
							 interpretation
* Discussion of management or test interpretation
							 with external physician/other qualified health care professional/appropriate
							 source (not separately reported)
additional diagnostic testing or
							 treatment
Examples only:
* Drug therapy requiring intensive monitoring for
							 toxicity
* Decision regarding elective major surgery with
							 identified patient or procedure risk factors
* Decision regarding emergency major surgery
* Decision regarding hospitalization or escalation of
							 hospital-level care
* Decision not to resuscitate or to de-escalate care
							 because of poor prognosis
* Decision regarding parenteral controlled
							 substances
Number and Complexity of Problems Addressed at the
				  Encounter
One element used in selecting the level of office or other
				  outpatient services is the number and complexity of the problems that are
				  addressed at an encounter. Multiple new or established conditions may be
				  addressed at the same time and may affect MDM. Symptoms may cluster around a
				  specific diagnosis and each symptom is not necessarily a unique condition.
				  Comorbidities/underlying diseases, in and of themselves, are not considered in
				  selecting a level of E/M services
unless
they are addressed, and
				  their presence increases the amount and/or complexity of data to be reviewed
				  and analyzed or the risk of complications and/or morbidity or mortality of
				  patient management. The final diagnosis for a condition does not, in and of
				  itself, determine the complexity or risk, as extensive evaluation may be
				  required to reach the conclusion that the signs or symptoms do not represent a
				  highly morbid condition. Therefore, presenting symptoms that are unlikely to
				  represent a highly morbid condition may "drive" MDM even when the ultimate
				  diagnosis is not highly morbid. The evaluation and/or treatment should be
				  consistent with the likely nature of the condition. Multiple problems of a
				  lower severity may, in the aggregate, create higher risk due to
				  interaction.
The term "risk" as used in these definitions relates to risk
				  from the condition. While condition risk and management risk may often
				  correlate, the risk from the condition is distinct from the risk of
				  management.
Definitions for the elements of MDM (see Table 1, Levels of
				  Medical Decision Making) are:
Problem: A problem is a disease, condition, illness, injury,
				  symptom, sign, finding, complaint, or other matter addressed at the encounter,
				  with or without a diagnosis being established at the time of the
				  encounter.
Problem addressed: A problem is addressed or managed when it
				  is evaluated or treated at the encounter by the physician or other qualified
				  healthcare provider reporting the service. This includes consideration of
				  further testing or treatment that may not be elected by virtue of risk/benefit
				  analysis or patient/parent/guardian/surrogate choice. Notation in the patient's
				  medical record that another professional is managing the problem without
				  additional assessment or care coordination documented does not qualify as being
				  addressed or managed by the physician or other qualified healthcare
				  professional reporting the service. Referral without evaluation (by history,
				  examination, or diagnostic study[ies]) or consideration of treatment does not
				  qualify as being addressed or managed by the physician or other qualified
				  health care professional reporting the service. For hospital inpatient and
				  observation care services the problem addressed is the problem status on the
				  date of the encounter, which may be significantly different than on admission.
				  It is the problem being managed or co-managed by the reporting physician or
				  other qualified health care professional and may not be the cause of admission
				  or continued stay.
Minimal problem: A problem that may not require the presence
				  of the physician or other qualified healthcare professional, but the service is
				  provided under the physician's or other qualified health care professional's
				  supervision (see CPT codes 99211, 99281).
Self-limiting or minor problem: A problem that runs a
				  definite and prescribed course, is transient in nature, and is not likely to
				  permanently alter health status.
Stable, chronic illness: A problem with an expected duration
				  of at least one year or until the death of the patient. For the purpose of
				  defining chronicity, conditions are treated as chronic whether or not stage or
				  severity changes (
e.g
., uncontrolled diabetes and controlled
				  diabetes are a single chronic condition). "Stable" for the purposes of
				  categorizing MDM is defined by the specific treatment goals for an individual
				  patient. A patient who is not at his or her treatment goal is not stable, even
				  if the condition has not changed and there is no short-term threat to life or
				  function. For example, in a patient with persistently poorly controlled blood
				  pressure for whom better control is a goal is not stable, even if the pressures
				  are not changing and the patient is asymptomatic, the risk of morbidity
without
treatment is significant.
Acute, uncomplicated illness or injury: A recent or new
				  short-term problem with low risk of morbidity for which treatment is
				  considered. There is little to no risk of mortality with treatment, and full
				  recovery without functional impairment is expected. A problem that is normally
				  self-limited or minor but is not resolving consistent with a definite and
				  prescribed course is an acute, uncomplicated illness.
Acute, uncomplicated illness or injury requiring hospital
				  inpatient or observation level care: A recent or new short-term problem with
				  low risk of morbidity for which treatment is required. There is little to no
				  risk of mortality with treatment, and full recovery without functional
				  impairment is expected. The treatment required is delivered in a hospital
				  inpatient or observation l level setting.
Stable, acute illness: A problem that is new or recent for
				  which treatment has been initiated. The patient is improved and, while
				  resolution may not be complete, is stable with respect to this
				  condition.
Chronic illness with exacerbation, progression, or side
				  effects of treatment: A chronic illness that is acutely worsening, poorly
				  controlled, or progressing with an intent to control progression and requiring
				  additional supportive care or requiring attention to treatment for side
				  effects.
Undiagnosed new problem with uncertain prognosis: A problem
				  in the differential diagnosis that represents a condition likely to result in a
				  high risk of morbidity without treatment.
Acute illness with systemic symptoms: An illness that causes
				  systemic symptoms and has a high risk of morbidity without treatment. For
				  systemic general symptoms, such as fever, body aches, or fatigue in a minor
				  illness that may be treated to alleviate symptoms, see the definitions for
self-limited or minor problem
or
acute, uncomplicated
				  illness or injury.
Systemic symptoms may not be general but may be a
				  single system.
Acute, complicated injury: An injury which requires treatment
				  that includes evaluation of body systems that are not directly part of the
				  injured organ, the injury is extensive, or the treatment options are multiple
				  and/or associated with a risk of morbidity.
Chronic illness with severe exacerbation, progression, or
				  side effects of treatment: The severe exacerbation or progression of a chronic
				  illness or severe side effects of treatment that have significant risk of
				  morbidity and may require escalation in level of care.
Acute or chronic illness or injury that poses a threat to
				  life or bodily function: An acute illness with systemic symptoms, and acute
				  complicated injury, or a chronic illness or injury with exacerbation and/or
				  progression or side effects of treatment, that poses a threat to life or bodily
				  function in the near term without treatment. Some symptoms may represent a
				  condition that is significantly probable and poses a potential threat to life
				  or bodily function. These may be included in this category when the evaluation
				  and treatment are consistent with this degree of potential severity.
Amount and/or Complexity of Data to Be Reviewed and
				  Analyzed
One element used in selecting the level of services is the
				  amount and/or complexity of data to be reviewed or analyzed at an
				  encounter.
Analyzed: the process of using the data as part of the MDM.
				  The data element itself may not be subject to analysis (
e.g
.,
				  glucose), but it is instead included in the thought processes for diagnosis,
				  evaluation, or treatment. Tests ordered are presumed to be analyzed when the
				  results are reported. Therefore, when they are ordered during an encounter,
				  they are counted in that encounter. Tests that are ordered outside of an
				  encounter may be counted in the encounter in which they are analyzed. In the
				  case of a recurring order, each new result may be counted in the encounter in
				  which it is analyzed. For example, an encounter that includes an order for
				  monthly prothrombin times would count for one prothrombin time ordered and
				  reviewed. Additional future results, if analyzed in a subsequent encounter, may
				  be counted as a single test in that subsequent encounter. Any service for which
				  the professional component is separately reported by the physician or other
				  qualified health care professional reporting the E/M services is not counted as
				  a data element ordered, reviewed, analyzed, or independently interpreted for
				  the purposes of determining the level of MDM.
Test: Tests are imaging, laboratory, psychometric, or
				  physiologic data. A clinical laboratory panel (
e.g
., basic
				  metabolic panel [80047]) is a single test. The differentiation between single
				  or multiple tests is defined in accordance with the
				  CPT® code set. For the purposes of data reviewed
				  and analyzed, pulse oximetry is not a test.
Unique: A unique test is defined by the
				  CPT® code set. When multiple results of the same
				  unique test (
e.g
., serial blood glucose values) are compared
				  during an E/M service, count it as one unique test. Tests that have overlapping
				  elements are not unique, even if they are identified with distinct
				  CPT® codes. For example, a CBC with differential
				  would incorporate the set of hemoglobin, CBC, without differential, and
				  platelet count. A unique source is defined as a physician or other qualified
				  healthcare professional in a distinct group or different specialty or
				  subspecialty, or a unique entity. Review of all the materials from any unique
				  source counts as one element toward MDM.
Combination of Data Elements: A combination of different data
				  elements, for example, a combination of notes reviewed, tests ordered, tests
				  reviewed, or independent historian, allows these elements to be summed. It does
				  not require each item type or category to be represented. A unique test
				  ordered, plus a note reviewed and an independent historian would be a
				  combination of three elements.
External: External records, communications, and/or test
				  results are from an external physician, other qualified health care
				  professional, facility, or health care organization.
External physician or other qualified health care
				  professional: An external physician or other qualified health care professional
				  who is not in the same group practice or is of a different specialty or
				  subspecialty. This includes licensed professionals who are practicing
				  independently. The individual may also be a facility or organizational provider
				  such as from a hospital, nursing facility, or home health care agency.
Discussion: Discussion requires an interactive exchange. The
				  exchange must be direct and not through intermediaries (
e.g
.,
				  clinical staff or trainees). Sending chart notes or written exchanges that are
				  within progress notes does not qualify as an interactive exchange. The
				  discussion does not need to be on the date of the encounter, but it is counted
				  only once and only when it is used in the decision making of the encounter. It
				  may be synchronous (
i.e
., does not need to be in person), but
				  it must be initiated and completed within a short time period
				  (
e.g
., within a day or two).
Independent historian(s): An individual
				  (
e.g
., parent, guardian, surrogate, spouse, witness) who
				  provides a history in addition to a history provided by the patient who is
				  unable to provide a complete or reliable history (
e.g
., due to
				  developmental stage, dementia, or psychosis) or because a confirmatory history
				  is judged to be necessary. In the case where there may be conflict or poor
				  communication between multiple historians and more than one historian is
				  needed, the independent historian requirement is met. It does not include
				  translation services. The independent history does not need to be obtained in
				  person but does need to be obtained directly from the historian providing the
				  independent information.
Independent interpretations: The interpretation of a test for
				  which there is a CPT® code and an interpretation
				  or report is customary. This does not apply when the physician or other
				  healthcare professional who reports the E/M service is reporting or has
				  previously reported the test. A form of interpretation should be documented but
				  need not conform to the usual standards of a complete report for the test. A
				  test that is ordered and independently interpreted may count both as a test
				  ordered and interpreted.
Appropriate source: For the purpose of the discussion of
				  management data element (see Table 1, levels of Medical Decision Making), an
				  appropriate source includes professionals who are not health care professionals
				  but may be involved in the management of the patient (
e.g
.,
				  lawyer, parole officer, case manager, teacher). It does not include discussion
				  with family or informal caregivers. For the purpose of documents reviewed,
				  documents from an appropriate source may be counted.
Risk of Complications and/or Morbidity or Mortality of
				  Patient Management
One element used in selecting the level of service is the
				  risk of complications and/or morbidity or mortality of patient management at an
				  encounter. This is distinct from the risk of the condition itself.
Risk: The probability and/or consequences of an event. The
				  assessment of the level of risk is affected by the nature of the event under
				  consideration. For example, a low probability of death may be high risk,
				  whereas a high chance of a minor, self-limited adverse effect of treatment may
				  be low risk. Definitions of risk are based upon the usual behavior and thought
				  processes of a physician or other qualified healthcare professional in the same
				  specialty. Trained clinicians apply common language usage meanings to terms
				  such as
high, medium, low,
or
minimal
risk
				  and do not require quantification for these definitions (though quantification
				  may be provided when evidence-based medicine has established probabilities).
				  For the purposes of MDM, level of risk is based upon consequences of the
				  problem(s) addressed at the encounter when appropriately treated. Risk also
				  includes MDM related to the need to initiate or forego further testing,
				  treatment and/or hospitalization. The risk of patient management criteria
				  applies to the patient management decisions made by the reporting physician or
				  other health care professional as part of the reported encounter.
Morbidity: A state of illness or functional impairment that
				  is expected to be of substantial duration during which function is limited,
				  quality of life is impaired, or there is organ damage that may not be transient
				  despite treatment.
Social determinants of health: Economic and social conditions
				  that influence the health of people and communities. Examples may include food
				  or housing insecurity.
Surgery (minor or major, elective, emergency, procedure or
				  patient risk):
Surgery - Minor or Major: The classification of surgery into
				  minor or major is based on the common meaning of such terms when used by
				  trained clinicians, similar to the use of the term "risk." These terms are not
				  defined by a surgical package classification.
Surgery - Elective or Emergency: Elective procedures and
				  emergent or urgent procedures describe the timing of the procedure when the
				  timing is related to the patient's condition. An elective procedure is
				  typically planned in advance (
e.g
., scheduled for weeks
				  later), while an emergent procedure is typically performed immediately or with
				  minimal delay to allow for patient stabilization. Both elective and emergent
				  procedures may be minor or major procedures.
Surgery - Risk Factors, Patient or Procedure: Risk factors
				  are those that are relevant to the patient and procedure. Evidence-based risk
				  calculators may be used, but are not required, in assessing patient and
				  procedure risk.
Drug therapy requiring intensive monitoring for toxicity: A
				  drug that requires intensive monitoring is a therapeutic agent that has the
				  potential to cause serious morbidity or death. The monitoring is performed for
				  assessment of these adverse effects and not primarily for assessment of
				  therapeutic efficacy. The monitoring should be that which is generally accepted
				  practice for the agent but may be patient-specific in some cases. Intensive
				  monitoring may be long-term or short-term. Long-term intensive monitoring is
				  not performed less than quarterly. The monitoring may be performed with a
				  laboratory test, a physiologic test, or imaging. Monitoring by history or
				  examination does not qualify. The monitoring affects the level of MDM in an
				  encounter in which it is considered in the management of the patient. An
				  example may be monitoring for cytopenia with the use of an antineoplastic agent
				  between dose cycles. Examples of monitoring that do not qualify include
				  monitoring glucose levels during insulin therapy, as the primary reason is the
				  therapeutic effect (unless severe hypoglycemia is a current, significant
				  concern); or annual electrolytes and renal function for a patient on a
				  diuretic, as the frequency does not meet the threshold.
Parenteral controlled substances: The level of risk is based
				  on the usual behavior and thought processes of a physician or other qualified
				  health care professional in the same specialty and subspecialty and not simply
				  based on the presence of an order for parenteral controlled substances.
Guidelines for Selecting Level of Service Based on
				  Time
Certain categories of time-based E/M codes that do not have
				  levels of services based on MDM (e.g., Critical Care Services) in the E/M
				  section use time differently. It is important to review the instructions for
				  each category.
Time is
not
a descriptive component for the
				  emergency department levels of E/M services because emergency department
				  services are typically provided on a variable intensity basis, often involving
				  multiple encounters with several patients over an extended period of
				  time.
When time is used for reporting E/M services codes, the time
				  defined in the service descriptors is used for selecting the appropriate level
				  of services. The E/M services for which these guidelines apply require a
				  face-to-face encounter with the physician or other qualified health care
				  professional and the patient and/or family/caregiver. For office or other
				  outpatient services, if the physician's or other qualified health care
				  professional's time is spent in the supervision of clinical staff who perform
				  the face-to-face services of the encounter, use 99211.
For coding purposes, time for these services is the total
				  time on the date of the encounter. It includes both the face-to-face time with
				  the patient and/or family/caregiver and non-face-to-face time personally spent
				  by the physician and/or other qualified health care professional(s) on the day
				  of the encounter (includes time in activities that require the physician or
				  other qualified health care professional and does not include time in
				  activities normally performed by clinical staff). It includes time regardless
				  of the location of the physician or other qualified health care professional
				  (e.g., whether on or off the inpatient unit or in or out of the outpatient
				  office). It does not include any time spent in the performance of other
				  separately reported service(s).
Each service that may be reported using time for code level
				  selection has a required time threshold. The concept of attaining a mid-point
				  between levels does not apply. A full 15 minutes is required to report any unit
				  of prolonged service codes 99417, and 99418.
Physician(s) and other qualified health care professional(s)
				  may each provide a portion of the face-to-face and non-face-to-face work
				  related to the service. When time is being used to select the appropriate level
				  of services for which time-based reporting is allowed, the time personally
				  spent by the physician(s) and other qualified health care professional(s)
				  assessing and managing the patient and/or counseling, educating, communicating
				  results to the patient/family/caregiver on the date of the encounter is summed
				  to define total time. Only distinct time should be summed (i.e., when two or
				  more individuals jointly meet with or discuss the patient, only the time of one
				  individual should be counted).
When prolonged time occurs, the appropriate prolonged
				  services code may be reported. The total time on the date of the encounter
				  spent caring for the patient should be documented in the medical record when it
				  is used as the basis for code selection.
Physician or other qualified health care professional time
				  includes the following activities, when performed:
* Preparing to see the patient (e.g., review of tests)
* Obtaining and/or reviewing separately obtained
				  history
* Performing a medically appropriate examination and/or
				  evaluation
* Counseling and educating the
				  patient/family/caregiver
* Ordering medications, tests, or procedures
* Referring and communicating with other health care
				  professionals (when not separately reported)
* Documenting clinical information in the electronic or other
				  health record
* Independently interpreting results (not separately
				  reported) and communicating results to the patient/family/caregiver
* Care coordination (not separately reported)
Do not count time spent on the following:
* The performance of other services that are reported
				  separately
* Travel
* Teaching that is general and not limited to discussion that
				  is required for the management of a specific patient
For split or shared visits, see the split or shared visits
				  guidelines.
C. UNLISTED SERVICE
An E/M service may be provided that is not listed in this
				  section of CPT® codebook. When reporting such a
				  service, the appropriate unlisted code may be used to indicate the service,
				  identifying it by "Special Report," as discussed in item E. The "Unlisted
				  Services" and accompanying codes for the E/M section are as follows:
99429 Unlisted preventive medicine service
99499 Unlisted evaluation and management service
D. SPECIAL REPORT.
An unlisted service or one that is unusual, variable, or new
				  may require a special report demonstrating the medical appropriateness of the
				  service. Pertinent information should include an adequate definition or
				  description of the nature, extent, and need for the procedure and the time,
				  effort, and equipment necessary to provide the service. Additional items that
				  may be included are complexity of symptoms, final diagnosis, pertinent physical
				  findings, diagnostic and therapeutic procedures, concurrent problems, and
				  follow-up care.
ARIZONA PHYSICIANS' FEE SCHEDULE
Evaluation and Management Codes 2024
E&M Conversion Factor $68.00
Code
Category
FY24 NF
							 RVU
FY24 FAC RVU
FY24 NF RBRVS Rate
FY24 FAC RBRVS
							 Rate
99202 00
E&M
2.17
1.41
147.56
95.88
99203 00
E&M
3.35
2.44
227.80
165.92
99204 00
E&M
5.02
3.97
341.36
269.96
99205 00
E&M
6.62
5.40
450.16
367.20
99211 00
E&M
0.70
0.26
47.60
17.68
99212 00
E&M
1.70
1.05
115.60
71.40
99213 00
E&M
2.73
1.96
185.64
133.28
99214 00
E&M
3.85
2.89
261.80
196.52
99215 00
E&M
5.42
4.29
368.56
291.72
99221 00
E&M
2.46
2.46
167.28
167.28
99222 00
E&M
3.88
3.88
263.84
263.84
99223 00
E&M
5.14
5.14
349.52
349.52
99231 00
E&M
1.47
1.47
99.96
99.96
99232 00
E&M
2.34
2.34
159.12
159.12
99233 00
E&M
3.52
3.52
239.36
239.36
99234 00
E&M
2.90
2.90
197.20
197.20
99235 00
E&M
4.73
4.73
321.64
321.64
99236 00
E&M
6.18
6.18
420.24
420.24
99238 00
E&M
2.41
2.41
163.88
163.88
99239 00
E&M
3.40
3.40
231.20
231.20
99242 00
E&M
2.25
1.66
153.00
112.88
99243 00
E&M
3.37
2.62
229.16
178.16
99244 00
E&M
4.81
3.99
327.08
271.32
99245 00
E&M
6.28
5.36
427.04
364.48
99252 00
E&M
2.11
2.11
143.48
143.48
99253 00
E&M
2.96
2.96
201.28
201.28
99254 00
E&M
4.11
4.11
279.48
279.48
99255 00
E&M
5.53
5.53
376.04
376.04
99281 00
E&M
0.34
0.34
23.12
23.12
99282 00
E&M
1.24
1.24
84.32
84.32
99283 00
E&M
2.11
2.11
143.48
143.48
99284 00
E&M
3.59
3.59
244.12
244.12
99285 00
E&M
5.20
5.20
353.60
353.60
99288 00
E&M
0.00
0.00
Bundled Code
Bundled Code
99291 00
E&M
8.18
6.31
556.24
429.08
99292 00
E&M
3.58
3.18
243.44
216.24
99304 00
E&M
2.39
2.39
162.52
162.52
99305 00
E&M
3.97
3.97
269.96
269.96
99306 00
E&M
5.42
5.42
368.56
368.56
99307 00
E&M
1.20
1.20
81.60
81.60
99308 00
E&M
2.22
2.22
150.96
150.96
99309 00
E&M
3.21
3.21
218.28
218.28
99310 00
E&M
4.58
4.58
311.44
311.44
99315 00
E&M
2.43
2.43
165.24
165.24
99316 00
E&M
3.90
3.90
265.20
265.20
99341 00
E&M
1.47
1.47
99.96
99.96
99342 00
E&M
2.33
2.33
158.44
158.44
99344 00
E&M
4.23
4.23
287.64
287.64
99345 00
E&M
6.01
6.01
408.68
408.68
99347 00
E&M
1.35
1.35
91.80
91.80
99348 00
E&M
2.28
2.28
155.04
155.04
99349 00
E&M
3.79
3.79
257.72
257.72
99350 00
E&M
5.52
5.52
375.36
375.36
99358 00
E&M
2.65
2.61
180.20
177.48
99359 00
E&M
1.13
1.09
76.84
74.12
99360 00
E&M
1.74
1.74
118.32
118.32
99366 00
E&M
1.22
1.19
82.96
80.92
99367 00
E&M
1.60
1.60
108.80
108.80
99368 00
E&M
1.04
1.04
70.72
70.72
99374 00
E&M
0.00
0.00
Bundled Code
Bundled Code
99375 00
E&M
3.03
2.50
206.04
170.00
99377 00
E&M
0.00
0.00
Bundled Code
Bundled Code
99378 00
E&M
3.03
2.50
206.04
170.00
99379 00
E&M
0.00
0.00
Bundled Code
Bundled Code
99380 00
E&M
0.00
0.00
Bundled Code
Bundled Code
99381 00
E&M
0.00
0.00
BR
BR
99382 00
E&M
0.00
0.00
BR
BR
99383 00
E&M
0.00
0.00
BR
BR
99384 00
E&M
0.00
0.00
BR
BR
99385 00
E&M
0.00
0.00
BR
BR
99386 00
E&M
0.00
0.00
BR
BR
99387 00
E&M
0.00
0.00
BR
BR
99391 00
E&M
0.00
0.00
BR
BR
99392 00
E&M
0.00
0.00
BR
BR
99393 00
E&M
0.00
0.00
BR
BR
99394 00
E&M
0.00
0.00
BR
BR
99395 00
E&M
0.00
0.00
BR
BR
99396 00
E&M
0.00
0.00
BR
BR
99397 00
E&M
0.00
0.00
BR
BR
99401 00
E&M
0.00
0.00
BR
BR
99402 00
E&M
0.00
0.00
BR
BR
99403 00
E&M
0.00
0.00
BR
BR
99404 00
E&M
0.00
0.00
BR
BR
99406 00
E&M
0.00
0.00
BR
BR
99407 00
E&M
0.00
0.00
BR
BR
99408 00
E&M
0.00
0.00
BR
BR
99409 00
E&M
0.00
0.00
BR
BR
99411 00
E&M
0.00
0.00
BR
BR
99412 00
E&M
0.00
0.00
BR
BR
99415 00
E&M
0.62
0.62
42.16
42.16
99416 00
E&M
0.29
0.29
19.72
19.72
99417 00
E&M
0.92
0.89
62.56
60.52
99418 00
E&M
1.17
1.17
79.56
79.56
99421 00
E&M
0.45
0.38
30.60
25.84
99422 00
E&M
0.88
0.75
59.84
51.00
99423 00
E&M
1.40
1.20
95.20
81.60
99424 00
E&M
2.48
2.21
168.64
150.28
99425 00
E&M
1.80
1.52
122.40
103.36
99426 00
E&M
1.86
1.47
126.48
99.96
99427 00
E&M
1.42
1.03
96.56
70.04
99429 00
E&M
0.00
0.00
BR
BR
99437 00
E&M
1.79
1.50
121.72
102.00
99439 00
E&M
1.44
1.04
97.92
70.72
99441 00
E&M
1.69
1.04
114.92
70.72
99442 00
E&M
2.72
1.95
184.96
132.60
99443 00
E&M
3.85
2.89
261.80
196.52
99446 00
E&M
0.53
0.53
36.04
36.04
99447 00
E&M
1.08
1.08
73.44
73.44
99448 00
E&M
1.60
1.60
108.80
108.80
99449 00
E&M
2.13
2.13
144.84
144.84
99450 00
E&M
0.00
0.00
BR
BR
99451 00
E&M
1.04
1.04
70.72
70.72
99452 00
E&M
1.01
1.01
68.68
68.68
99453 00
E&M
0.60
0.60
40.80
40.80
99454 00
E&M
1.42
1.42
96.56
96.56
99455 00
E&M
5.23
5.23
355.64
355.64
99456 00
E&M
6.87
6.87
467.16
467.16
99457 00
E&M
1.47
0.89
99.96
60.52
99458 00
E&M
1.18
0.89
80.24
60.52
99459 00
E&M
0.68
0.68
46.24
46.24
99460 00
E&M
2.75
2.75
187.00
187.00
99461 00
E&M
2.75
1.81
187.00
123.08
99462 00
E&M
1.21
1.21
82.28
82.28
99463 00
E&M
3.21
3.21
218.28
218.28
99464 00
E&M
2.15
2.15
146.20
146.20
99465 00
E&M
4.21
4.21
286.28
286.28
99466 00
E&M
6.87
6.87
467.16
467.16
99467 00
E&M
3.45
3.45
234.60
234.60
99468 00
E&M
26.48
26.48
1800.64
1800.64
99469 00
E&M
11.45
11.45
778.60
778.60
99471 00
E&M
22.94
22.94
1559.92
1559.92
99472 00
E&M
11.75
11.75
799.00
799.00
99473 00
E&M
0.43
0.43
29.24
29.24
99474 00
E&M
0.50
0.26
34.00
17.68
99475 00
E&M
16.53
16.53
1124.04
1124.04
99476 00
E&M
9.95
9.95
676.60
676.60
99477 00
E&M
10.03
10.03
682.04
682.04
99478 00
E&M
3.95
3.95
268.60
268.60
99479 00
E&M
3.59
3.59
244.12
244.12
99480 00
E&M
3.45
3.45
234.60
234.60
99483 00
E&M
8.19
5.74
556.92
390.32
99484 00
E&M
1.65
1.31
112.20
89.08
99485 00
E&M
0.00
0.00
Bundled Code
Bundled Code
99486 00
E&M
0.00
0.00
Bundled Code
Bundled Code
99487 00
E&M
4.03
2.68
274.04
182.24
99489 00
E&M
2.17
1.49
147.56
101.32
99490 00
E&M
1.88
1.49
127.84
101.32
99491 00
E&M
2.54
2.24
172.72
152.32
99492 00
E&M
4.60
2.79
312.80
189.72
99493 00
E&M
4.20
3.05
285.60
207.40
99494 00
E&M
1.78
1.22
121.04
82.96
99495 00
E&M
6.21
4.16
422.28
282.88
99496 00
E&M
8.40
5.65
571.20
384.20
99497 00
E&M
2.46
2.24
167.28
152.32
99498 00
E&M
2.13
2.11
144.84
143.48
99499 00
E&M
0.00
0.00
BR
BR
G2010 00
E&M
0.37
0.27
25.16
18.36
G2012 00
E&M
0.42
0.38
28.56
25.84
CATEGORY III CODES GUIDELINES
Information regarding publications incorporated by reference
				  is found in the Introduction Section of the Fee Schedule.
The following Commission guidelines are in addition to the
				  CPT® guidelines and represent additional
				  guidance from the Commission relative to unit values for these services. To the
				  extent that a conflict may exist between an incorporated portion of the
				  CPT® publication or HCPCS code and a code,
				  guideline, identifier or modifier unique to Arizona, then the Arizona code,
				  guideline, identifier, or modifier shall control. Codes that are unique to
				  Arizona are preceded by an AZ identifier and numbered in the following format:
				  AZxxx.
Category III Codes are temporary codes developed to allow
				  collection of data for emerging technology, services, and procedures. The five
				  character alphanumeric codes contain four numbers with one alpha character in
				  the fifth place. If a Category III Code is available, this code must be
				  reported instead of a Category I unlisted code.
ARIZONA PHYSICIANS' FEE SCHEDULE
Category III Codes 2024
Code
Category
FY24 NF
							 RVU
FY24 FAC RVU
FY24 NF RBRVS Rate
FY24 FAC RBRVS
							 Rate
0042T 00
Category III
0.00
0.00
RNE
RNE
0054T 00
Category III
0.00
0.00
RNE
RNE
0055T 00
Category III
0.00
0.00
RNE
RNE
0071T 00
Category III
0.00
0.00
RNE
RNE
0072T 00
Category III
0.00
0.00
RNE
RNE
0075T 00
Category III
0.00
0.00
RNE
RNE
0075T 26
Category III
0.00
0.00
RNE
RNE
0075T TC
Category III
0.00
0.00
RNE
RNE
0076T 00
Category III
0.00
0.00
RNE
RNE
0076T 26
Category III
0.00
0.00
RNE
RNE
0076T TC
Category III
0.00
0.00
RNE
RNE
0095T 00
Category III
0.00
0.00
RNE
RNE
0098T 00
Category III
0.00
0.00
RNE
RNE
0100T 00
Category III
0.00
0.00
RNE
RNE
0101T 00
Category III
0.00
0.00
RNE
RNE
0102T 00
Category III
0.00
0.00
RNE
RNE
0106T 00
Category III
0.00
0.00
RNE
RNE
0107T 00
Category III
0.00
0.00
RNE
RNE
0108T 00
Category III
0.00
0.00
RNE
RNE
0109T 00
Category III
0.00
0.00
RNE
RNE
0110T 00
Category III
0.00
0.00
RNE
RNE
0164T 00
Category III
0.00
0.00
RNE
RNE
0165T 00
Category III
0.00
0.00
RNE
RNE
0174T 00
Category III
0.00
0.00
RNE
RNE
0175T 00
Category III
0.00
0.00
RNE
RNE
0184T 00
Category III
0.00
0.00
RNE
RNE
0198T 00
Category III
0.00
0.00
RNE
RNE
0200T 00
Category III
0.00
0.00
RNE
RNE
0201T 00
Category III
0.00
0.00
RNE
RNE
0202T 00
Category III
0.00
0.00
RNE
RNE
0207T 00
Category III
0.00
0.00
RNE
RNE
0208T 00
Category III
0.00
0.00
RNE
RNE
0209T 00
Category III
0.00
0.00
RNE
RNE
0210T 00
Category III
0.00
0.00
RNE
RNE
0211T 00
Category III
0.00
0.00
RNE
RNE
0212T 00
Category III
0.00
0.00
RNE
RNE
0213T 00
Category III
0.00
0.00
RNE
RNE
0214T 00
Category III
0.00
0.00
RNE
RNE
0215T 00
Category III
0.00
0.00
RNE
RNE
0216T 00
Category III
0.00
0.00
RNE
RNE
0217T 00
Category III
0.00
0.00
RNE
RNE
0218T 00
Category III
0.00
0.00
RNE
RNE
0219T 00
Category III
0.00
0.00
RNE
RNE
0220T 00
Category III
0.00
0.00
RNE
RNE
0221T 00
Category III
0.00
0.00
RNE
RNE
0222T 00
Category III
0.00
0.00
RNE
RNE
0232T 00
Category III
0.00
0.00
RNE
RNE
0234T 00
Category III
0.00
0.00
RNE
RNE
0235T 00
Category III
0.00
0.00
RNE
RNE
0236T 00
Category III
0.00
0.00
RNE
RNE
0237T 00
Category III
0.00
0.00
RNE
RNE
0238T 00
Category III
0.00
0.00
RNE
RNE
0253T 00
Category III
0.00
0.00
RNE
RNE
0263T 00
Category III
0.00
0.00
RNE
RNE
0264T 00
Category III
0.00
0.00
RNE
RNE
0265T 00
Category III
0.00
0.00
RNE
RNE
0266T 00
Category III
0.00
0.00
RNE
RNE
0267T 00
Category III
0.00
0.00
RNE
RNE
0268T 00
Category III
0.00
0.00
RNE
RNE
0269T 00
Category III
0.00
0.00
RNE
RNE
0270T 00
Category III
0.00
0.00
RNE
RNE
0271T 00
Category III
0.00
0.00
RNE
RNE
0272T 00
Category III
0.00
0.00
RNE
RNE
0273T 00
Category III
0.00
0.00
RNE
RNE
0274T 00
Category III
0.00
0.00
RNE
RNE
0275T 00
Category III
0.00
0.00
RNE
RNE
0278T 00
Category III
0.00
0.00
RNE
RNE
0308T 00
Category III
0.00
0.00
RNE
RNE
0329T 00
Category III
0.00
0.00
RNE
RNE
0330T 00
Category III
0.00
0.00
RNE
RNE
0331T 00
Category III
0.00
0.00
RNE
RNE
0332T 00
Category III
0.00
0.00
RNE
RNE
0333T 00
Category III
0.00
0.00
RNE
RNE
0335T 00
Category III
0.00
0.00
RNE
RNE
0338T 00
Category III
0.00
0.00
RNE
RNE
0339T 00
Category III
0.00
0.00
RNE
RNE
0342T 00
Category III
0.00
0.00
RNE
RNE
0345T 00
Category III
0.00
0.00
RNE
RNE
0347T 00
Category III
0.00
0.00
RNE
RNE
0348T 00
Category III
0.00
0.00
RNE
RNE
0349T 00
Category III
0.00
0.00
RNE
RNE
0350T 00
Category III
0.00
0.00
RNE
RNE
0351T 00
Category III
0.00
0.00
RNE
RNE
0352T 00
Category III
0.00
0.00
RNE
RNE
0353T 00
Category III
0.00
0.00
RNE
RNE
0354T 00
Category III
0.00
0.00
RNE
RNE
0358T 00
Category III
0.00
0.00
RNE
RNE
0362T 00
Category III
0.00
0.00
RNE
RNE
0373T 00
Category III
0.00
0.00
RNE
RNE
0378T 00
Category III
0.00
0.00
RNE
RNE
0379T 00
Category III
0.00
0.00
RNE
RNE
0394T 00
Category III
0.00
0.00
RNE
RNE
0395T 00
Category III
0.00
0.00
RNE
RNE
0397T 00
Category III
0.00
0.00
RNE
RNE
0398T 00
Category III
0.00
0.00
RNE
RNE
0398T 26
Category III
0.00
0.00
RNE
RNE
0398T TC
Category III
0.00
0.00
RNE
RNE
0402T 00
Category III
0.00
0.00
RNE
RNE
0403T 00
Category III
0.00
0.00
RNE
RNE
0408T 00
Category III
0.00
0.00
RNE
RNE
0409T 00
Category III
0.00
0.00
RNE
RNE
0410T 00
Category III
0.00
0.00
RNE
RNE
0411T 00
Category III
0.00
0.00
RNE
RNE
0412T 00
Category III
0.00
0.00
RNE
RNE
0413T 00
Category III
0.00
0.00
RNE
RNE
0414T 00
Category III
0.00
0.00
RNE
RNE
0415T 00
Category III
0.00
0.00
RNE
RNE
0416T 00
Category III
0.00
0.00
RNE
RNE
0417T 00
Category III
0.00
0.00
RNE
RNE
0418T 00
Category III
0.00
0.00
RNE
RNE
0419T 00
Category III
0.00
0.00
RNE
RNE
0420T 00
Category III
0.00
0.00
RNE
RNE
0421T 00
Category III
0.00
0.00
RNE
RNE
0422T 00
Category III
0.00
0.00
RNE
RNE
0437T 00
Category III
0.00
0.00
RNE
RNE
0439T 00
Category III
0.00
0.00
RNE
RNE
0440T 00
Category III
0.00
0.00
RNE
RNE
0441T 00
Category III
0.00
0.00
RNE
RNE
0442T 00
Category III
0.00
0.00
RNE
RNE
0443T 00
Category III
0.00
0.00
RNE
RNE
0444T 00
Category III
0.00
0.00
RNE
RNE
0445T 00
Category III
0.00
0.00
RNE
RNE
0449T 00
Category III
0.00
0.00
RNE
RNE
0450T 00
Category III
0.00
0.00
RNE
RNE
0464T 00
Category III
0.00
0.00
RNE
RNE
0469T 00
Category III
0.00
0.00
RNE
RNE
0472T 00
Category III
0.00
0.00
RNE
RNE
0473T 00
Category III
0.00
0.00
RNE
RNE
0474T 00
Category III
0.00
0.00
RNE
RNE
0479T 00
Category III
0.00
0.00
RNE
RNE
0480T 00
Category III
0.00
0.00
RNE
RNE
0481T 00
Category III
0.00
0.00
RNE
RNE
0483T 00
Category III
0.00
0.00
RNE
RNE
0484T 00
Category III
0.00
0.00
RNE
RNE
0485T 00
Category III
0.00
0.00
RNE
RNE
0485T 26
Category III
0.00
0.00
RNE
RNE
0485T TC
Category III
0.00
0.00
RNE
RNE
0486T 00
Category III
0.00
0.00
RNE
RNE
0486T 26
Category III
0.00
0.00
RNE
RNE
0486T TC
Category III
0.00
0.00
RNE
RNE
0488T 00
Category III
0.00
0.00
RNE
RNE
0489T 00
Category III
0.00
0.00
RNE
RNE
0490T 00
Category III
0.00
0.00
RNE
RNE
0494T 00
Category III
0.00
0.00
RNE
RNE
0495T 00
Category III
0.00
0.00
RNE
RNE
0496T 00
Category III
0.00
0.00
RNE
RNE
0500T 00
Category III
0.00
0.00
RNE
RNE
0505T 00
Category III
0.00
0.00
RNE
RNE
0506T 00
Category III
0.00
0.00
RNE
RNE
0506T 26
Category III
0.00
0.00
RNE
RNE
0506T TC
Category III
0.00
0.00
RNE
RNE
0507T 00
Category III
0.00
0.00
RNE
RNE
0507T 26
Category III
0.00
0.00
RNE
RNE
0507T TC
Category III
0.00
0.00
RNE
RNE
0510T 00
Category III
0.00
0.00
RNE
RNE
0511T 00
Category III
0.00
0.00
RNE
RNE
0512T 00
Category III
0.00
0.00
RNE
RNE
0513T 00
Category III
0.00
0.00
RNE
RNE
0515T 00
Category III
0.00
0.00
RNE
RNE
0516T 00
Category III
0.00
0.00
RNE
RNE
0517T 00
Category III
0.00
0.00
RNE
RNE
0518T 00
Category III
0.00
0.00
RNE
RNE
0519T 00
Category III
0.00
0.00
RNE
RNE
0520T 00
Category III
0.00
0.00
RNE
RNE
0521T 00
Category III
0.00
0.00
RNE
RNE
0521T 26
Category III
0.00
0.00
RNE
RNE
0521T TC
Category III
0.00
0.00
RNE
RNE
0522T 00
Category III
0.00
0.00
RNE
RNE
0522T 26
Category III
0.00
0.00
RNE
RNE
0522T TC
Category III
0.00
0.00
RNE
RNE
0523T 00
Category III
0.00
0.00
RNE
RNE
0524T 00
Category III
0.00
0.00
RNE
RNE
0525T 00
Category III
0.00
0.00
RNE
RNE
0526T 00
Category III
0.00
0.00
RNE
RNE
0527T 00
Category III
0.00
0.00
RNE
RNE
0528T 00
Category III
0.00
0.00
RNE
RNE
0528T 26
Category III
0.00
0.00
RNE
RNE
0528T TC
Category III
0.00
0.00
RNE
RNE
0529T 00
Category III
0.00
0.00
RNE
RNE
0529T 26
Category III
0.00
0.00
RNE
RNE
0529T TC
Category III
0.00
0.00
RNE
RNE
0530T 00
Category III
0.00
0.00
RNE
RNE
0531T 00
Category III
0.00
0.00
RNE
RNE
0532T 00
Category III
0.00
0.00
RNE
RNE
0537T 00
Category III
0.00
0.00
Bundled Code
Bundled Code
0538T 00
Category III
0.00
0.00
Bundled Code
Bundled Code
0539T 00
Category III
0.00
0.00
Bundled Code
Bundled Code
0540T 00
Category III
0.00
0.00
RNE
RNE
0541T 00
Category III
0.00
0.00
RNE
RNE
0542T 00
Category III
0.00
0.00
RNE
RNE
0543T 00
Category III
0.00
0.00
RNE
RNE
0544T 00
Category III
0.00
0.00
RNE
RNE
0545T 00
Category III
0.00
0.00
RNE
RNE
0546T 00
Category III
0.00
0.00
RNE
RNE
0547T 00
Category III
0.00
0.00
RNE
RNE
0552T 00
Category III
0.00
0.00
RNE
RNE
0553T 00
Category III
0.00
0.00
RNE
RNE
0554T 00
Category III
0.00
0.00
RNE
RNE
0555T 00
Category III
0.00
0.00
RNE
RNE
0556T 00
Category III
0.00
0.00
RNE
RNE
0557T 00
Category III
0.00
0.00
RNE
RNE
0558T 00
Category III
0.00
0.00
RNE
RNE
0559T 00
Category III
0.00
0.00
RNE
RNE
0560T 00
Category III
0.00
0.00
RNE
RNE
0561T 00
Category III
0.00
0.00
RNE
RNE
0562T 00
Category III
0.00
0.00
RNE
RNE
0563T 00
Category III
0.00
0.00
RNE
RNE
0564T 00
Category III
0.00
0.00
RNE
RNE
0565T 00
Category III
0.00
0.00
RNE
RNE
0566T 00
Category III
0.00
0.00
RNE
RNE
0567T 00
Category III
0.00
0.00
RNE
RNE
0568T 00
Category III
0.00
0.00
RNE
RNE
0569T 00
Category III
0.00
0.00
RNE
RNE
0570T 00
Category III
0.00
0.00
RNE
RNE
0571T 00
Category III
0.00
0.00
RNE
RNE
0572T 00
Category III
0.00
0.00
RNE
RNE
0573T 00
Category III
0.00
0.00
RNE
RNE
0574T 00
Category III
0.00
0.00
RNE
RNE
0575T 00
Category III
0.00
0.00
RNE
RNE
0576T 00
Category III
0.00
0.00
RNE
RNE
0577T 00
Category III
0.00
0.00
RNE
RNE
0578T 00
Category III
0.00
0.00
RNE
RNE
0579T 00
Category III
0.00
0.00
RNE
RNE
0580T 00
Category III
0.00
0.00
RNE
RNE
0581T 00
Category III
0.00
0.00
RNE
RNE
0582T 00
Category III
0.00
0.00
RNE
RNE
0583T 00
Category III
0.00
0.00
RNE
RNE
0584T 00
Category III
0.00
0.00
RNE
RNE
0585T 00
Category III
0.00
0.00
RNE
RNE
0586T 00
Category III
0.00
0.00
RNE
RNE
0587T 00
Category III
0.00
0.00
RNE
RNE
0588T 00
Category III
0.00
0.00
RNE
RNE
0589T 00
Category III
0.00
0.00
RNE
RNE
0590T 00
Category III
0.00
0.00
RNE
RNE
0591T 00
Category III
0.00
0.00
RNE
RNE
0592T 00
Category III
0.00
0.00
RNE
RNE
0593T 00
Category III
0.00
0.00
RNE
RNE
0594T 00
Category III
0.00
0.00
RNE
RNE
0596T 00
Category III
0.00
0.00
RNE
RNE
0597T 00
Category III
0.00
0.00
RNE
RNE
0598T 00
Category III
0.00
0.00
RNE
RNE
0599T 00
Category III
0.00
0.00
RNE
RNE
0600T 00
Category III
0.00
0.00
RNE
RNE
0601T 00
Category III
0.00
0.00
RNE
RNE
0602T 00
Category III
0.00
0.00
RNE
RNE
0603T 00
Category III
0.00
0.00
RNE
RNE
0604T 00
Category III
0.00
0.00
RNE
RNE
0605T 00
Category III
0.00
0.00
RNE
RNE
0606T 00
Category III
0.00
0.00
RNE
RNE
0607T 00
Category III
0.00
0.00
RNE
RNE
0608T 00
Category III
0.00
0.00
RNE
RNE
0609T 00
Category III
0.00
0.00
RNE
RNE
0610T 00
Category III
0.00
0.00
RNE
RNE
0611T 00
Category III
0.00
0.00
RNE
RNE
0612T 00
Category III
0.00
0.00
RNE
RNE
0613T 00
Category III
0.00
0.00
RNE
RNE
0614T 00
Category III
0.00
0.00
RNE
RNE
0615T 00
Category III
0.00
0.00
RNE
RNE
0616T 00
Category III
0.00
0.00
RNE
RNE
0617T 00
Category III
0.00
0.00
RNE
RNE
0618T 00
Category III
0.00
0.00
RNE
RNE
0619T 00
Category III
0.00
0.00
RNE
RNE
0620T 00
Category III
0.00
0.00
RNE
RNE
0621T 00
Category III
0.00
0.00
RNE
RNE
0622T 00
Category III
0.00
0.00
RNE
RNE
0623T 00
Category III
0.00
0.00
RNE
RNE
0624T 00
Category III
0.00
0.00
RNE
RNE
0625T 00
Category III
0.00
0.00
RNE
RNE
0626T 00
Category III
0.00
0.00
RNE
RNE
0627T 00
Category III
0.00
0.00
RNE
RNE
0628T 00
Category III
0.00
0.00
RNE
RNE
0629T 00
Category III
0.00
0.00
RNE
RNE
0630T 00
Category III
0.00
0.00
RNE
RNE
0631T 00
Category III
0.00
0.00
RNE
RNE
0632T 00
Category III
0.00
0.00
RNE
RNE
0633T 00
Category III
0.00
0.00
RNE
RNE
0633T 26
Category III
0.00
0.00
RNE
RNE
0633T TC
Category III
0.00
0.00
RNE
RNE
0634T 00
Category III
0.00
0.00
RNE
RNE
0634T 26
Category III
0.00
0.00
RNE
RNE
0634T TC
Category III
0.00
0.00
RNE
RNE
0635T 00
Category III
0.00
0.00
RNE
RNE
0635T 26
Category III
0.00
0.00
RNE
RNE
0635T TC
Category III
0.00
0.00
RNE
RNE
0636T 00
Category III
0.00
0.00
RNE
RNE
0636T 26
Category III
0.00
0.00
RNE
RNE
0636T TC
Category III
0.00
0.00
RNE
RNE
0637T 00
Category III
0.00
0.00
RNE
RNE
0637T 26
Category III
0.00
0.00
RNE
RNE
0637T TC
Category III
0.00
0.00
RNE
RNE
0638T 00
Category III
0.00
0.00
RNE
RNE
0638T 26
Category III
0.00
0.00
RNE
RNE
0638T TC
Category III
0.00
0.00
RNE
RNE
0639T 00
Category III
0.00
0.00
RNE
RNE
0640T 00
Category III
0.00
0.00
RNE
RNE
0643T 00
Category III
0.00
0.00
RNE
RNE
0644T 00
Category III
0.00
0.00
RNE
RNE
0645T 00
Category III
0.00
0.00
RNE
RNE
0646T 00
Category III
0.00
0.00
RNE
RNE
0647T 00
Category III
0.00
0.00
RNE
RNE
0648T 00
Category III
0.00
0.00
RNE
RNE
0648T 26
Category III
0.00
0.00
RNE
RNE
0648T TC
Category III
0.00
0.00
RNE
RNE
0649T 00
Category III
0.00
0.00
RNE
RNE
0649T 26
Category III
0.00
0.00
RNE
RNE
0649T TC
Category III
0.00
0.00
RNE
RNE
0650T 00
Category III
0.00
0.00
RNE
RNE
0650T 26
Category III
0.00
0.00
RNE
RNE
0650T TC
Category III
0.00
0.00
RNE
RNE
0651T 00
Category III
0.00
0.00
RNE
RNE
0652T 00
Category III
0.00
0.00
RNE
RNE
0653T 00
Category III
0.00
0.00
RNE
RNE
0654T 00
Category III
0.00
0.00
RNE
RNE
0655T 00
Category III
0.00
0.00
RNE
RNE
0656T 00
Category III
0.00
0.00
RNE
RNE
0657T 00
Category III
0.00
0.00
RNE
RNE
0658T 00
Category III
0.00
0.00
RNE
RNE
0659T 00
Category III
0.00
0.00
RNE
RNE
0660T 00
Category III
0.00
0.00
RNE
RNE
0661T 00
Category III
0.00
0.00
RNE
RNE
0662T 00
Category III
0.00
0.00
RNE
RNE
0663T 00
Category III
0.00
0.00
RNE
RNE
0664T 00
Category III
0.00
0.00
RNE
RNE
0665T 00
Category III
0.00
0.00
RNE
RNE
0666T 00
Category III
0.00
0.00
RNE
RNE
0667T 00
Category III
0.00
0.00
RNE
RNE
0668T 00
Category III
0.00
0.00
RNE
RNE
0669T 00
Category III
0.00
0.00
RNE
RNE
0670T 00
Category III
0.00
0.00
RNE
RNE
0671T 00
Category III
0.00
0.00
RNE
RNE
0672T 00
Category III
0.00
0.00
RNE
RNE
0673T 00
Category III
0.00
0.00
RNE
RNE
0674T 00
Category III
0.00
0.00
RNE
RNE
0675T 00
Category III
0.00
0.00
RNE
RNE
0676T 00
Category III
0.00
0.00
RNE
RNE
0677T 00
Category III
0.00
0.00
RNE
RNE
0678T 00
Category III
0.00
0.00
RNE
RNE
0679T 00
Category III
0.00
0.00
RNE
RNE
0680T 00
Category III
0.00
0.00
RNE
RNE
0681T 00
Category III
0.00
0.00
RNE
RNE
0682T 00
Category III
0.00
0.00
RNE
RNE
0683T 00
Category III
0.00
0.00
RNE
RNE
0683T 26
Category III
0.00
0.00
RNE
RNE
0683T TC
Category III
0.00
0.00
RNE
RNE
0684T 00
Category III
0.00
0.00
RNE
RNE
0684T 26
Category III
0.00
0.00
RNE
RNE
0684T TC
Category III
0.00
0.00
RNE
RNE
0685T 00
Category III
0.00
0.00
RNE
RNE
0685T 26
Category III
0.00
0.00
RNE
RNE
0685T TC
Category III
0.00
0.00
RNE
RNE
0686T 00
Category III
0.00
0.00
RNE
RNE
0687T 00
Category III
0.00
0.00
RNE
RNE
0688T 00
Category III
0.00
0.00
RNE
RNE
0689T 00
Category III
0.00
0.00
RNE
RNE
0689T 26
Category III
0.00
0.00
RNE
RNE
0689T TC
Category III
0.00
0.00
RNE
RNE
0690T 00
Category III
0.00
0.00
RNE
RNE
0690T 26
Category III
0.00
0.00
RNE
RNE
0690T TC
Category III
0.00
0.00
RNE
RNE
0691T 00
Category III
0.00
0.00
RNE
RNE
0691T 26
Category III
0.00
0.00
RNE
RNE
0691T TC
Category III
0.00
0.00
RNE
RNE
0692T 00
Category III
0.00
0.00
RNE
RNE
0693T 00
Category III
0.00
0.00
RNE
RNE
0694T 00
Category III
0.00
0.00
RNE
RNE
0694T 26
Category III
0.00
0.00
RNE
RNE
0694T TC
Category III
0.00
0.00
RNE
RNE
0695T 00
Category III
0.00
0.00
RNE
RNE
0696T 00
Category III
0.00
0.00
RNE
RNE
0697T 00
Category III
0.00
0.00
RNE
RNE
0697T 26
Category III
0.00
0.00
RNE
RNE
0697T TC
Category III
0.00
0.00
RNE
RNE
0698T 00
Category III
0.00
0.00
RNE
RNE
0698T 26
Category III
0.00
0.00
RNE
RNE
0698T TC
Category III
0.00
0.00
RNE
RNE
0699T 00
Category III
0.00
0.00
RNE
RNE
0700T 00
Category III
0.00
0.00
RNE
RNE
0700T 26
Category III
0.00
0.00
RNE
RNE
0700T TC
Category III
0.00
0.00
RNE
RNE
0701T 00
Category III
0.00
0.00
RNE
RNE
0701T 26
Category III
0.00
0.00
RNE
RNE
0701T TC
Category III
0.00
0.00
RNE
RNE
0704T 00
Category III
0.00
0.00
RNE
RNE
0705T 00
Category III
0.00
0.00
RNE
RNE
0706T 00
Category III
0.00
0.00
RNE
RNE
0707T 00
Category III
0.00
0.00
RNE
RNE
0708T 00
Category III
0.00
0.00
RNE
RNE
0709T 00
Category III
0.00
0.00
RNE
RNE
0710T 00
Category III
0.00
0.00
RNE
RNE
0711T 00
Category III
0.00
0.00
RNE
RNE
0712T 00
Category III
0.00
0.00
RNE
RNE
0713T 00
Category III
0.00
0.00
RNE
RNE
0714T 00
Category III
0.00
0.00
RNE
RNE
0716T 00
Category III
0.00
0.00
RNE
RNE
0717T 00
Category III
0.00
0.00
RNE
RNE
0718T 00
Category III
0.00
0.00
RNE
RNE
0719T 00
Category III
0.00
0.00
RNE
RNE
0720T 00
Category III
0.00
0.00
RNE
RNE
0721T 00
Category III
0.00
0.00
RNE
RNE
0721T 26
Category III
0.00
0.00
RNE
RNE
0721T TC
Category III
0.00
0.00
RNE
RNE
0722T 00
Category III
0.00
0.00
RNE
RNE
0722T 26
Category III
0.00
0.00
RNE
RNE
0722T TC
Category III
0.00
0.00
RNE
RNE
0723T 00
Category III
0.00
0.00
RNE
RNE
0723T 26
Category III
0.00
0.00
RNE
RNE
0723T TC
Category III
0.00
0.00
RNE
RNE
0724T 00
Category III
0.00
0.00
RNE
RNE
0724T 26
Category III
0.00
0.00
RNE
RNE
0724T TC
Category III
0.00
0.00
RNE
RNE
0725T 00
Category III
0.00
0.00
RNE
RNE
0726T 00
Category III
0.00
0.00
RNE
RNE
0727T 00
Category III
0.00
0.00
RNE
RNE
0728T 00
Category III
0.00
0.00
RNE
RNE
0729T 00
Category III
0.00
0.00
RNE
RNE
0730T 00
Category III
0.00
0.00
RNE
RNE
0731T 00
Category III
0.00
0.00
RNE
RNE
0732T 00
Category III
0.00
0.00
RNE
RNE
0733T 00
Category III
0.00
0.00
RNE
RNE
0734T 00
Category III
0.00
0.00
RNE
RNE
0735T 00
Category III
0.00
0.00
RNE
RNE
0736T 00
Category III
0.00
0.00
RNE
RNE
0737T 00
Category III
0.00
0.00
RNE
RNE
0738T 00
Category III
0.00
0.00
RNE
RNE
0739T 00
Category III
0.00
0.00
RNE
RNE
0740T 00
Category III
0.00
0.00
RNE
RNE
0741T 00
Category III
0.00
0.00
RNE
RNE
0742T 00
Category III
0.00
0.00
RNE
RNE
0742T 26
Category III
0.00
0.00
RNE
RNE
0742T TC
Category III
0.00
0.00
RNE
RNE
0743T 00
Category III
0.00
0.00
RNE
RNE
0743T 26
Category III
0.00
0.00
RNE
RNE
0743T TC
Category III
0.00
0.00
RNE
RNE
0744T 00
Category III
0.00
0.00
RNE
RNE
0745T 00
Category III
0.00
0.00
RNE
RNE
0746T 00
Category III
0.00
0.00
RNE
RNE
0747T 00
Category III
0.00
0.00
RNE
RNE
0748T 00
Category III
0.00
0.00
RNE
RNE
0749T 00
Category III
0.00
0.00
RNE
RNE
0750T 00
Category III
0.00
0.00
RNE
RNE
0751T 00
Category III
0.00
0.00
RNE
RNE
0752T 00
Category III
0.00
0.00
RNE
RNE
0753T 00
Category III
0.00
0.00
RNE
RNE
0754T 00
Category III
0.00
0.00
RNE
RNE
0755T 00
Category III
0.00
0.00
RNE
RNE
0756T 00
Category III
0.00
0.00
RNE
RNE
0757T 00
Category III
0.00
0.00
RNE
RNE
0758T 00
Category III
0.00
0.00
RNE
RNE
0759T 00
Category III
0.00
0.00
RNE
RNE
0760T 00
Category III
0.00
0.00
RNE
RNE
0761T 00
Category III
0.00
0.00
RNE
RNE
0762T 00
Category III
0.00
0.00
RNE
RNE
0763T 00
Category III
0.00
0.00
RNE
RNE
0764T 00
Category III
0.00
0.00
RNE
RNE
0765T 00
Category III
0.00
0.00
RNE
RNE
0766T 00
Category III
0.00
0.00
RNE
RNE
0767T 00
Category III
0.00
0.00
RNE
RNE
0770T 00
Category III
0.00
0.00
RNE
RNE
0771T 00
Category III
0.00
0.00
RNE
RNE
0772T 00
Category III
0.00
0.00
RNE
RNE
0773T 00
Category III
0.00
0.00
RNE
RNE
0774T 00
Category III
0.00
0.00
RNE
RNE
0776T 00
Category III
0.00
0.00
RNE
RNE
0777T 00
Category III
0.00
0.00
RNE
RNE
0777T 26
Category III
0.00
0.00
RNE
RNE
0777T TC
Category III
0.00
0.00
RNE
RNE
0778T 00
Category III
0.00
0.00
RNE
RNE
0779T 00
Category III
0.00
0.00
RNE
RNE
0779T 26
Category III
0.00
0.00
RNE
RNE
0779T TC
Category III
0.00
0.00
RNE
RNE
0780T 00
Category III
0.00
0.00
RNE
RNE
0781T 00
Category III
0.00
0.00
RNE
RNE
0782T 00
Category III
0.00
0.00
RNE
RNE
0783T 00
Category III
0.00
0.00
RNE
RNE
0784T 00
Category III
0.00
0.00
RNE
RNE
0785T 00
Category III
0.00
0.00
RNE
RNE
0786T 00
Category III
0.00
0.00
RNE
RNE
0787T 00
Category III
0.00
0.00
RNE
RNE
0788T 00
Category III
0.00
0.00
RNE
RNE
0789T 00
Category III
0.00
0.00
RNE
RNE
0790T 00
Category III
0.00
0.00
RNE
RNE
0791T 00
Category III
0.00
0.00
RNE
RNE
0792T 00
Category III
0.00
0.00
RNE
RNE
0793T 00
Category III
0.00
0.00
RNE
RNE
0794T 00
Category III
0.00
0.00
RNE
RNE
0795T 00
Category III
0.00
0.00
RNE
RNE
0796T 00
Category III
0.00
0.00
RNE
RNE
0797T 00
Category III
0.00
0.00
RNE
RNE
0798T 00
Category III
0.00
0.00
RNE
RNE
0799T 00
Category III
0.00
0.00
RNE
RNE
0800T 00
Category III
0.00
0.00
RNE
RNE
0801T 00
Category III
0.00
0.00
RNE
RNE
0802T 00
Category III
0.00
0.00
RNE
RNE
0803T 00
Category III
0.00
0.00
RNE
RNE
0804T 00
Category III
0.00
0.00
RNE
RNE
0804T 26
Category III
0.00
0.00
RNE
RNE
0804T TC
Category III
0.00
0.00
RNE
RNE
0805T 00
Category III
0.00
0.00
RNE
RNE
0806T 00
Category III
0.00
0.00
RNE
RNE
0807T 00
Category III
0.00
0.00
RNE
RNE
0807T 26
Category III
0.00
0.00
RNE
RNE
0807T TC
Category III
0.00
0.00
RNE
RNE
0808T 00
Category III
0.00
0.00
RNE
RNE
0808T 26
Category III
0.00
0.00
RNE
RNE
0808T TC
Category III
0.00
0.00
RNE
RNE
0810T 00
Category III
0.00
0.00
RNE
RNE
0811T 00
Category III
0.00
0.00
RNE
RNE
0812T 00
Category III
0.00
0.00
RNE
RNE
0813T 00
Category III
0.00
0.00
RNE
RNE
0814T 00
Category III
0.00
0.00
RNE
RNE
0815T 00
Category III
0.00
0.00
RNE
RNE
0815T 26
Category III
0.00
0.00
RNE
RNE
0815T TC
Category III
0.00
0.00
RNE
RNE
0816T 00
Category III
0.00
0.00
RNE
RNE
0817T 00
Category III
0.00
0.00
RNE
RNE
0818T 00
Category III
0.00
0.00
RNE
RNE
0819T 00
Category III
0.00
0.00
RNE
RNE
0820T 00
Category III
0.00
0.00
RNE
RNE
0821T 00
Category III
0.00
0.00
RNE
RNE
0822T 00
Category III
0.00
0.00
RNE
RNE
0823T 00
Category III
0.00
0.00
RNE
RNE
0824T 00
Category III
0.00
0.00
RNE
RNE
0825T 00
Category III
0.00
0.00
RNE
RNE
0826T 00
Category III
0.00
0.00
RNE
RNE
0826T 26
Category III
0.00
0.00
RNE
RNE
0826T TC
Category III
0.00
0.00
RNE
RNE
0827T 00
Category III
0.00
0.00
RNE
RNE
0828T 00
Category III
0.00
0.00
RNE
RNE
0829T 00
Category III
0.00
0.00
RNE
RNE
0830T 00
Category III
0.00
0.00
RNE
RNE
0831T 00
Category III
0.00
0.00
RNE
RNE
0832T 00
Category III
0.00
0.00
RNE
RNE
0833T 00
Category III
0.00
0.00
RNE
RNE
0834T 00
Category III
0.00
0.00
RNE
RNE
0835T 00
Category III
0.00
0.00
RNE
RNE
0836T 00
Category III
0.00
0.00
RNE
RNE
0837T 00
Category III
0.00
0.00
RNE
RNE
0838T 00
Category III
0.00
0.00
RNE
RNE
0839T 00
Category III
0.00
0.00
RNE
RNE
0840T 00
Category III
0.00
0.00
RNE
RNE
0841T 00
Category III
0.00
0.00
RNE
RNE
0842T 00
Category III
0.00
0.00
RNE
RNE
0843T 00
Category III
0.00
0.00
RNE
RNE
0844T 00
Category III
0.00
0.00
RNE
RNE
0845T 00
Category III
0.00
0.00
RNE
RNE
0846T 00
Category III
0.00
0.00
RNE
RNE
0847T 00
Category III
0.00
0.00
RNE
RNE
0848T 00
Category III
0.00
0.00
RNE
RNE
0849T 00
Category III
0.00
0.00
RNE
RNE
0850T 00
Category III
0.00
0.00
RNE
RNE
0851T 00
Category III
0.00
0.00
RNE
RNE
0852T 00
Category III
0.00
0.00
RNE
RNE
0853T 00
Category III
0.00
0.00
RNE
RNE
0854T 00
Category III
0.00
0.00
RNE
RNE
0855T 00
Category III
0.00
0.00
RNE
RNE
0856T 00
Category III
0.00
0.00
RNE
RNE
0857T 00
Category III
0.00
0.00
RNE
RNE
0857T 26
Category III
0.00
0.00
RNE
RNE
0857T TC
Category III
0.00
0.00
RNE
RNE
0858T 00
Category III
0.00
0.00
RNE
RNE
0858T 26
Category III
0.00
0.00
RNE
RNE
0858T TC
Category III
0.00
0.00
RNE
RNE
0859T 00
Category III
0.00
0.00
RNE
RNE
0860T 00
Category III
0.00
0.00
RNE
RNE
0861T 00
Category III
0.00
0.00
RNE
RNE
0862T 00
Category III
0.00
0.00
RNE
RNE
0863T 00
Category III
0.00
0.00
RNE
RNE
0864T 00
Category III
0.00
0.00
RNE
RNE
0865T 00
Category III
0.00
0.00
RNE
RNE
0865T 26
Category III
0.00
0.00
RNE
RNE
0865T TC
Category III
0.00
0.00
RNE
RNE
0866T 00
Category III
0.00
0.00
RNE
RNE
0866T 26
Category III
0.00
0.00
RNE
RNE
0866T TC
Category III
0.00
0.00
RNE
RNE
HCPCS GUIDELINES
Information regarding the incorporation of HCPCS codes is
				  found in the Introduction to the Fee Schedule.
HCPCS codes are five-character codes with a leading
				  alpha-character followed by four numeric digits.
The following Commission guidelines are provided in addition
				  to the Center for Medicare & Medicaid Services' (CMS) HCPCS codes and
				  descriptions and represent additional guidance from the Commission relative to
				  services unique or uniquely utilized in Workers' Compensation. To the extent
				  that a conflict may exist between an incorporated HCPCS code and a code,
				  guideline, identifier, or modifier unique to Arizona, then the Arizona code,
				  guideline, identifier, or modifier shall control. Codes that contain
				  explanatory language specific to Arizona are preceded by Î" in this Fee
				  Schedule. Codes that are unique to Arizona are preceded by an AZ identifier and
				  numbered in the following format: AZxxx.
HCPCS codes in this section are used to bill for services,
				  equipment, and supplies including:
* Medical and surgical supplies
* Durable medical equipment
* Physician-administered drugs
* Prosthetics and orthotics
* Vision and hearing supplies
In this section, any reference to Durable Medical Equipment
				  (DME) includes reimbursable supplies, prosthetics, and orthotics
A. REIMBURSEMENT
1. Materials and supplies normally necessary to perform a
				  service, such as needles and syringes, ultrasound pads and gel, band-aids, and
				  dressings are considered part of a healthcare provider's overhead and are not
				  separately reimbursable. Please see Section J of the Introduction Guidelines to
				  the Fee Schedule for more examples of non-reimbursable supplies and
				  materials.
2. This section of the fee schedule includes maximum
				  reimbursement amounts for DME, services, and procedures billed with HCPCS
				  codes.
3. DME dispensed by a healthcare provider to the patient
				  ancillary to an office visit shall be reimbursed at the lesser of the
				  provider's billed charge or the value listed in the fee schedule.
4. DME may be reimbursed differently based on whether the zip
				  code where the materials are provided are classified by CMS as rural or
				  nonrural. The fee schedule includes different rates for rural and nonrural zip
				  codes where applicable. The zip codes included on the list below shall be
				  reimbursed based on the fees in the "Rural" column in the fee schedule. All
				  other zip codes shall be reimbursed based on the "Nonrural" fee.
Rural Zip Codes
85135
85371
85542
85621
85920
85936
86034
86511
85192
85390
85543
85623
85922
85937
86039
86512
85320
85501
85544
85624
85923
85938
86042
86514
85321
85502
85545
85628
85924
85939
86043
86515
85325
85530
85546
85631
85925
85940
86047
86520
85328
85531
85547
85634
85926
85941
86054
86535
85334
85532
85548
85637
85927
85942
86502
86538
85341
85533
85550
85640
85928
86025
86503
86540
85344
85534
85551
85646
85929
86028
86504
86544
85346
85535
85552
85648
85930
86029
86505
86545
85348
85536
85553
85901
85932
86030
86506
86547
85357
85539
85554
85902
85933
86031
86507
86556
85358
85540
85611
85911
85934
86032
86508
85359
85541
85618
85912
85935
86033
86510
5. DME shipped to the patient shall be reimbursed based on
				  the location of the patient when determining if the fees for rural or nonrural
				  zip codes apply.
6. HCPCS codes describing physician-administered drugs and
				  biologicals including, chemotherapy and immunosuppressive drugs, inhalation
				  solutions and other miscellaneous drugs and solutions shall be used when
				  billing for these products. Please refer to the Pharmaceutical Fee Schedule for
				  billing and reimbursement information for prescription and over-the-counter
				  drugs, including those that are described by HCPCS codes.
7. Services and materials that are listed as By Report or
				  have no listed value in the fee schedule, shall be reimbursed based on a
				  predetermined agreement between the provider and the payer. HCPCS codes
				  representing professional services that are not listed in the fee schedule may
				  be reimbursed based on a predetermined agreement between the provider and the
				  payer.
8. Reimbursement for DME shall not be less than the actual
				  cost of an item. Specialized (
e.g.,
bariatric) equipment may
				  have an actual cost that is greater than the reimbursement value listed in the
				  Fee Schedule. The DME provider must demonstrate the actual cost of the DME is
				  greater than the listed reimbursement value by presenting a copy of the
				  original invoice for that item. The reimbursement value for the item shall be
				  based on a predetermined agreement between the DME provider and the payer. When
				  the DME was procured from an intermediary entity (
e.g.,
wholesaler) and not the original manufacturer, the provider must disclose any
				  rebates, reductions, discounts, or relationship with that intermediary entity
				  and the impact on the original manufacturer's cost of that item.
9. Home Health Care - please see the Home Health Care Fee
				  Schedule Guidelines.
B. MODIFIERS
1. As appropriate, durable medical equipment, should be
				  billed with the following modifiers:
a. NU - indicates the purchase of new equipment.
b. UE - indicates the purchase of used equipment.
c. RR - indicates that the equipment is being rented. Rental
				  periods shall be considered monthly unless defined differently in the code
				  description.
i. The maximum rental period is 13 months. After 13 months,
				  the equipment shall be considered purchased.
Note:
Not all durable medical equipment will
				  have modifiers. For example, certain supplies are low cost and therefore will
				  not have used or rental options; other codes may have "rental" or "used"
				  included in the code description.
C. BILLING
1. Providers of orthotics and prostheses may bill for
				  fitting, training, and management using CPT®
				  codes 97760-97763.
2. DME and Implantable devices shall be billed separately
				  from facility and professional service fees only if they are not considered
				  bundled with the primary service code.
3. Certain DME may be rented. Determination to purchase or
				  rent DME shall be based on CMS Medicare guidelines in effect on the date the
				  patient takes possession of the DME.
4. Materials, supplies, and equipment billed with a
				  miscellaneous code (e.g., E1399 - durable medical equipment, miscellaneous)
				  shall include the brand name and model number of the DME being supplied when
				  available.
5. Actual shipping or delivery costs necessary to transit DME
				  to the injured worker may be billed. Documentation demonstrating the cost of
				  shipping shall be included with the invoice.
ARIZONA PHYSICIANS' FEE SCHEDULE
HCPCS Codes 2024
Code
Modifier
FY24 Non-rural
							 Rate
FY24 Rural Rate
A2001
$ 737.28
$ 737.28
A2002
$ 99.12
$ 99.12
A2005
$ 234.63
$ 234.63
A2006
BR
BR
A2007
$ 314.38
$ 314.38
A2008
BR
BR
A2009
$ 67.13
$ 67.13
A2010
BR
BR
A2011
BR
BR
A2012
BR
BR
A2013
$ 1,005.31
$ 1,005.31
A2014
$ 43.64
$ 43.64
A4100
BR
BR
A4206
$ 0.77
$ 0.77
A4207
$ 1.36
$ 1.36
A4208
$ 6.79
$ 6.79
A4209
$ 1.36
$ 1.36
A4210
$ 1.36
$ 1.36
A4211
$ 23.88
$ 23.88
A4212
$ 9.90
$ 9.90
A4213
$ 4.07
$ 4.07
A4215
$ 0.84
$ 0.84
A4216
$ 0.84
$ 0.84
A4217
$ 5.99
$ 5.99
A4218
$ 1.30
$ 1.30
A4220
$ 50.44
$ 50.44
A4221
$ 34.24
$ 38.39
A4222
$ 64.95
$ 74.65
A4223
$ 80.60
$ 80.60
A4224
$ 34.24
$ 38.39
A4225
$ 4.59
$ 4.79
A4230
$ 9.90
$ 9.90
A4231
$ 6.79
$ 6.79
A4232
$ 3.18
$ 3.18
A4233
NU
$ 0.71
$ 0.71
A4234
NU
$ 3.30
$ 3.30
A4235
NU
$ 1.40
$ 1.40
A4236
NU
$ 1.62
$ 1.62
A4238
$ 407.62
$ 407.62
A4239
$ 366.30
$ 366.30
A4244
$ 1.81
$ 1.81
A4245
$ 4.98
$ 4.98
A4246
$ 6.79
$ 6.79
A4247
$ 9.90
$ 9.90
A4248
$ 0.10
$ 0.10
A4250
$ 16.70
$ 16.70
A4252
$ 13.08
$ 13.08
A4253
NU
$ 11.65
$ 11.65
A4255
$ 7.85
$ 7.85
A4256
$ 4.73
$ 4.73
A4257
$ 24.37
$ 24.37
A4258
$ 2.97
$ 2.97
A4259
$ 1.99
$ 1.99
A4262
$ 20.27
$ 20.27
A4263
$ 45.05
$ 45.05
A4264
$ 67.52
$ 67.52
A4265
$ 6.51
$ 6.51
A4266
$ 61.70
$ 61.70
A4267
$ 0.67
$ 0.67
A4268
$ 0.84
$ 0.84
A4269
$ 15.79
$ 15.79
A4270
$ 11.72
$ 11.72
A4280
$ 9.90
$ 9.90
A4281
$ 13.47
$ 13.47
A4282
$ 14.88
$ 14.88
A4283
$ 2.66
$ 2.66
A4284
$ 7.18
$ 7.18
A4285
$ 4.98
$ 4.98
A4286
$ 5.89
$ 5.89
A4290
$ 234.63
$ 234.63
A4300
$ 16.70
$ 16.70
A4301
$ 166.19
$ 166.19
A4305
$ 53.61
$ 53.61
A4306
$ 26.60
$ 26.60
A4310
$ 14.73
$ 14.73
A4311
$ 28.01
$ 28.01
A4312
$ 34.45
$ 34.45
A4313
$ 35.38
$ 35.38
A4314
$ 41.05
$ 41.05
A4315
$ 50.39
$ 50.39
A4316
$ 54.25
$ 54.25
A4320
$ 10.04
$ 10.04
A4321
$ 22.08
$ 22.08
A4322
$ 5.82
$ 5.82
A4326
$ 20.61
$ 20.61
A4327
$ 80.74
$ 80.74
A4328
$ 19.94
$ 19.94
A4330
$ 13.69
$ 13.69
A4331
$ 6.08
$ 6.08
A4332
$ 0.21
$ 0.21
A4333
$ 4.24
$ 4.24
A4334
$ 9.39
$ 9.39
A4335
BR
BR
A4336
$ 2.74
$ 2.74
A4338
$ 23.44
$ 23.44
A4340
$ 60.65
$ 60.65
A4341
$ 466.12
$ 466.12
A4342
$ 1,176.92
$ 1,176.92
A4344
$ 30.58
$ 30.58
A4346
$ 36.78
$ 36.78
A4349
$ 3.84
$ 3.84
A4351
$ 3.46
$ 3.46
A4352
$ 12.26
$ 12.26
A4353
$ 13.38
$ 13.38
A4354
$ 22.55
$ 22.55
A4355
$ 15.04
$ 15.04
A4356
$ 81.76
$ 81.76
A4357
$ 18.45
$ 18.45
A4358
$ 11.26
$ 11.26
A4360
$ 0.90
$ 0.90
A4361
$ 35.07
$ 35.07
A4362
$ 6.64
$ 6.64
A4363
$ 4.24
$ 4.24
A4364
$ 5.61
$ 5.61
A4366
$ 2.46
$ 2.46
A4367
$ 14.06
$ 14.06
A4368
$ 0.48
$ 0.48
A4369
$ 3.93
$ 3.93
A4371
$ 6.86
$ 6.86
A4372
$ 8.02
$ 8.02
A4373
$ 11.97
$ 11.97
A4375
$ 32.80
$ 32.80
A4376
$ 90.89
$ 90.89
A4377
$ 8.19
$ 8.19
A4378
$ 58.73
$ 58.73
A4379
$ 28.69
$ 28.69
A4380
$ 71.32
$ 71.32
A4381
$ 8.83
$ 8.83
A4382
$ 47.03
$ 47.03
A4383
$ 53.84
$ 53.84
A4384
$ 18.35
$ 18.35
A4385
$ 9.73
$ 9.73
A4387
$ 4.30
$ 4.30
A4388
$ 8.33
$ 8.33
A4389
$ 11.86
$ 11.86
A4390
$ 18.34
$ 18.34
A4391
$ 13.50
$ 13.50
A4392
$ 15.61
$ 15.61
A4393
$ 17.26
$ 17.26
A4394
$ 4.96
$ 4.96
A4395
$ 0.07
$ 0.07
A4396
$ 77.32
$ 77.32
A4398
$ 26.40
$ 26.40
A4399
$ 23.44
$ 23.44
A4400
$ 93.35
$ 93.35
A4402
$ 3.05
$ 3.05
A4404
$ 2.93
$ 2.93
A4405
$ 6.52
$ 6.52
A4406
$ 10.93
$ 10.93
A4407
$ 16.73
$ 16.73
A4408
$ 18.86
$ 18.86
A4409
$ 11.86
$ 11.86
A4410
$ 17.26
$ 17.26
A4411
$ 9.73
$ 9.73
A4412
$ 5.17
$ 5.17
A4413
$ 10.53
$ 10.53
A4414
$ 9.39
$ 9.39
A4415
$ 11.45
$ 11.45
A4416
$ 5.26
$ 5.26
A4417
$ 7.13
$ 7.13
A4418
$ 3.46
$ 3.46
A4419
$ 3.29
$ 3.29
A4420
$ 1.81
$ 1.81
A4421
BR
BR
A4422
$ 0.21
$ 0.21
A4423
$ 3.54
$ 3.54
A4424
$ 9.09
$ 9.09
A4425
$ 6.83
$ 6.83
A4426
$ 5.21
$ 5.21
A4427
$ 5.33
$ 5.33
A4428
$ 12.46
$ 12.46
A4429
$ 15.76
$ 15.76
A4430
$ 16.27
$ 16.27
A4431
$ 11.86
$ 11.86
A4432
$ 6.85
$ 6.85
A4433
$ 6.41
$ 6.41
A4434
$ 7.18
$ 7.18
A4435
$ 11.00
$ 11.00
A4436
$ 31.14
$ 31.14
A4437
$ 31.14
$ 31.14
A4450
$ 0.11
$ 0.11
A4452
$ 0.42
$ 0.42
A4453
$ 42.34
$ 42.34
A4455
$ 2.31
$ 2.31
A4456
$ 0.46
$ 0.46
A4458
$ 7.18
$ 7.18
A4459
$ 4,101.89
$ 4,101.89
A4461
$ 6.30
$ 6.30
A4463
$ 25.42
$ 25.42
A4465
$ 28.87
$ 28.87
A4467
$ 23.44
$ 23.44
A4480
$ 20.27
$ 20.27
A4481
$ 0.70
$ 0.70
A4483
$ 4.52
$ 4.52
A4495
$ 26.15
$ 26.15
A4500
$ 26.15
$ 26.15
A4510
$ 83.78
$ 83.78
A4520
$ 0.77
$ 0.77
A4541
$ 54.15
$ 54.15
A4542
$ 706.17
$ 706.17
A4550
$ 36.06
$ 36.06
A4553
$ 10.81
$ 10.81
A4554
$ 0.46
$ 0.46
A4555
$ 13.47
$ 13.47
A4556
$ 23.20
$ 23.20
A4557
$ 15.93
$ 26.43
A4558
$ 10.42
$ 10.42
A4559
$ 0.18
$ 0.18
A4561
$ 38.11
$ 38.11
A4562
$ 94.91
$ 94.91
A4563
$ 2,198.63
$ 2,198.63
A4565
$ 14.71
$ 14.71
A4566
$ 29.65
$ 29.65
A4570
$ 23.44
$ 23.44
A4575
$ 485.56
$ 485.56
A4580
$ 67.13
$ 67.13
A4590
$ 53.61
$ 53.61
A4595
$ 17.00
$ 36.36
A4596
$ 54.15
$ 54.15
A4600
$ 27.97
$ 27.97
A4601
$ 103.12
$ 103.12
A4602
NU
$ 7.13
$ 7.13
A4604
NU
$ 65.55
$ 91.69
A4605
NU
$ 31.33
$ 31.33
A4606
$ 63.06
$ 63.06
A4608
$ 95.76
$ 95.76
A4613
NU
$ 480.05
$ 480.05
A4613
RR
$ 48.30
$ 48.30
A4613
UE
$ 359.80
$ 359.80
A4614
$ 45.43
$ 45.43
A4615
$ 1.40
$ 1.40
A4616
$ 0.11
$ 0.11
A4617
$ 5.92
$ 5.92
A4618
NU
$ 14.45
$ 14.45
A4618
RR
$ 1.97
$ 1.97
A4618
UE
$ 10.84
$ 10.84
A4619
NU
$ 3.40
$ 3.47
A4620
$ 1.15
$ 1.15
A4623
$ 10.65
$ 10.65
A4624
NU
$ 5.04
$ 5.04
A4625
$ 12.59
$ 12.59
A4626
$ 5.18
$ 5.18
A4627
$ 26.99
$ 26.99
A4628
NU
$ 6.97
$ 6.97
A4629
$ 8.83
$ 8.83
A4630
NU
$ 11.82
$ 11.82
A4633
NU
$ 78.40
$ 78.40
A4635
NU
$ 8.29
$ 8.29
A4635
RR
$ 1.33
$ 1.33
A4635
UE
$ 5.53
$ 5.53
A4636
NU
$ 5.25
$ 5.57
A4636
RR
$ 0.53
$ 0.62
A4636
UE
$ 3.93
$ 4.12
A4637
NU
$ 2.91
$ 2.95
A4637
RR
$ 0.29
$ 0.39
A4637
UE
$ 2.18
$ 2.23
A4639
RR
$ 54.88
$ 54.88
A4640
NU
$ 82.33
$ 99.36
A4640
RR
$ 8.23
$ 10.96
A4640
UE
$ 61.75
$ 72.39
A4648
$ 214.35
$ 214.35
A4649
BR
BR
A4651
$ 9.90
$ 9.90
A4657
$ 0.91
$ 0.91
A4660
$ 41.44
$ 41.44
A4663
$ 33.35
$ 33.35
A4670
$ 112.59
$ 112.59
A4671
$ 90.51
$ 90.51
A4674
$ 81.12
$ 81.12
A4680
$ 95.89
$ 95.89
A4690
$ 138.74
$ 138.74
A4706
$ 41.44
$ 41.44
A4709
$ 40.53
$ 40.53
A4714
$ 25.26
$ 25.26
A4723
$ 13.08
$ 13.08
A4725
$ 8.09
$ 8.09
A4726
$ 37.35
$ 37.35
A4736
$ 31.53
$ 31.53
A4750
$ 11.27
$ 11.27
A4755
$ 92.32
$ 92.32
A4770
$ 6.79
$ 6.79
A4772
$ 1.30
$ 1.30
A4860
$ 5.89
$ 5.89
A4890
$ 442.32
$ 442.32
A4911
$ 10.81
$ 10.81
A4913
BR
BR
A4927
$ 10.81
$ 10.81
A4928
$ 4.91
$ 4.91
A4930
$ 0.78
$ 0.78
A4931
$ 11.72
$ 11.72
A5051
$ 3.93
$ 3.93
A5052
$ 2.84
$ 2.84
A5053
$ 2.80
$ 2.80
A5054
$ 3.43
$ 3.43
A5055
$ 2.66
$ 2.66
A5056
$ 8.93
$ 8.93
A5057
$ 18.34
$ 18.34
A5061
$ 6.75
$ 6.75
A5062
$ 3.96
$ 3.96
A5063
$ 5.17
$ 5.17
A5071
$ 11.48
$ 11.48
A5072
$ 6.58
$ 6.58
A5073
$ 5.81
$ 5.81
A5081
$ 5.38
$ 5.38
A5082
$ 19.32
$ 19.32
A5083
$ 1.23
$ 1.23
A5093
$ 3.74
$ 3.74
A5102
$ 37.32
$ 37.32
A5105
$ 77.88
$ 77.88
A5112
$ 66.15
$ 66.15
A5113
$ 9.00
$ 9.00
A5114
$ 17.09
$ 17.09
A5120
$ 0.42
$ 0.42
A5121
$ 12.10
$ 12.10
A5122
$ 24.53
$ 24.53
A5126
$ 2.51
$ 2.51
A5131
$ 25.75
$ 25.75
A5200
$ 21.57
$ 21.57
A5500
$ 121.48
$ 121.48
A5501
$ 364.31
$ 364.31
A5503
$ 61.95
$ 61.95
A5504
$ 61.95
$ 61.95
A5505
$ 61.95
$ 61.95
A5506
$ 61.95
$ 61.95
A5507
$ 61.95
$ 61.95
A5508
$ 73.81
$ 73.81
A5510
$ 108.05
$ 108.05
A5512
$ 49.55
$ 49.55
A5513
$ 73.93
$ 73.93
A5514
$ 73.93
$ 73.93
A6010
$ 59.16
$ 59.16
A6011
$ 4.37
$ 4.37
A6021
$ 40.17
$ 40.17
A6022
$ 40.17
$ 40.17
A6023
$ 363.54
$ 363.54
A6024
$ 11.82
$ 11.82
A6025
$ 22.47
$ 22.47
A6154
$ 27.44
$ 27.44
A6196
$ 14.06
$ 14.06
A6197
$ 31.42
$ 31.42
A6198
$ 26.15
$ 26.15
A6199
$ 10.08
$ 10.08
A6203
$ 6.44
$ 6.44
A6204
$ 11.89
$ 11.89
A6205
$ 0.28
$ 0.28
A6206
$ 9.00
$ 9.00
A6207
$ 14.03
$ 14.03
A6208
$ 69.85
$ 69.85
A6209
$ 14.28
$ 14.28
A6210
$ 38.07
$ 38.07
A6211
$ 56.11
$ 56.11
A6212
$ 18.55
$ 18.55
A6213
$ 12.68
$ 12.68
A6214
$ 19.67
$ 19.67
A6215
$ 4.07
$ 4.07
A6216
$ 0.07
$ 0.07
A6217
$ 0.29
$ 0.29
A6218
$ 0.17
$ 0.17
A6219
$ 1.82
$ 1.82
A6220
$ 4.96
$ 4.96
A6221
$ 2.72
$ 2.72
A6222
$ 4.07
$ 4.07
A6223
$ 4.63
$ 4.63
A6224
$ 6.87
$ 6.87
A6228
$ 4.47
$ 4.47
A6229
$ 6.87
$ 6.87
A6231
$ 8.96
$ 8.96
A6232
$ 13.12
$ 13.12
A6233
$ 36.62
$ 36.62
A6234
$ 12.52
$ 12.52
A6235
$ 32.13
$ 32.13
A6236
$ 52.05
$ 52.05
A6237
$ 15.11
$ 15.11
A6238
$ 43.55
$ 43.55
A6240
$ 23.39
$ 23.39
A6241
$ 4.91
$ 4.91
A6242
$ 11.56
$ 11.56
A6243
$ 23.55
$ 23.55
A6244
$ 75.04
$ 75.04
A6245
$ 13.89
$ 13.89
A6246
$ 18.97
$ 18.97
A6247
$ 45.43
$ 45.43
A6248
$ 31.04
$ 31.04
A6251
$ 3.79
$ 3.79
A6252
$ 6.22
$ 6.22
A6253
$ 12.10
$ 12.10
A6254
$ 2.28
$ 2.28
A6255
$ 5.81
$ 5.81
A6256
$ 3.11
$ 3.11
A6257
$ 2.93
$ 2.93
A6258
$ 8.23
$ 8.23
A6259
$ 20.89
$ 20.89
A6260
$ 0.32
$ 0.32
A6261
$ 44.55
$ 44.55
A6262
$ 0.63
$ 0.63
A6266
$ 3.65
$ 3.65
A6402
$ 0.21
$ 0.21
A6403
$ 0.78
$ 0.78
A6404
$ 0.91
$ 0.91
A6407
$ 3.57
$ 3.57
A6410
$ 0.71
$ 0.71
A6411
$ 6.79
$ 6.79
A6412
$ 0.64
$ 0.64
A6413
$ 0.20
$ 0.20
A6441
$ 1.30
$ 1.30
A6442
$ 0.31
$ 0.31
A6443
$ 0.53
$ 0.53
A6444
$ 1.06
$ 1.06
A6445
$ 0.60
$ 0.60
A6446
$ 0.74
$ 0.74
A6447
$ 1.30
$ 1.30
A6448
$ 2.20
$ 2.20
A6449
$ 3.35
$ 3.35
A6450
$ 3.35
$ 3.35
A6451
$ 3.35
$ 3.35
A6452
$ 11.27
$ 11.27
A6453
$ 1.20
$ 1.20
A6454
$ 1.50
$ 1.50
A6455
$ 2.66
$ 2.66
A6456
$ 2.39
$ 2.39
A6457
$ 2.17
$ 2.17
A6501
$ 45.05
$ 45.05
A6502
$ 363.01
$ 363.01
A6503
$ 0.36
$ 0.36
A6504
$ 301.76
$ 301.76
A6505
$ 441.80
$ 441.80
A6506
$ 308.56
$ 308.56
A6507
$ 204.90
$ 204.90
A6508
$ 559.37
$ 559.37
A6509
$ 402.23
$ 402.23
A6511
$ 537.29
$ 537.29
A6520
$ 167.36
$ 167.36
A6521
$ 664.06
$ 664.06
A6522
$ 406.66
$ 406.66
A6523
$ 964.84
$ 964.84
A6524
$ 507.35
$ 507.35
A6525
$ 1,024.24
$ 1,024.24
A6526
$ 917.25
$ 917.25
A6527
$ 1,686.72
$ 1,686.72
A6528
$ 882.00
$ 882.00
A6529
$ 1,393.70
$ 1,393.70
A6530
$ 51.70
$ 51.70
A6531
$ 41.44
$ 41.44
A6532
$ 77.04
$ 77.04
A6533
$ 72.60
$ 72.60
A6534
$ 82.91
$ 82.91
A6535
$ 95.45
$ 95.45
A6536
$ 97.87
$ 97.87
A6537
$ 116.03
$ 116.03
A6538
$ 135.86
$ 135.86
A6539
$ 129.51
$ 129.51
A6540
$ 154.42
$ 154.42
A6541
$ 182.92
$ 182.92
A6544
$ 67.13
$ 67.13
A6545
$ 86.49
$ 86.49
A6549
$ 266.60
$ 266.60
A6550
$ 41.50
$ 45.18
A6552
$ 76.73
$ 76.73
A6553
$ 299.61
$ 299.61
A6554
$ 105.50
$ 105.50
A6555
$ 299.61
$ 299.61
A6556
$ 410.61
$ 410.61
A6557
$ 410.61
$ 410.61
A6558
$ 423.74
$ 423.74
A6562
$ 1,343.83
$ 1,343.83
A6563
$ 1,343.83
$ 1,343.83
A6564
$ 1,447.60
$ 1,447.60
A6565
$ 232.20
$ 232.20
A6566
$ 337.16
$ 337.16
A6567
$ 1,059.35
$ 1,059.35
A6568
$ 220.04
$ 220.04
A6569
$ 1,253.00
$ 1,253.00
A6570
$ 149.93
$ 149.93
A6571
$ 901.08
$ 901.08
A6572
$ 139.12
$ 139.12
A6573
$ 330.12
$ 330.12
A6574
$ 420.85
$ 420.85
A6575
$ 136.39
$ 136.39
A6576
$ 258.30
$ 258.30
A6577
$ 213.78
$ 213.78
A6578
$ 105.28
$ 105.28
A6579
$ 414.60
$ 414.60
A6580
$ 411.54
$ 411.54
A6581
$ 96.60
$ 96.60
A6582
$ 64.43
$ 64.43
A6583
$ 211.93
$ 211.93
A6585
$ 250.94
$ 250.94
A6586
$ 739.28
$ 739.28
A6587
$ 96.84
$ 96.84
A6588
$ 322.76
$ 322.76
A6589
$ 127.41
$ 127.41
A6590
$ 598.08
$ 598.08
A6591
$ 121.49
$ 121.49
A6594
$ 46.40
$ 46.40
A6595
$ 45.63
$ 45.63
A6596
$ 0.24
$ 0.24
A6597
$ 2.06
$ 2.06
A6598
$ 0.99
$ 0.99
A6599
$ 2.25
$ 2.25
A6600
$ 4.06
$ 4.06
A6601
$ 4.56
$ 4.56
A6602
$ 6.66
$ 6.66
A6603
$ 3.12
$ 3.12
A6604
$ 1.82
$ 1.82
A6605
$ 2.09
$ 2.09
A6606
$ 6.19
$ 6.19
A6607
$ 1.65
$ 1.65
A6608
$ 6.89
$ 6.89
A6610
$ 299.61
$ 299.61
A7000
NU
$ 13.93
$ 15.43
A7001
NU
$ 63.18
$ 63.18
A7002
NU
$ 7.32
$ 7.32
A7003
NU
$ 2.56
$ 4.00
A7004
NU
$ 2.07
$ 2.87
A7005
NU
$ 18.52
$ 40.25
A7006
NU
$ 11.00
$ 15.68
A7007
NU
$ 4.91
$ 7.31
A7008
NU
$ 21.00
$ 21.00
A7009
NU
$ 80.33
$ 80.33
A7010
NU
$ 23.31
$ 36.53
A7012
NU
$ 4.30
$ 6.17
A7013
NU
$ 0.85
$ 1.30
A7014
NU
$ 5.05
$ 7.24
A7015
NU
$ 2.03
$ 2.95
A7016
NU
$ 13.86
$ 13.86
A7017
NU
$ 173.14
$ 233.86
A7017
RR
$ 17.32
$ 23.39
A7017
UE
$ 129.86
$ 175.39
A7018
$ 0.50
$ 0.66
A7020
NU
$ 26.63
$ 26.63
A7025
RR
$ 83.09
$ 83.09
A7026
NU
$ 54.91
$ 54.91
A7027
NU
$ 194.74
$ 281.34
A7028
NU
$ 54.08
$ 78.22
A7029
NU
$ 25.61
$ 33.49
A7030
NU
$ 145.12
$ 237.34
A7031
NU
$ 55.19
$ 88.63
A7032
NU
$ 31.01
$ 50.81
A7033
NU
$ 25.63
$ 37.69
A7034
NU
$ 92.64
$ 148.16
A7035
NU
$ 29.86
$ 49.69
A7036
NU
$ 17.21
$ 24.71
A7037
NU
$ 19.50
$ 44.77
A7038
NU
$ 3.47
$ 6.38
A7039
NU
$ 10.16
$ 18.21
A7040
$ 75.39
$ 75.39
A7041
$ 141.72
$ 141.72
A7044
NU
$ 131.87
$ 175.87
A7045
NU
$ 18.93
$ 27.13
A7045
RR
$ 1.89
$ 2.72
A7045
UE
$ 14.20
$ 20.36
A7046
NU
$ 21.52
$ 28.31
A7047
NU
$ 230.96
$ 230.96
A7048
$ 78.90
$ 78.90
A7501
$ 200.61
$ 200.61
A7502
$ 95.37
$ 95.37
A7503
$ 21.67
$ 21.67
A7504
$ 1.30
$ 1.30
A7505
$ 8.96
$ 8.96
A7506
$ 0.62
$ 0.62
A7507
$ 4.77
$ 4.77
A7508
$ 5.49
$ 5.49
A7509
$ 2.69
$ 2.69
A7520
$ 90.69
$ 90.69
A7521
$ 89.87
$ 89.87
A7522
$ 86.27
$ 86.27
A7523
$ 27.97
$ 27.97
A7524
$ 147.88
$ 147.88
A7525
$ 3.93
$ 3.93
A7526
$ 6.48
$ 6.48
A7527
$ 6.83
$ 6.83
A8000
NU
$ 292.96
$ 292.96
A8000
RR
$ 29.30
$ 29.30
A8000
UE
$ 219.77
$ 219.77
A8001
NU
$ 292.96
$ 292.96
A8001
RR
$ 29.30
$ 29.30
A8001
UE
$ 219.77
$ 219.77
A9152
$ 0.13
$ 0.13
A9153
$ 41.89
$ 41.89
A9180
$ 89.60
$ 89.60
A9272
$ 1.81
$ 1.81
A9273
$ 7.18
$ 7.18
A9274
$ 34.69
$ 34.69
A9276
$ 17.99
$ 17.99
A9277
$ 1,372.91
$ 1,372.91
A9278
$ 1,185.03
$ 1,185.03
A9281
$ 62.61
$ 62.61
A9282
$ 638.22
$ 638.22
A9283
$ 28.36
$ 28.36
A9284
$ 18.90
$ 18.90
A9500
$ 290.11
$ 290.11
A9502
$ 262.60
$ 262.60
A9503
$ 68.43
$ 68.43
A9505
$ 315.28
$ 315.28
A9509
$ 596.72
$ 596.72
A9510
$ 63.06
$ 63.06
A9512
$ 28.36
$ 28.36
A9513
$ 541.42
$ 541.42
A9516
$ 286.87
$ 286.87
A9517
$ 78.79
$ 78.79
A9520
$ 1,031.00
$ 1,031.00
A9521
$ 735.98
$ 735.98
A9526
$ 1,567.01
$ 1,567.01
A9528
$ 263.05
$ 263.05
A9531
$ 13.52
$ 13.52
A9537
$ 138.74
$ 138.74
A9538
$ 119.77
$ 119.77
A9539
$ 132.45
$ 132.45
A9540
$ 354.52
$ 354.52
A9541
$ 264.85
$ 264.85
A9548
$ 2,071.86
$ 2,071.86
A9552
$ 714.81
$ 714.81
A9555
$ 840.92
$ 840.92
A9556
$ 168.00
$ 168.00
A9558
$ 517.03
$ 517.03
A9560
$ 262.99
$ 262.99
A9561
$ 72.51
$ 72.51
A9562
$ 1,298.46
$ 1,298.46
A9567
$ 189.63
$ 189.63
A9568
$ 10.36
$ 10.36
A9569
$ 2,865.46
$ 2,865.46
A9570
$ 7,432.64
$ 7,432.64
A9572
$ 6,801.16
$ 6,801.16
A9573
$ 5.89
$ 5.89
A9575
$ 0.17
$ 0.17
A9576
$ 2.14
$ 2.14
A9577
$ 2.58
$ 2.58
A9578
$ 2.48
$ 2.48
A9579
$ 2.13
$ 2.13
A9580
$ 603.53
$ 603.53
A9581
$ 20.64
$ 20.64
A9584
$ 4,746.78
$ 4,746.78
A9585
$ 0.48
$ 0.48
A9587
$ 171.63
$ 171.63
A9588
$ 1,039.56
$ 1,039.56
A9589
$ 1,850.58
$ 1,850.58
A9590
$ 1,262.00
$ 1,262.00
A9591
$ 1,576.85
$ 1,576.85
A9592
$ 2,483.56
$ 2,483.56
A9595
$ 967.04
$ 967.04
A9596
$ 2,413.75
$ 2,413.75
A9606
$ 353.11
$ 353.11
A9607
$ 523.82
$ 523.82
A9700
$ 273.41
$ 273.41
A9800
$ 1,437.72
$ 1,437.72
A9900
BR
BR
A9901
BR
BR
A9999
BR
BR
E0100
NU
$ 39.65
$ 39.65
E0100
RR
$ 11.31
$ 11.31
E0100
UE
$ 29.72
$ 29.72
E0105
NU
$ 93.83
$ 93.83
E0105
RR
$ 16.94
$ 16.94
E0105
UE
$ 71.46
$ 71.46
E0110
NU
$ 125.99
$ 125.99
E0110
RR
$ 30.53
$ 30.53
E0110
UE
$ 94.44
$ 94.44
E0111
NU
$ 86.45
$ 86.45
E0111
RR
$ 16.10
$ 16.10
E0111
UE
$ 66.75
$ 66.75
E0112
NU
$ 60.10
$ 60.10
E0112
RR
$ 18.98
$ 18.98
E0112
UE
$ 45.84
$ 45.84
E0113
NU
$ 34.33
$ 34.33
E0113
RR
$ 9.81
$ 9.81
E0113
UE
$ 25.75
$ 25.75
E0114
NU
$ 76.62
$ 76.62
E0114
RR
$ 16.37
$ 16.37
E0114
UE
$ 57.93
$ 57.93
E0116
NU
$ 45.05
$ 45.05
E0116
RR
$ 10.23
$ 10.23
E0116
UE
$ 33.92
$ 33.92
E0117
RR
$ 36.79
$ 36.79
E0118
$ 681.70
$ 681.70
E0130
NU
$ 70.81
$ 98.91
E0130
RR
$ 7.08
$ 17.95
E0130
UE
$ 53.10
$ 75.15
E0135
NU
$ 70.81
$ 110.18
E0135
RR
$ 7.08
$ 18.31
E0135
UE
$ 53.10
$ 83.83
E0140
RR
$ 42.52
$ 55.03
E0141
NU
$ 79.03
$ 135.30
E0141
RR
$ 7.90
$ 22.71
E0141
UE
$ 59.28
$ 101.46
E0143
NU
$ 79.03
$ 141.86
E0143
RR
$ 7.90
$ 22.06
E0143
UE
$ 59.28
$ 106.25
E0144
RR
$ 45.47
$ 48.97
E0147
NU
$ 661.54
$ 841.85
E0147
RR
$ 66.15
$ 84.20
E0147
UE
$ 496.16
$ 631.40
E0148
NU
$ 128.74
$ 179.33
E0148
RR
$ 12.88
$ 17.95
E0148
UE
$ 96.56
$ 134.48
E0149
RR
$ 18.34
$ 28.97
E0153
NU
$ 126.34
$ 126.34
E0153
RR
$ 14.99
$ 14.99
E0153
UE
$ 94.74
$ 94.74
E0154
NU
$ 75.08
$ 102.30
E0154
RR
$ 7.50
$ 11.47
E0154
UE
$ 56.31
$ 77.28
E0155
NU
$ 32.37
$ 40.94
E0155
RR
$ 3.23
$ 5.05
E0155
UE
$ 24.29
$ 30.98
E0156
NU
$ 24.60
$ 35.95
E0156
RR
$ 2.46
$ 4.21
E0156
UE
$ 18.45
$ 26.96
E0157
NU
$ 83.41
$ 118.10
E0157
RR
$ 8.34
$ 12.47
E0157
UE
$ 62.57
$ 88.58
E0158
NU
$ 33.21
$ 42.04
E0158
RR
$ 3.32
$ 4.89
E0158
UE
$ 24.91
$ 31.64
E0159
NU
$ 23.10
$ 27.96
E0159
RR
$ 2.31
$ 2.81
E0159
UE
$ 17.33
$ 20.99
E0160
NU
$ 44.84
$ 52.93
E0160
RR
$ 4.48
$ 6.20
E0160
UE
$ 33.64
$ 39.69
E0161
NU
$ 37.79
$ 42.57
E0161
RR
$ 3.78
$ 5.66
E0161
UE
$ 28.35
$ 31.88
E0162
NU
$ 236.59
$ 236.59
E0162
RR
$ 24.84
$ 24.84
E0162
UE
$ 183.46
$ 183.46
E0163
NU
$ 86.66
$ 153.05
E0163
RR
$ 8.67
$ 28.08
E0163
UE
$ 65.00
$ 117.01
E0165
RR
$ 19.50
$ 28.81
E0167
NU
$ 17.47
$ 21.25
E0167
RR
$ 1.75
$ 2.17
E0167
UE
$ 13.12
$ 15.99
E0168
NU
$ 184.34
$ 249.94
E0168
RR
$ 18.44
$ 24.99
E0168
UE
$ 138.25
$ 187.45
E0170
RR
$ 264.43
$ 301.07
E0171
RR
$ 49.78
$ 55.24
E0175
NU
$ 107.53
$ 107.53
E0175
RR
$ 10.75
$ 10.75
E0175
UE
$ 79.16
$ 79.16
E0181
RR
$ 26.26
$ 38.95
E0182
RR
$ 34.09
$ 43.82
E0183
RR
$ 26.26
$ 38.95
E0184
NU
$ 251.55
$ 303.51
E0184
RR
$ 25.16
$ 34.50
E0184
UE
$ 188.66
$ 230.31
E0185
NU
$ 285.53
$ 412.87
E0185
RR
$ 28.55
$ 51.81
E0185
UE
$ 214.16
$ 314.19
E0186
RR
$ 30.38
$ 36.29
E0187
RR
$ 35.57
$ 40.64
E0188
NU
$ 37.70
$ 47.53
E0188
RR
$ 3.78
$ 5.19
E0188
UE
$ 28.28
$ 35.67
E0189
NU
$ 84.53
$ 94.61
E0189
RR
$ 8.46
$ 9.87
E0189
UE
$ 63.41
$ 70.95
E0190
NU
$ 90.57
$ 90.57
E0190
RR
$ 9.10
$ 9.10
E0190
UE
$ 67.58
$ 67.58
E0191
NU
$ 16.23
$ 16.23
E0191
RR
$ 1.97
$ 1.97
E0191
UE
$ 12.10
$ 12.10
E0193
RR
$ 1,141.27
$ 1,322.87
E0194
RR
$ 6,216.50
$ 6,216.50
E0196
RR
$ 51.74
$ 52.75
E0197
RR
$ 28.56
$ 41.22
E0198
RR
$ 41.87
$ 41.87
E0199
NU
$ 50.72
$ 58.16
E0199
RR
$ 5.07
$ 5.80
E0199
UE
$ 38.04
$ 43.61
E0200
NU
$ 128.72
$ 128.72
E0200
RR
$ 17.49
$ 17.49
E0200
UE
$ 96.60
$ 96.60
E0202
RR
$ 101.68
$ 101.68
E0203
$ 437.67
$ 437.67
E0205
NU
$ 315.10
$ 315.10
E0205
RR
$ 38.64
$ 38.64
E0205
UE
$ 236.32
$ 236.32
E0210
NU
$ 53.03
$ 53.03
E0210
RR
$ 5.88
$ 5.88
E0210
UE
$ 39.73
$ 39.73
E0215
NU
$ 122.51
$ 122.51
E0215
RR
$ 14.17
$ 14.17
E0215
UE
$ 91.84
$ 91.84
E0217
NU
$ 948.36
$ 948.36
E0217
RR
$ 105.57
$ 105.57
E0217
UE
$ 711.23
$ 711.23
E0218
NU
$ 2,148.40
$ 2,148.40
E0218
RR
$ 216.13
$ 216.13
E0218
UE
$ 1,610.22
$ 1,610.22
E0221
$ 3,311.67
$ 3,311.67
E0225
NU
$ 742.41
$ 742.41
E0225
RR
$ 73.18
$ 73.18
E0225
UE
$ 556.81
$ 556.81
E0235
RR
$ 32.96
$ 32.96
E0236
RR
$ 77.57
$ 77.57
E0239
NU
$ 859.28
$ 859.28
E0239
RR
$ 85.95
$ 85.95
E0239
UE
$ 644.48
$ 644.48
E0240
NU
$ 163.02
$ 163.02
E0240
RR
$ 16.39
$ 16.39
E0240
UE
$ 121.65
$ 121.65
E0241
$ 46.23
$ 46.23
E0243
$ 71.08
$ 71.08
E0244
$ 93.14
$ 93.14
E0245
$ 100.74
$ 100.74
E0246
$ 99.82
$ 99.82
E0247
NU
$ 144.90
$ 144.90
E0247
RR
$ 14.57
$ 14.57
E0247
UE
$ 108.14
$ 108.14
E0248
NU
$ 210.10
$ 210.10
E0248
RR
$ 21.14
$ 21.14
E0248
UE
$ 156.80
$ 156.80
E0249
NU
$ 161.73
$ 161.73
E0249
RR
$ 17.77
$ 17.77
E0249
UE
$ 121.27
$ 121.27
E0250
RR
$ 102.19
$ 135.44
E0251
RR
$ 95.73
$ 112.64
E0255
RR
$ 102.56
$ 152.08
E0256
RR
$ 100.32
$ 122.05
E0260
RR
$ 102.56
$ 171.05
E0261
RR
$ 102.56
$ 168.10
E0265
RR
$ 243.53
$ 286.31
E0266
RR
$ 211.90
$ 250.88
E0271
NU
$ 197.48
$ 294.57
E0271
RR
$ 19.75
$ 30.17
E0271
UE
$ 148.12
$ 226.62
E0272
NU
$ 222.11
$ 293.41
E0272
RR
$ 22.22
$ 30.09
E0272
UE
$ 166.59
$ 219.46
E0274
NU
$ 673.26
$ 673.26
E0274
RR
$ 67.73
$ 67.73
E0274
UE
$ 504.60
$ 504.60
E0275
NU
$ 23.11
$ 24.86
E0275
RR
$ 2.31
$ 2.80
E0275
UE
$ 17.35
$ 18.63
E0276
NU
$ 20.13
$ 21.60
E0276
RR
$ 2.02
$ 2.59
E0276
UE
$ 15.11
$ 16.67
E0277
RR
$ 339.65
$ 705.42
E0280
NU
$ 51.49
$ 53.47
E0280
RR
$ 5.15
$ 6.23
E0280
UE
$ 38.63
$ 40.10
E0290
RR
$ 96.31
$ 113.08
E0291
RR
$ 74.54
$ 81.72
E0292
RR
$ 102.31
$ 122.84
E0293
RR
$ 96.45
$ 109.69
E0294
RR
$ 102.56
$ 162.95
E0295
RR
$ 102.56
$ 160.19
E0296
RR
$ 190.01
$ 209.90
E0297
RR
$ 167.68
$ 197.82
E0300
RR
$ 423.40
$ 445.37
E0301
RR
$ 268.76
$ 350.81
E0302
RR
$ 779.52
$ 1,014.34
E0303
RR
$ 273.50
$ 380.20
E0304
RR
$ 788.76
$ 1,071.50
E0305
RR
$ 17.84
$ 24.23
E0310
NU
$ 181.48
$ 260.93
E0310
RR
$ 18.14
$ 27.48
E0310
UE
$ 136.12
$ 196.78
E0315
$ 256.66
$ 256.66
E0316
RR
$ 295.67
$ 295.67
E0325
NU
$ 15.55
$ 16.44
E0325
RR
$ 1.55
$ 2.27
E0325
UE
$ 10.86
$ 10.86
E0326
NU
$ 16.06
$ 17.63
E0326
RR
$ 1.61
$ 2.02
E0326
UE
$ 12.04
$ 13.23
E0328
$ 15,984.64
$ 15,984.64
E0329
$ 23,217.54
$ 23,217.54
E0371
RR
$ 339.65
$ 513.46
E0372
RR
$ 339.65
$ 586.12
E0373
RR
$ 339.65
$ 646.10
E0424
RR
$ 129.92
$ 236.54
E0425
$ 17.77
$ 17.77
E0430
$ 17.77
$ 17.77
E0431
RR
$ 29.26
$ 42.21
E0433
RR
$ 62.43
$ 71.65
E0434
RR
$ 62.43
$ 71.65
E0439
RR
$ 129.92
$ 236.54
E0441
$ 89.77
$ 103.33
E0442
$ 89.77
$ 103.33
E0443
$ 81.35
$ 98.80
E0444
$ 81.35
$ 98.80
E0445
$ 17.77
$ 17.77
E0446
$ 303.91
$ 303.91
E0447
$ 122.04
$ 149.98
E0462
RR
$ 473.17
$ 473.17
E0465
RR
$ 1,823.36
$ 1,823.36
E0466
RR
$ 1,823.36
$ 1,823.36
E0467
RR
$ 2,102.53
$ 2,138.78
E0470
RR
$ 176.54
$ 278.04
E0471
RR
$ 429.28
$ 773.93
E0472
RR
$ 653.59
$ 895.65
E0480
RR
$ 83.96
$ 83.96
E0481
$ 1,184.71
$ 1,184.71
E0482
RR
$ 762.43
$ 762.43
E0483
RR
$ 2,030.84
$ 2,030.84
E0484
NU
$ 70.56
$ 70.56
E0484
RR
$ 7.06
$ 7.06
E0484
UE
$ 52.92
$ 52.92
E0485
NU
$ 241.49
$ 241.49
E0485
RR
$ 24.29
$ 24.29
E0485
UE
$ 180.21
$ 180.21
E0486
NU
$ 7,848.36
$ 7,848.36
E0486
RR
$ 789.57
$ 789.57
E0486
UE
$ 5,856.98
$ 5,856.98
E0490
RR
$ 171.01
$ 171.01
E0491
$ 141.23
$ 141.23
E0500
RR
$ 202.36
$ 202.36
E0530
RR
$ 49.76
$ 49.76
E0550
RR
$ 95.77
$ 95.77
E0555
NU
$ 6.03
$ 6.03
E0555
RR
$ 0.60
$ 0.60
E0555
UE
$ 4.51
$ 4.51
E0560
NU
$ 282.37
$ 282.37
E0560
RR
$ 33.08
$ 33.08
E0560
UE
$ 211.79
$ 211.79
E0561
NU
$ 113.53
$ 154.10
E0561
RR
$ 11.35
$ 15.40
E0561
UE
$ 85.15
$ 115.57
E0562
NU
$ 224.74
$ 374.09
E0562
RR
$ 22.47
$ 37.39
E0562
UE
$ 168.56
$ 280.57
E0565
RR
$ 69.59
$ 87.75
E0570
RR
$ 9.46
$ 20.62
E0572
RR
$ 38.58
$ 60.05
E0574
RR
$ 71.79
$ 71.79
E0575
RR
$ 169.64
$ 169.64
E0580
NU
$ 220.70
$ 220.70
E0580
RR
$ 22.08
$ 22.08
E0580
UE
$ 165.49
$ 165.49
E0585
RR
$ 42.57
$ 54.21
E0600
RR
$ 80.86
$ 80.86
E0601
RR
$ 67.38
$ 129.57
E0602
NU
$ 56.38
$ 56.38
E0602
RR
$ 5.68
$ 5.68
E0602
UE
$ 42.29
$ 42.29
E0603
NU
$ 362.24
$ 362.24
E0603
RR
$ 36.44
$ 36.44
E0603
UE
$ 270.33
$ 270.33
E0604
NU
$ 1,080.16
$ 1,080.16
E0604
RR
$ 108.67
$ 108.67
E0604
UE
$ 809.56
$ 809.56
E0605
NU
$ 47.88
$ 47.88
E0605
RR
$ 5.88
$ 5.88
E0605
UE
$ 35.92
$ 35.92
E0606
RR
$ 43.83
$ 43.83
E0607
NU
$ 127.64
$ 127.64
E0607
RR
$ 12.75
$ 12.75
E0607
UE
$ 95.70
$ 95.70
E0610
NU
$ 454.34
$ 454.34
E0610
RR
$ 47.92
$ 47.92
E0610
UE
$ 340.80
$ 340.80
E0615
NU
$ 905.53
$ 905.53
E0615
RR
$ 94.99
$ 94.99
E0615
UE
$ 679.15
$ 679.15
E0617
RR
$ 580.78
$ 580.78
E0618
RR
$ 520.80
$ 520.80
E0619
RR
$ 487.45
$ 487.45
E0620
RR
$ 167.01
$ 167.01
E0621
NU
$ 140.24
$ 164.12
E0621
RR
$ 14.03
$ 16.39
E0621
UE
$ 105.18
$ 123.12
E0627
NU
$ 421.27
$ 553.28
E0627
RR
$ 42.13
$ 55.33
E0627
UE
$ 315.95
$ 414.95
E0629
NU
$ 413.50
$ 550.59
E0629
RR
$ 41.36
$ 55.06
E0629
UE
$ 310.13
$ 412.93
E0630
RR
$ 96.38
$ 149.37
E0635
RR
$ 208.12
$ 222.96
E0636
RR
$ 1,641.26
$ 1,900.39
E0637
NU
$ 5,020.53
$ 5,020.53
E0637
RR
$ 505.08
$ 505.08
E0637
UE
$ 3,746.65
$ 3,746.65
E0638
NU
$ 5,417.78
$ 5,417.78
E0638
RR
$ 545.05
$ 545.05
E0638
UE
$ 4,043.12
$ 4,043.12
E0639
RR
$ 213.09
$ 213.09
E0640
RR
$ 213.09
$ 213.09
E0641
$ 13,216.64
$ 13,216.64
E0642
$ 8,710.49
$ 8,710.49
E0650
NU
$ 1,375.75
$ 1,375.75
E0650
RR
$ 165.51
$ 165.51
E0650
UE
$ 1,031.83
$ 1,031.83
E0651
NU
$ 1,732.86
$ 1,732.86
E0651
RR
$ 179.23
$ 179.23
E0651
UE
$ 1,299.68
$ 1,299.68
E0652
NU
$ 10,126.98
$ 10,126.98
E0652
RR
$ 1,000.85
$ 1,000.85
E0652
UE
$ 7,588.45
$ 7,588.45
E0655
NU
$ 206.18
$ 206.18
E0655
RR
$ 24.23
$ 24.23
E0655
UE
$ 154.83
$ 154.83
E0656
RR
$ 110.39
$ 110.39
E0657
RR
$ 103.70
$ 103.70
E0660
NU
$ 304.98
$ 304.98
E0660
RR
$ 31.75
$ 31.75
E0660
UE
$ 228.76
$ 228.76
E0665
NU
$ 261.70
$ 261.70
E0665
RR
$ 26.87
$ 26.87
E0665
UE
$ 196.29
$ 196.29
E0666
NU
$ 263.79
$ 263.79
E0666
RR
$ 27.16
$ 27.16
E0666
UE
$ 197.88
$ 197.88
E0667
NU
$ 618.46
$ 618.46
E0667
RR
$ 69.83
$ 69.83
E0667
UE
$ 463.88
$ 463.88
E0668
NU
$ 844.09
$ 844.09
E0668
RR
$ 83.30
$ 83.30
E0668
UE
$ 633.09
$ 633.09
E0669
NU
$ 350.18
$ 350.18
E0669
RR
$ 35.01
$ 35.01
E0669
UE
$ 262.67
$ 262.67
E0670
NU
$ 2,401.25
$ 2,401.25
E0670
RR
$ 257.04
$ 257.04
E0670
UE
$ 1,800.85
$ 1,800.85
E0671
NU
$ 793.42
$ 793.42
E0671
RR
$ 79.39
$ 79.39
E0671
UE
$ 595.01
$ 595.01
E0672
NU
$ 616.46
$ 616.46
E0672
RR
$ 61.70
$ 61.70
E0672
UE
$ 462.38
$ 462.38
E0673
NU
$ 512.25
$ 512.25
E0673
RR
$ 51.23
$ 51.23
E0673
UE
$ 384.26
$ 384.26
E0675
RR
$ 734.57
$ 734.57
E0676
NU
$ 3,467.55
$ 3,467.55
E0676
RR
$ 348.85
$ 348.85
E0676
UE
$ 2,598.92
$ 2,598.92
E0677
RR
$ 110.39
$ 110.39
E0678
RR
$ 61.85
$ 61.85
E0679
RR
$ 35.01
$ 35.01
E0680
RR
$ 1,012.70
$ 1,012.70
E0681
RR
$ 173.29
$ 173.29
E0682
RR
$ 84.41
$ 84.41
E0691
NU
$ 1,716.50
$ 1,716.50
E0691
RR
$ 171.64
$ 171.64
E0691
UE
$ 1,287.38
$ 1,287.38
E0692
NU
$ 2,155.47
$ 2,155.47
E0692
RR
$ 215.52
$ 215.52
E0692
UE
$ 1,616.59
$ 1,616.59
E0693
NU
$ 2,657.07
$ 2,657.07
E0693
RR
$ 265.72
$ 265.72
E0693
UE
$ 1,992.80
$ 1,992.80
E0694
NU
$ 8,457.23
$ 8,457.23
E0694
RR
$ 845.71
$ 845.71
E0694
UE
$ 6,342.97
$ 6,342.97
E0705
NU
$ 74.52
$ 94.44
E0705
RR
$ 7.45
$ 9.53
E0705
UE
$ 55.89
$ 64.13
E0720
NU
$ 93.76
$ 373.04
E0730
NU
$ 93.13
$ 377.02
E0731
NU
$ 119.45
$ 416.43
E0732
RR
$ 62.51
$ 62.51
E0733
RR
$ 62.51
$ 62.51
E0734
RR
$ 600.94
$ 600.94
E0735
RR
$ 62.51
$ 62.51
E0740
RR
$ 99.89
$ 99.89
E0744
RR
$ 174.93
$ 174.93
E0745
RR
$ 171.01
$ 171.01
E0761
$ 2,982.38
$ 2,982.38
E0762
RR
$ 210.04
$ 210.04
E0764
NU
$ 22,434.15
$ 22,434.15
E0764
UE
$ 16,814.34
$ 16,814.34
E0765
NU
$ 160.71
$ 160.71
E0765
RR
$ 16.10
$ 16.10
E0765
UE
$ 120.57
$ 120.57
E0770
NU
$ 478.13
$ 478.13
E0770
RR
$ 48.10
$ 48.10
E0770
UE
$ 356.82
$ 356.82
E0776
NU
$ 232.46
$ 232.46
E0776
RR
$ 24.32
$ 29.97
E0776
UE
$ 172.27
$ 172.27
E0779
RR
$ 29.81
$ 29.81
E0780
NU
$ 19.81
$ 19.81
E0781
RR
$ 409.39
$ 439.49
E0784
RR
$ 738.18
$ 767.83
E0791
RR
$ 486.35
$ 545.19
E0830
$ 676.24
$ 676.24
E0840
NU
$ 139.96
$ 139.96
E0840
RR
$ 26.52
$ 26.52
E0840
UE
$ 104.93
$ 104.93
E0849
RR
$ 98.45
$ 98.45
E0850
NU
$ 170.56
$ 170.56
E0850
RR
$ 27.57
$ 27.57
E0850
UE
$ 127.93
$ 127.93
E0855
RR
$ 94.42
$ 94.42
E0856
RR
$ 29.40
$ 29.40
E0860
NU
$ 72.16
$ 72.16
E0860
RR
$ 12.46
$ 12.46
E0860
UE
$ 54.15
$ 54.15
E0870
NU
$ 222.19
$ 222.19
E0870
RR
$ 25.62
$ 25.62
E0870
UE
$ 166.67
$ 166.67
E0880
NU
$ 224.27
$ 224.27
E0880
RR
$ 37.65
$ 37.65
E0880
UE
$ 168.18
$ 168.18
E0890
NU
$ 195.50
$ 195.50
E0890
RR
$ 62.72
$ 62.72
E0890
UE
$ 157.49
$ 157.49
E0900
NU
$ 208.05
$ 208.05
E0900
RR
$ 52.78
$ 52.78
E0900
UE
$ 156.09
$ 156.09
E0910
RR
$ 17.95
$ 26.49
E0911
RR
$ 68.42
$ 79.07
E0912
RR
$ 135.23
$ 168.07
E0920
RR
$ 88.17
$ 88.17
E0930
RR
$ 87.25
$ 87.25
E0935
RR
$ 36.93
$ 36.93
E0936
$ 157.65
$ 157.65
E0940
RR
$ 33.95
$ 47.64
E0941
RR
$ 82.91
$ 82.91
E0942
NU
$ 32.23
$ 32.23
E0942
RR
$ 4.49
$ 4.49
E0942
UE
$ 24.11
$ 24.11
E0944
NU
$ 76.58
$ 76.58
E0944
RR
$ 8.82
$ 8.82
E0944
UE
$ 57.47
$ 57.47
E0945
NU
$ 76.58
$ 76.58
E0945
RR
$ 8.46
$ 8.46
E0945
UE
$ 57.47
$ 57.47
E0946
RR
$ 113.02
$ 113.02
E0947
NU
$ 1,158.47
$ 1,158.47
E0947
RR
$ 120.11
$ 120.11
E0947
UE
$ 868.83
$ 868.83
E0948
NU
$ 1,120.49
$ 1,120.49
E0948
RR
$ 112.01
$ 112.01
E0948
UE
$ 790.31
$ 790.31
E0950
NU
$ 123.06
$ 141.50
E0950
RR
$ 12.31
$ 15.36
E0950
UE
$ 92.30
$ 105.41
E0951
NU
$ 19.99
$ 27.31
E0951
RR
$ 2.00
$ 2.77
E0951
UE
$ 14.99
$ 20.48
E0952
NU
$ 27.45
$ 27.87
E0952
RR
$ 2.74
$ 2.98
E0952
UE
$ 20.59
$ 20.90
E0953
NU
$ 123.93
$ 149.21
E0953
RR
$ 12.39
$ 14.92
E0953
UE
$ 92.95
$ 111.92
E0954
NU
$ 86.48
$ 94.33
E0954
RR
$ 8.65
$ 9.66
E0954
UE
$ 64.86
$ 70.73
E0955
RR
$ 23.17
$ 29.57
E0956
NU
$ 123.93
$ 149.21
E0956
RR
$ 12.39
$ 14.92
E0956
UE
$ 92.95
$ 111.92
E0957
NU
$ 198.98
$ 220.63
E0957
RR
$ 19.89
$ 22.06
E0957
UE
$ 149.24
$ 165.47
E0958
RR
$ 67.21
$ 78.64
E0959
NU
$ 71.75
$ 71.78
E0959
RR
$ 7.18
$ 8.19
E0959
UE
$ 53.80
$ 54.32
E0960
NU
$ 118.06
$ 139.44
E0960
RR
$ 11.80
$ 13.96
E0960
UE
$ 88.55
$ 104.58
E0961
NU
$ 31.98
$ 46.63
E0961
RR
$ 3.19
$ 4.79
E0961
UE
$ 23.98
$ 27.85
E0966
NU
$ 117.08
$ 131.29
E0966
RR
$ 11.70
$ 13.05
E0966
UE
$ 87.81
$ 98.48
E0967
NU
$ 115.99
$ 123.40
E0967
RR
$ 11.59
$ 12.33
E0967
UE
$ 87.00
$ 92.50
E0968
RR
$ 34.20
$ 34.20
E0969
NU
$ 299.19
$ 299.19
E0969
RR
$ 29.62
$ 29.62
E0969
UE
$ 224.41
$ 224.41
E0971
NU
$ 46.33
$ 68.35
E0971
RR
$ 4.63
$ 6.85
E0971
UE
$ 34.75
$ 51.28
E0973
NU
$ 82.35
$ 142.20
E0973
RR
$ 8.23
$ 13.76
E0973
UE
$ 61.77
$ 106.64
E0974
NU
$ 121.87
$ 127.32
E0974
RR
$ 12.19
$ 14.48
E0974
UE
$ 91.41
$ 96.21
E0978
NU
$ 36.68
$ 53.89
E0978
RR
$ 3.67
$ 5.70
E0978
UE
$ 27.51
$ 40.40
E0980
NU
$ 53.68
$ 53.68
E0980
RR
$ 6.33
$ 6.33
E0980
UE
$ 40.03
$ 40.03
E0981
NU
$ 68.78
$ 70.80
E0981
RR
$ 6.87
$ 7.39
E0981
UE
$ 51.59
$ 53.10
E0982
NU
$ 72.11
$ 72.11
E0982
RR
$ 7.62
$ 8.05
E0982
UE
$ 54.10
$ 54.10
E0983
RR
$ 444.02
$ 444.02
E0984
RR
$ 364.94
$ 364.94
E0985
RR
$ 34.64
$ 38.57
E0986
RR
$ 929.21
$ 929.21
E0988
RR
$ 549.82
$ 549.82
E0990
NU
$ 107.49
$ 159.17
E0990
RR
$ 10.75
$ 17.14
E0990
UE
$ 80.63
$ 122.42
E0992
NU
$ 127.37
$ 162.11
E0992
RR
$ 12.74
$ 15.95
E0992
UE
$ 95.54
$ 121.59
E0994
NU
$ 33.68
$ 33.68
E0994
RR
$ 3.40
$ 3.40
E0994
UE
$ 25.26
$ 25.26
E0995
NU
$ 44.20
$ 46.62
E0995
RR
$ 4.42
$ 4.72
E0995
UE
$ 33.15
$ 34.99
E1002
RR
$ 613.35
$ 640.33
E1003
RR
$ 717.92
$ 720.47
E1004
RR
$ 789.10
$ 795.35
E1005
RR
$ 863.21
$ 865.45
E1006
RR
$ 1,062.85
$ 1,062.85
E1007
RR
$ 1,321.11
$ 1,380.16
E1008
RR
$ 1,355.10
$ 1,397.20
E1010
RR
$ 184.16
$ 186.24
E1012
RR
$ 184.16
$ 186.24
E1014
RR
$ 69.78
$ 69.78
E1015
NU
$ 190.99
$ 215.57
E1015
RR
$ 19.10
$ 21.55
E1015
UE
$ 143.23
$ 161.67
E1016
NU
$ 180.94
$ 207.61
E1016
RR
$ 18.10
$ 20.78
E1016
UE
$ 135.70
$ 155.69
E1020
RR
$ 29.30
$ 36.01
E1028
RR
$ 20.76
$ 28.98
E1029
RR
$ 60.82
$ 60.82
E1030
RR
$ 191.86
$ 191.86
E1031
RR
$ 69.41
$ 86.10
E1035
RR
$ 950.70
$ 1,111.04
E1036
RR
$ 1,339.52
$ 1,585.42
E1037
RR
$ 166.35
$ 199.12
E1038
RR
$ 23.81
$ 30.28
E1039
RR
$ 51.74
$ 62.02
E1050
RR
$ 194.56
$ 194.56
E1060
RR
$ 240.80
$ 240.80
E1070
RR
$ 209.24
$ 209.24
E1083
RR
$ 127.85
$ 127.85
E1084
RR
$ 187.39
$ 187.39
E1086
NU
$ 2,400.40
$ 2,400.40
E1086
RR
$ 241.49
$ 241.49
E1086
UE
$ 1,799.08
$ 1,799.08
E1087
RR
$ 205.45
$ 205.45
E1088
RR
$ 272.92
$ 272.92
E1090
NU
$ 4,080.64
$ 4,080.64
E1090
RR
$ 410.52
$ 410.52
E1090
UE
$ 3,058.43
$ 3,058.43
E1092
RR
$ 245.49
$ 245.49
E1093
RR
$ 211.12
$ 211.12
E1100
RR
$ 182.46
$ 182.46
E1110
RR
$ 182.46
$ 182.46
E1130
NU
$ 840.18
$ 840.18
E1130
RR
$ 84.53
$ 84.53
E1130
UE
$ 629.72
$ 629.72
E1140
NU
$ 2,306.60
$ 2,306.60
E1140
RR
$ 232.05
$ 232.05
E1140
UE
$ 1,728.79
$ 1,728.79
E1150
RR
$ 155.82
$ 155.82
E1160
RR
$ 119.41
$ 119.41
E1161
RR
$ 451.96
$ 451.96
E1170
RR
$ 170.63
$ 170.63
E1171
RR
$ 153.10
$ 153.10
E1172
RR
$ 187.17
$ 187.17
E1180
RR
$ 193.58
$ 193.58
E1190
RR
$ 223.64
$ 223.64
E1195
RR
$ 239.96
$ 239.96
E1200
RR
$ 166.21
$ 166.21
E1221
RR
$ 90.76
$ 90.76
E1222
RR
$ 126.17
$ 126.17
E1223
RR
$ 141.39
$ 141.39
E1224
RR
$ 155.02
$ 155.02
E1225
RR
$ 59.37
$ 76.52
E1226
NU
$ 593.15
$ 780.16
E1226
RR
$ 59.32
$ 87.36
E1226
UE
$ 444.86
$ 585.09
E1227
NU
$ 450.58
$ 450.58
E1227
RR
$ 53.02
$ 53.02
E1227
UE
$ 337.99
$ 337.99
E1228
RR
$ 53.54
$ 53.54
E1230
NU
$ 4,320.57
$ 4,320.57
E1230
RR
$ 424.94
$ 424.94
E1230
UE
$ 3,417.05
$ 3,417.05
E1232
RR
$ 408.52
$ 408.52
E1233
RR
$ 423.23
$ 423.23
E1234
RR
$ 368.48
$ 368.48
E1235
RR
$ 354.83
$ 354.83
E1236
RR
$ 313.04
$ 313.04
E1237
RR
$ 315.76
$ 315.76
E1238
RR
$ 313.04
$ 313.04
E1240
RR
$ 188.47
$ 188.47
E1260
NU
$ 3,075.69
$ 3,075.69
E1260
RR
$ 309.43
$ 309.43
E1260
UE
$ 2,305.23
$ 2,305.23
E1270
RR
$ 141.85
$ 141.85
E1280
RR
$ 250.73
$ 250.73
E1290
NU
$ 2,640.48
$ 2,640.48
E1290
RR
$ 265.64
$ 265.64
E1290
UE
$ 1,979.03
$ 1,979.03
E1295
RR
$ 232.02
$ 232.02
E1296
NU
$ 798.29
$ 798.29
E1296
RR
$ 95.44
$ 95.44
E1296
UE
$ 598.74
$ 598.74
E1297
NU
$ 199.82
$ 199.82
E1297
RR
$ 22.20
$ 22.20
E1297
UE
$ 149.84
$ 149.84
E1298
NU
$ 809.28
$ 809.28
E1298
RR
$ 82.80
$ 82.80
E1298
UE
$ 606.96
$ 606.96
E1310
NU
$ 3,486.74
$ 3,486.74
E1310
RR
$ 348.68
$ 348.68
E1310
UE
$ 2,615.03
$ 2,615.03
E1353
$ 54.10
$ 54.10
E1354
$ 29.61
$ 29.61
E1355
$ 40.77
$ 40.77
E1356
$ 466.68
$ 466.68
E1372
NU
$ 180.81
$ 244.17
E1372
RR
$ 18.09
$ 30.42
E1372
UE
$ 135.60
$ 181.85
E1390
RR
$ 129.92
$ 236.54
E1391
RR
$ 129.92
$ 236.54
E1392
RR
$ 62.43
$ 71.65
E1405
RR
$ 172.49
$ 290.75
E1406
RR
$ 139.38
$ 257.17
E1510
NU
$ 1,080.16
$ 1,080.16
E1510
RR
$ 108.67
$ 108.67
E1510
UE
$ 809.56
$ 809.56
E1610
NU
$ 6,481.03
$ 6,481.03
E1610
RR
$ 652.02
$ 652.02
E1610
UE
$ 4,857.51
$ 4,857.51
E1637
$ 67.02
$ 67.02
E1639
$ 153.20
$ 153.20
E1700
RR
$ 65.88
$ 65.88
E1701
$ 20.24
$ 20.24
E1702
$ 43.09
$ 43.09
E1800
RR
$ 234.01
$ 234.01
E1801
RR
$ 228.76
$ 228.76
E1802
RR
$ 624.29
$ 624.29
E1805
RR
$ 241.21
$ 241.21
E1806
RR
$ 187.71
$ 187.71
E1810
RR
$ 238.00
$ 238.00
E1811
RR
$ 237.76
$ 237.76
E1812
RR
$ 164.26
$ 164.26
E1815
RR
$ 241.21
$ 241.21
E1816
RR
$ 241.53
$ 241.53
E1818
RR
$ 246.57
$ 246.57
E1820
NU
$ 147.31
$ 147.31
E1820
RR
$ 14.76
$ 14.76
E1820
UE
$ 110.49
$ 110.49
E1821
NU
$ 201.03
$ 201.03
E1821
RR
$ 20.05
$ 20.05
E1821
UE
$ 150.82
$ 150.82
E1825
RR
$ 241.21
$ 241.21
E1830
RR
$ 241.21
$ 241.21
E1831
RR
$ 121.38
$ 121.38
E1840
RR
$ 699.82
$ 699.82
E1841
RR
$ 865.31
$ 865.31
E1905
RR
$ 904.46
$ 904.46
E2000
RR
$ 91.84
$ 91.84
E2001
RR
$ 80.86
$ 80.86
E2100
NU
$ 1,228.61
$ 1,228.61
E2100
RR
$ 122.89
$ 122.89
E2100
UE
$ 921.49
$ 921.49
E2101
NU
$ 360.18
$ 360.18
E2101
RR
$ 36.02
$ 36.02
E2101
UE
$ 270.14
$ 270.14
E2103
NU
$ 403.82
$ 403.82
E2103
RR
$ 40.39
$ 40.39
E2103
UE
$ 302.86
$ 302.86
E2120
RR
$ 541.59
$ 541.59
E2201
NU
$ 492.42
$ 629.02
E2201
RR
$ 49.24
$ 62.90
E2201
UE
$ 369.32
$ 471.76
E2202
NU
$ 702.74
$ 849.94
E2202
RR
$ 70.27
$ 84.99
E2202
UE
$ 527.07
$ 637.49
E2203
NU
$ 671.69
$ 829.14
E2203
RR
$ 67.17
$ 82.91
E2203
UE
$ 503.76
$ 621.84
E2204
NU
$ 1,154.37
$ 1,427.19
E2204
RR
$ 115.44
$ 142.73
E2204
UE
$ 865.77
$ 1,070.40
E2205
NU
$ 55.19
$ 61.35
E2205
RR
$ 5.52
$ 6.09
E2205
UE
$ 41.40
$ 46.06
E2206
NU
$ 60.19
$ 71.92
E2206
RR
$ 6.02
$ 7.18
E2206
UE
$ 45.14
$ 53.96
E2207
NU
$ 72.59
$ 81.05
E2207
RR
$ 7.27
$ 8.12
E2207
UE
$ 54.45
$ 60.79
E2208
NU
$ 120.88
$ 163.86
E2208
RR
$ 12.10
$ 16.39
E2208
UE
$ 90.66
$ 122.89
E2209
NU
$ 131.14
$ 160.64
E2209
RR
$ 13.12
$ 16.06
E2209
UE
$ 98.35
$ 120.50
E2210
NU
$ 8.44
$ 10.11
E2210
RR
$ 0.84
$ 1.02
E2210
UE
$ 6.33
$ 7.60
E2211
NU
$ 53.56
$ 63.28
E2211
RR
$ 5.35
$ 6.83
E2211
UE
$ 40.17
$ 46.34
E2212
NU
$ 9.87
$ 11.02
E2212
RR
$ 0.99
$ 1.15
E2212
UE
$ 7.41
$ 8.29
E2213
NU
$ 47.00
$ 54.84
E2213
RR
$ 4.70
$ 5.52
E2213
UE
$ 35.25
$ 41.10
E2214
NU
$ 50.65
$ 58.14
E2214
RR
$ 5.07
$ 6.66
E2214
UE
$ 38.00
$ 43.60
E2215
NU
$ 16.04
$ 18.03
E2215
RR
$ 1.61
$ 1.81
E2215
UE
$ 12.04
$ 13.52
E2216
NU
$ 69.50
$ 76.78
E2216
RR
$ 6.94
$ 9.14
E2216
UE
$ 52.12
$ 57.58
E2217
NU
$ 61.50
$ 67.94
E2217
RR
$ 6.15
$ 8.09
E2217
UE
$ 46.13
$ 50.96
E2218
NU
$ 69.50
$ 76.78
E2218
RR
$ 6.94
$ 9.14
E2218
UE
$ 52.12
$ 57.58
E2219
NU
$ 61.50
$ 67.94
E2219
RR
$ 6.15
$ 8.09
E2219
UE
$ 46.13
$ 50.96
E2220
NU
$ 44.65
$ 53.02
E2220
RR
$ 4.47
$ 5.21
E2220
UE
$ 33.49
$ 40.17
E2221
NU
$ 41.80
$ 47.49
E2221
RR
$ 4.19
$ 4.72
E2221
UE
$ 31.36
$ 35.62
E2222
NU
$ 35.77
$ 39.75
E2222
RR
$ 3.57
$ 3.95
E2222
UE
$ 26.82
$ 29.82
E2224
NU
$ 144.97
$ 159.21
E2224
RR
$ 14.50
$ 18.17
E2224
UE
$ 108.72
$ 119.42
E2225
NU
$ 29.88
$ 33.18
E2225
RR
$ 2.98
$ 3.32
E2225
UE
$ 22.41
$ 24.86
E2226
NU
$ 62.20
$ 70.95
E2226
RR
$ 6.23
$ 7.10
E2226
UE
$ 46.65
$ 53.21
E2227
RR
$ 343.57
$ 343.57
E2228
RR
$ 148.96
$ 173.45
E2231
NU
$ 221.41
$ 269.56
E2231
RR
$ 22.15
$ 26.96
E2231
UE
$ 166.05
$ 202.16
E2291
$ 643.41
$ 643.41
E2292
$ 716.49
$ 716.49
E2293
$ 1,225.08
$ 1,225.08
E2294
$ 774.76
$ 774.76
E2300
$ 6,121.05
$ 6,121.05
E2301
$ 22,712.63
$ 22,712.63
E2310
RR
$ 179.61
$ 186.13
E2311
RR
$ 362.43
$ 376.25
E2312
RR
$ 370.44
$ 370.44
E2313
RR
$ 58.87
$ 58.87
E2321
RR
$ 244.03
$ 252.84
E2322
RR
$ 230.55
$ 231.36
E2323
NU
$ 112.38
$ 113.13
E2323
RR
$ 11.24
$ 11.31
E2323
UE
$ 84.29
$ 84.84
E2324
NU
$ 72.14
$ 72.14
E2324
RR
$ 7.18
$ 7.18
E2324
UE
$ 54.11
$ 54.11
E2325
RR
$ 220.35
$ 221.06
E2326
RR
$ 57.18
$ 57.18
E2327
RR
$ 430.09
$ 430.09
E2328
RR
$ 813.55
$ 814.69
E2329
RR
$ 290.78
$ 290.78
E2330
RR
$ 563.40
$ 563.40
E2331
$ 1,697.77
$ 1,697.77
E2340
NU
$ 684.53
$ 684.53
E2340
RR
$ 68.49
$ 68.49
E2340
UE
$ 513.46
$ 513.46
E2341
NU
$ 1,026.90
$ 1,026.90
E2341
RR
$ 102.68
$ 102.68
E2341
UE
$ 770.21
$ 770.21
E2342
NU
$ 855.76
$ 855.76
E2342
RR
$ 85.57
$ 85.57
E2342
UE
$ 641.83
$ 641.83
E2343
NU
$ 1,369.23
$ 1,369.23
E2343
RR
$ 136.91
$ 136.91
E2343
UE
$ 1,026.90
$ 1,026.90
E2351
NU
$ 1,150.66
$ 1,150.66
E2351
RR
$ 115.07
$ 115.07
E2351
UE
$ 862.99
$ 862.99
E2359
NU
$ 266.69
$ 307.82
E2359
RR
$ 26.67
$ 30.79
E2359
UE
$ 200.02
$ 230.86
E2360
NU
$ 182.42
$ 182.42
E2360
RR
$ 20.20
$ 21.56
E2360
UE
$ 136.78
$ 136.78
E2361
NU
$ 179.65
$ 214.91
E2361
RR
$ 17.96
$ 21.50
E2361
UE
$ 134.74
$ 161.18
E2362
NU
$ 172.77
$ 172.77
E2362
RR
$ 17.28
$ 17.28
E2362
UE
$ 129.54
$ 129.54
E2363
NU
$ 220.92
$ 279.51
E2363
RR
$ 22.09
$ 27.96
E2363
UE
$ 165.69
$ 209.64
E2364
NU
$ 182.42
$ 182.42
E2364
RR
$ 20.43
$ 20.86
E2364
UE
$ 136.78
$ 136.78
E2365
NU
$ 115.64
$ 158.80
E2365
RR
$ 11.56
$ 15.88
E2365
UE
$ 86.73
$ 119.13
E2366
NU
$ 238.22
$ 323.16
E2366
RR
$ 23.83
$ 35.63
E2366
UE
$ 178.67
$ 242.38
E2367
NU
$ 619.28
$ 678.54
E2367
RR
$ 61.92
$ 67.86
E2367
UE
$ 464.45
$ 508.90
E2368
RR
$ 64.50
$ 78.74
E2369
RR
$ 59.81
$ 71.34
E2370
RR
$ 84.00
$ 113.06
E2371
NU
$ 221.41
$ 247.87
E2371
RR
$ 22.13
$ 24.79
E2371
UE
$ 166.05
$ 185.91
E2373
RR
$ 129.15
$ 129.15
E2374
RR
$ 82.75
$ 85.34
E2375
RR
$ 106.32
$ 130.33
E2376
RR
$ 205.60
$ 213.30
E2377
RR
$ 76.16
$ 78.06
E2378
RR
$ 88.54
$ 97.36
E2381
NU
$ 95.14
$ 115.58
E2381
RR
$ 9.52
$ 11.55
E2381
UE
$ 71.36
$ 86.69
E2382
NU
$ 30.17
$ 31.88
E2382
RR
$ 3.01
$ 3.16
E2382
UE
$ 22.64
$ 23.93
E2383
NU
$ 203.94
$ 236.10
E2383
RR
$ 20.40
$ 23.60
E2383
UE
$ 152.95
$ 177.09
E2384
NU
$ 96.04
$ 119.90
E2384
RR
$ 9.60
$ 11.97
E2384
UE
$ 72.03
$ 89.91
E2385
NU
$ 72.39
$ 76.27
E2385
RR
$ 7.24
$ 7.63
E2385
UE
$ 54.29
$ 57.19
E2386
NU
$ 163.79
$ 212.56
E2386
RR
$ 16.38
$ 21.25
E2386
UE
$ 122.85
$ 159.45
E2387
NU
$ 77.31
$ 96.11
E2387
RR
$ 7.73
$ 9.59
E2387
UE
$ 57.97
$ 72.07
E2388
NU
$ 78.78
$ 80.85
E2388
RR
$ 7.88
$ 8.09
E2388
UE
$ 59.08
$ 60.66
E2389
NU
$ 44.03
$ 44.55
E2389
RR
$ 4.40
$ 4.47
E2389
UE
$ 33.03
$ 33.39
E2390
NU
$ 68.17
$ 69.30
E2390
RR
$ 6.82
$ 6.93
E2390
UE
$ 51.13
$ 51.97
E2391
NU
$ 27.78
$ 32.49
E2391
RR
$ 2.77
$ 3.26
E2391
UE
$ 20.83
$ 24.37
E2392
NU
$ 65.20
$ 81.72
E2392
RR
$ 6.52
$ 8.19
E2392
UE
$ 48.90
$ 61.29
E2394
NU
$ 92.90
$ 114.73
E2394
RR
$ 9.30
$ 11.48
E2394
UE
$ 69.68
$ 86.04
E2395
NU
$ 69.79
$ 83.50
E2395
RR
$ 6.99
$ 8.36
E2395
UE
$ 52.35
$ 62.64
E2396
NU
$ 80.91
$ 101.15
E2396
RR
$ 8.09
$ 10.50
E2396
UE
$ 60.68
$ 75.88
E2397
NU
$ 704.69
$ 789.57
E2397
RR
$ 70.48
$ 78.96
E2397
UE
$ 528.53
$ 592.16
E2398
NU
$ 219.13
$ 219.13
E2398
RR
$ 21.91
$ 21.91
E2398
UE
$ 164.33
$ 164.33
E2402
RR
$ 1,056.17
$ 2,008.87
E2500
NU
$ 746.98
$ 746.98
E2500
RR
$ 74.70
$ 74.70
E2500
UE
$ 560.24
$ 560.24
E2502
NU
$ 2,284.23
$ 2,284.23
E2502
RR
$ 228.45
$ 228.45
E2502
UE
$ 1,713.19
$ 1,713.19
E2504
NU
$ 3,013.23
$ 3,013.23
E2504
RR
$ 301.35
$ 301.35
E2504
UE
$ 2,259.94
$ 2,259.94
E2506
NU
$ 4,418.26
$ 4,418.26
E2506
RR
$ 441.81
$ 441.81
E2506
UE
$ 3,313.63
$ 3,313.63
E2508
NU
$ 6,832.13
$ 6,832.13
E2508
RR
$ 683.21
$ 683.21
E2508
UE
$ 5,124.11
$ 5,124.11
E2510
NU
$ 12,928.89
$ 12,928.89
E2510
RR
$ 1,292.89
$ 1,292.89
E2510
UE
$ 9,696.64
$ 9,696.64
E2511
NU
$ 50.72
$ 50.72
E2511
RR
$ 5.11
$ 5.11
E2511
UE
$ 37.84
$ 37.84
E2512
NU
$ 1,436.85
$ 1,436.85
E2512
RR
$ 144.55
$ 144.55
E2512
UE
$ 1,072.29
$ 1,072.29
E2601
NU
$ 60.12
$ 84.84
E2601
RR
$ 6.01
$ 8.50
E2601
UE
$ 45.09
$ 63.64
E2602
NU
$ 129.98
$ 172.69
E2602
RR
$ 13.01
$ 17.28
E2602
UE
$ 97.48
$ 129.51
E2603
NU
$ 163.79
$ 215.96
E2603
RR
$ 16.38
$ 21.60
E2603
UE
$ 122.84
$ 161.99
E2604
NU
$ 238.74
$ 284.23
E2604
RR
$ 23.87
$ 28.42
E2604
UE
$ 179.06
$ 213.19
E2605
NU
$ 335.85
$ 407.67
E2605
RR
$ 33.59
$ 40.77
E2605
UE
$ 251.89
$ 305.77
E2606
NU
$ 541.94
$ 644.07
E2606
RR
$ 54.19
$ 64.41
E2606
UE
$ 406.46
$ 483.03
E2607
NU
$ 325.99
$ 418.77
E2607
RR
$ 32.59
$ 41.87
E2607
UE
$ 244.50
$ 314.08
E2608
NU
$ 416.60
$ 513.52
E2608
RR
$ 41.66
$ 51.34
E2608
UE
$ 312.45
$ 385.14
E2609
$ 3,306.21
$ 3,306.21
E2611
NU
$ 244.75
$ 395.79
E2611
RR
$ 24.47
$ 39.56
E2611
UE
$ 183.55
$ 296.87
E2612
NU
$ 483.28
$ 618.46
E2612
RR
$ 48.33
$ 61.85
E2612
UE
$ 362.46
$ 463.85
E2613
NU
$ 491.09
$ 597.42
E2613
RR
$ 49.11
$ 59.75
E2613
UE
$ 368.33
$ 448.07
E2614
NU
$ 723.84
$ 851.86
E2614
RR
$ 72.38
$ 85.19
E2614
UE
$ 542.89
$ 638.90
E2615
NU
$ 561.37
$ 684.74
E2615
RR
$ 56.14
$ 68.49
E2615
UE
$ 421.04
$ 513.56
E2616
NU
$ 755.92
$ 921.75
E2616
RR
$ 75.60
$ 92.18
E2616
UE
$ 566.94
$ 691.32
E2617
$ 3,871.92
$ 3,871.92
E2619
NU
$ 81.10
$ 82.80
E2619
RR
$ 8.11
$ 8.29
E2619
UE
$ 60.83
$ 62.13
E2620
NU
$ 613.27
$ 785.71
E2620
RR
$ 61.33
$ 78.57
E2620
UE
$ 459.96
$ 589.29
E2621
NU
$ 721.71
$ 869.76
E2621
RR
$ 72.17
$ 86.98
E2621
UE
$ 541.28
$ 652.33
E2622
NU
$ 514.50
$ 530.11
E2622
RR
$ 51.45
$ 53.02
E2622
UE
$ 385.88
$ 397.59
E2623
NU
$ 650.64
$ 672.52
E2623
RR
$ 65.06
$ 67.26
E2623
UE
$ 487.97
$ 504.38
E2624
NU
$ 522.83
$ 536.52
E2624
RR
$ 52.29
$ 53.66
E2624
UE
$ 392.13
$ 402.40
E2625
NU
$ 647.04
$ 671.79
E2625
RR
$ 64.71
$ 67.17
E2625
UE
$ 485.28
$ 503.83
E2626
NU
$ 1,000.68
$ 1,164.81
E2626
RR
$ 100.07
$ 116.47
E2626
UE
$ 750.51
$ 873.57
E2627
NU
$ 1,609.47
$ 1,828.20
E2627
RR
$ 160.94
$ 182.85
E2627
UE
$ 1,207.11
$ 1,371.15
E2628
NU
$ 1,195.75
$ 1,397.91
E2628
RR
$ 119.57
$ 139.79
E2628
UE
$ 896.83
$ 1,048.43
E2629
NU
$ 1,555.74
$ 1,763.23
E2629
RR
$ 155.57
$ 176.32
E2629
UE
$ 1,166.80
$ 1,322.43
E2630
NU
$ 1,078.41
$ 1,215.69
E2630
RR
$ 107.84
$ 121.58
E2630
UE
$ 808.81
$ 911.76
E2631
NU
$ 435.04
$ 494.38
E2631
RR
$ 43.50
$ 49.45
E2631
UE
$ 326.27
$ 370.78
E2632
NU
$ 274.97
$ 310.38
E2632
RR
$ 27.50
$ 31.04
E2632
UE
$ 206.23
$ 232.78
E2633
NU
$ 228.91
$ 261.73
E2633
RR
$ 22.89
$ 26.18
E2633
UE
$ 171.68
$ 196.31
E3000
RR
$ 328.17
$ 328.17
E8000
$ 4,461.93
$ 4,461.93
E8001
$ 6,908.36
$ 6,908.36
E8002
$ 6,884.42
$ 6,884.42
G0480-G0483, G0659
BR
BR
G2010, G2012
BR
BR
JXXXX
BR
BR
K0001
RR
$ 37.74
$ 71.06
K0002
RR
$ 61.31
$ 113.97
K0003
RR
$ 58.79
$ 106.06
K0004
RR
$ 69.72
$ 165.98
K0005
NU
$ 3,472.48
$ 3,472.48
K0005
RR
$ 347.26
$ 347.26
K0005
UE
$ 2,604.39
$ 2,604.39
K0006
RR
$ 101.60
$ 176.69
K0007
RR
$ 137.86
$ 237.66
K0009
RR
$ 136.53
$ 136.53
K0010
RR
$ 813.74
$ 813.74
K0011
RR
$ 938.99
$ 938.99
K0012
RR
$ 576.02
$ 576.02
K0015
RR
$ 22.89
$ 27.29
K0017
NU
$ 78.08
$ 80.40
K0017
RR
$ 7.81
$ 8.05
K0017
UE
$ 58.56
$ 60.30
K0018
NU
$ 44.14
$ 45.19
K0018
RR
$ 4.41
$ 4.51
K0018
UE
$ 33.11
$ 33.91
K0019
NU
$ 19.54
$ 25.98
K0019
RR
$ 1.96
$ 2.60
K0019
UE
$ 14.67
$ 19.50
K0020
NU
$ 75.21
$ 75.21
K0020
RR
$ 7.52
$ 7.52
K0020
UE
$ 56.39
$ 56.39
K0037
NU
$ 73.46
$ 76.37
K0037
RR
$ 7.07
$ 7.07
K0037
UE
$ 55.10
$ 57.30
K0038
NU
$ 39.03
$ 39.14
K0038
RR
$ 3.91
$ 3.91
K0038
UE
$ 29.27
$ 29.34
K0039
NU
$ 83.80
$ 85.51
K0039
RR
$ 8.39
$ 8.58
K0039
UE
$ 62.85
$ 64.12
K0040
NU
$ 84.90
$ 106.96
K0040
RR
$ 8.48
$ 10.70
K0040
UE
$ 63.67
$ 80.22
K0041
NU
$ 80.08
$ 82.91
K0041
RR
$ 8.01
$ 8.29
K0041
UE
$ 60.06
$ 62.15
K0042
NU
$ 50.99
$ 50.99
K0042
RR
$ 5.10
$ 5.10
K0042
UE
$ 38.22
$ 38.22
K0043
NU
$ 31.61
$ 31.61
K0043
RR
$ 3.16
$ 3.16
K0043
UE
$ 23.72
$ 23.72
K0044
NU
$ 26.95
$ 26.95
K0044
RR
$ 2.70
$ 2.70
K0044
UE
$ 20.17
$ 20.17
K0045
NU
$ 90.87
$ 92.05
K0045
RR
$ 9.09
$ 9.35
K0045
UE
$ 68.15
$ 69.03
K0046
NU
$ 31.61
$ 31.61
K0046
RR
$ 3.16
$ 3.16
K0046
UE
$ 23.72
$ 23.72
K0047
NU
$ 112.94
$ 118.36
K0047
RR
$ 11.30
$ 11.84
K0047
UE
$ 84.70
$ 88.79
K0050
NU
$ 52.40
$ 52.50
K0050
RR
$ 5.24
$ 5.25
K0050
UE
$ 39.30
$ 39.40
K0051
NU
$ 82.89
$ 84.01
K0051
RR
$ 8.29
$ 8.40
K0051
UE
$ 62.17
$ 63.01
K0052
NU
$ 112.92
$ 137.82
K0052
RR
$ 11.30
$ 13.80
K0052
UE
$ 84.69
$ 103.35
K0053
NU
$ 134.39
$ 157.57
K0053
RR
$ 13.44
$ 15.76
K0053
UE
$ 100.79
$ 118.16
K0056
NU
$ 147.08
$ 172.90
K0056
RR
$ 14.71
$ 17.30
K0056
UE
$ 110.32
$ 129.70
K0065
NU
$ 74.86
$ 83.33
K0065
RR
$ 7.49
$ 8.33
K0065
UE
$ 56.14
$ 62.52
K0069
NU
$ 149.81
$ 177.83
K0069
RR
$ 14.98
$ 17.79
K0069
UE
$ 112.36
$ 133.38
K0070
RR
$ 25.44
$ 31.28
K0071
NU
$ 174.86
$ 199.47
K0071
RR
$ 17.49
$ 19.98
K0071
UE
$ 131.14
$ 149.62
K0072
NU
$ 109.31
$ 121.97
K0072
RR
$ 10.93
$ 12.19
K0072
UE
$ 81.98
$ 91.48
K0073
NU
$ 56.25
$ 62.87
K0073
RR
$ 5.63
$ 6.29
K0073
UE
$ 42.20
$ 47.12
K0077
NU
$ 86.11
$ 102.90
K0077
RR
$ 8.61
$ 10.28
K0077
UE
$ 64.60
$ 77.15
K0098
NU
$ 38.47
$ 42.70
K0098
RR
$ 3.85
$ 4.28
K0098
UE
$ 28.87
$ 32.03
K0105
NU
$ 159.10
$ 181.76
K0105
RR
$ 15.90
$ 18.17
K0105
UE
$ 119.32
$ 136.33
K0195
RR
$ 16.80
$ 26.17
K0455
RR
$ 469.56
$ 469.56
K0552
$ 4.59
$ 4.79
K0601
NU
$ 2.09
$ 2.10
K0602
NU
$ 11.75
$ 11.94
K0603
NU
$ 1.05
$ 1.06
K0604
NU
$ 11.33
$ 11.47
K0605
NU
$ 27.06
$ 27.48
K0607
RR
$ 37.11
$ 37.11
K0608
NU
$ 231.53
$ 231.53
K0608
RR
$ 23.20
$ 23.20
K0608
UE
$ 173.64
$ 173.64
K0609
$ 1,539.79
$ 1,539.79
K0669
$ 594.82
$ 594.82
K0672
$ 136.32
$ 136.32
K0730
RR
$ 329.31
$ 329.31
K0733
NU
$ 45.68
$ 49.74
K0733
RR
$ 4.56
$ 5.01
K0733
UE
$ 34.26
$ 37.32
K0738
RR
$ 62.43
$ 71.65
K0739
$ 51.86
$ 51.86
K0740
$ 29.62
$ 29.62
K0800
NU
$ 1,347.72
$ 1,812.36
K0800
RR
$ 134.78
$ 181.24
K0800
UE
$ 1,010.79
$ 1,359.27
K0801
NU
$ 2,419.96
$ 3,083.91
K0801
RR
$ 241.99
$ 308.36
K0801
UE
$ 1,814.97
$ 2,312.93
K0802
NU
$ 3,269.80
$ 3,764.89
K0802
RR
$ 326.98
$ 376.49
K0802
UE
$ 2,452.35
$ 2,823.67
K0806
NU
$ 2,314.56
$ 2,444.69
K0806
RR
$ 231.46
$ 244.47
K0806
UE
$ 1,735.93
$ 1,833.54
K0807
NU
$ 3,587.00
$ 3,747.03
K0807
RR
$ 358.69
$ 374.71
K0807
UE
$ 2,690.25
$ 2,810.28
K0808
NU
$ 5,544.91
$ 5,794.95
K0808
RR
$ 554.50
$ 579.49
K0808
UE
$ 4,158.69
$ 4,346.20
K0813
RR
$ 429.91
$ 533.29
K0814
RR
$ 447.19
$ 624.79
K0815
RR
$ 498.18
$ 702.83
K0816
RR
$ 458.00
$ 664.93
K0820
RR
$ 445.47
$ 560.00
K0821
RR
$ 458.00
$ 657.99
K0822
RR
$ 498.18
$ 761.99
K0823
RR
$ 458.00
$ 746.61
K0824
RR
$ 708.04
$ 982.88
K0825
RR
$ 662.56
$ 904.08
K0826
RR
$ 1,133.82
$ 1,425.86
K0827
RR
$ 1,006.11
$ 1,227.67
K0828
RR
$ 1,472.16
$ 1,660.71
K0829
RR
$ 1,420.52
$ 1,566.68
K0835
RR
$ 594.71
$ 798.36
K0836
RR
$ 616.84
$ 827.99
K0837
RR
$ 762.79
$ 979.37
K0838
RR
$ 676.09
$ 872.98
K0839
RR
$ 1,013.24
$ 1,280.79
K0840
RR
$ 1,555.64
$ 1,950.66
K0841
RR
$ 670.18
$ 868.38
K0842
RR
$ 669.21
$ 867.89
K0843
RR
$ 794.44
$ 1,039.28
K0848
RR
$ 1,305.08
$ 1,305.08
K0849
RR
$ 1,254.74
$ 1,254.74
K0850
RR
$ 1,513.81
$ 1,513.81
K0851
RR
$ 1,455.55
$ 1,455.55
K0852
RR
$ 1,749.12
$ 1,749.12
K0853
RR
$ 1,796.80
$ 1,796.80
K0854
RR
$ 2,380.36
$ 2,380.36
K0855
RR
$ 2,248.60
$ 2,248.60
K0856
RR
$ 1,400.83
$ 1,400.83
K0857
RR
$ 1,428.91
$ 1,428.91
K0858
RR
$ 1,738.03
$ 1,738.03
K0859
RR
$ 1,657.54
$ 1,657.54
K0860
RR
$ 2,483.00
$ 2,483.00
K0861
RR
$ 1,403.08
$ 1,403.08
K0862
RR
$ 1,738.03
$ 1,738.03
K0863
RR
$ 2,483.00
$ 2,483.00
K0864
RR
$ 2,954.77
$ 2,954.77
K0884
$ 35,538.37
$ 35,538.37
K0899
$ 4,336.99
$ 4,336.99
K1027
$ 8,414.41
$ 8,414.41
L0112
$ 2,250.30
$ 2,250.30
L0113
$ 458.50
$ 458.50
L0120
$ 54.50
$ 54.50
L0130
$ 272.19
$ 272.19
L0140
$ 98.60
$ 98.60
L0150
$ 221.93
$ 221.93
L0160
$ 272.27
$ 272.27
L0170
$ 1,313.23
$ 1,313.23
L0172
$ 245.17
$ 245.17
L0174
$ 564.16
$ 564.16
L0180
$ 731.39
$ 731.39
L0190
$ 1,017.31
$ 1,017.31
L0200
$ 1,060.54
$ 1,060.54
L0220
$ 188.64
$ 188.64
L0450
$ 181.09
$ 274.48
L0452
$ 640.93
$ 640.93
L0454
$ 557.61
$ 557.61
L0455
$ 336.18
$ 457.06
L0456
$ 1,599.07
$ 1,599.07
L0457
$ 964.07
$ 1,310.69
L0458
$ 1,433.87
$ 1,433.87
L0460
$ 1,613.92
$ 1,613.92
L0462
$ 2,007.47
$ 2,007.47
L0464
$ 2,389.86
$ 2,389.86
L0466
$ 767.28
$ 767.28
L0467
$ 377.03
$ 583.55
L0468
$ 929.96
$ 929.96
L0469
$ 480.41
$ 719.71
L0470
$ 1,309.32
$ 1,309.32
L0472
$ 830.40
$ 830.40
L0480
$ 2,491.76
$ 2,491.76
L0482
$ 2,841.68
$ 2,841.68
L0484
$ 3,197.87
$ 3,197.87
L0486
$ 3,463.35
$ 3,463.35
L0488
$ 1,613.92
$ 1,613.92
L0490
$ 454.83
$ 454.83
L0491
$ 1,234.76
$ 1,234.76
L0492
$ 852.08
$ 852.08
L0621
$ 95.48
$ 145.31
L0622
$ 530.54
$ 530.54
L0623
$ 171.14
$ 233.00
L0625
$ 53.42
$ 72.59
L0626
$ 125.30
$ 125.30
L0627
$ 660.91
$ 660.91
L0628
$ 81.33
$ 110.57
L0629
$ 273.50
$ 273.50
L0630
$ 260.39
$ 260.39
L0631
$ 1,650.53
$ 1,650.53
L0633
$ 461.06
$ 461.06
L0635
$ 1,965.77
$ 1,965.77
L0636
$ 2,910.07
$ 2,910.07
L0637
$ 1,945.17
$ 1,945.17
L0638
$ 2,120.51
$ 2,120.51
L0639
$ 1,945.17
$ 1,945.17
L0640
$ 1,682.44
$ 1,682.44
L0641
$ 75.57
$ 102.72
L0642
$ 398.54
$ 541.77
L0643
$ 157.01
$ 213.44
L0648
$ 995.32
$ 1,352.99
L0649
$ 278.03
$ 377.94
L0650
$ 1,151.64
$ 1,583.20
L0651
$ 1,151.64
$ 1,583.20
L0700
$ 4,151.92
$ 4,151.92
L0710
$ 4,289.11
$ 4,289.11
L0810
$ 5,297.31
$ 5,297.31
L0820
$ 4,175.89
$ 4,175.89
L0830
$ 6,439.89
$ 6,439.89
L0859
$ 1,876.39
$ 1,876.39
L0861
$ 346.53
$ 346.53
L0970
$ 234.72
$ 234.72
L0972
$ 211.36
$ 211.36
L0974
$ 355.39
$ 355.39
L0976
$ 250.89
$ 250.89
L0978
$ 395.32
$ 395.32
L0980
$ 26.89
$ 26.89
L0982
$ 26.67
$ 26.67
L0984
$ 105.32
$ 105.32
L1000
$ 4,169.42
$ 4,169.42
L1005
$ 5,145.98
$ 5,145.98
L1010
$ 117.00
$ 117.00
L1020
$ 177.51
$ 177.51
L1025
$ 239.13
$ 239.13
L1030
$ 102.63
$ 102.63
L1040
$ 160.22
$ 160.22
L1050
$ 171.00
$ 171.00
L1060
$ 196.41
$ 196.41
L1070
$ 184.80
$ 184.80
L1080
$ 98.29
$ 98.29
L1085
$ 316.12
$ 316.12
L1090
$ 188.24
$ 188.24
L1100
$ 326.59
$ 326.59
L1110
$ 524.51
$ 524.51
L1120
$ 81.56
$ 81.56
L1200
$ 3,217.75
$ 3,217.75
L1210
$ 537.36
$ 537.36
L1220
$ 454.99
$ 454.99
L1230
$ 914.23
$ 914.23
L1240
$ 159.46
$ 159.46
L1250
$ 126.49
$ 126.49
L1260
$ 138.31
$ 138.31
L1270
$ 159.12
$ 159.12
L1280
$ 177.17
$ 177.17
L1290
$ 161.42
$ 161.42
L1300
$ 3,430.53
$ 3,430.53
L1310
$ 3,223.79
$ 3,223.79
L1600
$ 252.21
$ 252.21
L1610
$ 90.16
$ 90.16
L1620
$ 255.88
$ 255.88
L1630
$ 283.93
$ 283.93
L1640
$ 710.72
$ 710.72
L1650
$ 416.11
$ 416.11
L1652
$ 573.10
$ 573.10
L1660
$ 263.59
$ 263.59
L1680
$ 2,502.25
$ 2,502.25
L1681
$ 3,746.71
$ 3,746.71
L1685
$ 2,442.82
$ 2,442.82
L1686
$ 1,873.35
$ 1,873.35
L1690
$ 3,109.06
$ 3,109.06
L1700
$ 3,136.20
$ 3,136.20
L1710
$ 3,671.26
$ 3,671.26
L1720
$ 2,706.16
$ 2,706.16
L1730
$ 2,324.32
$ 2,324.32
L1755
$ 3,234.90
$ 3,234.90
L1810
$ 200.10
$ 200.10
L1812
$ 92.81
$ 156.77
L1820
$ 243.66
$ 243.66
L1830
$ 83.62
$ 140.94
L1831
$ 473.21
$ 473.21
L1832
$ 1,118.19
$ 1,118.19
L1833
$ 602.41
$ 927.22
L1834
$ 1,506.76
$ 1,506.76
L1836
$ 118.24
$ 179.54
L1840
$ 1,888.32
$ 1,888.32
L1843
$ 1,442.60
$ 1,442.60
L1844
$ 3,265.49
$ 3,265.49
L1845
$ 1,258.94
$ 1,258.94
L1846
$ 2,294.22
$ 2,294.22
L1847
$ 924.76
$ 924.76
L1848
$ 924.76
$ 924.76
L1850
$ 272.34
$ 462.00
L1851
$ 795.12
$ 1,207.22
L1852
$ 758.53
$ 1,093.01
L1860
$ 2,203.71
$ 2,203.71
L1900
$ 470.01
$ 470.01
L1902
$ 140.88
$ 140.88
L1904
$ 965.72
$ 965.72
L1906
$ 246.97
$ 246.97
L1907
$ 904.69
$ 904.69
L1910
$ 549.19
$ 549.19
L1920
$ 561.51
$ 561.51
L1930
$ 485.81
$ 485.81
L1932
$ 1,434.72
$ 1,434.72
L1940
$ 1,015.64
$ 1,015.64
L1945
$ 1,901.07
$ 1,901.07
L1950
$ 1,529.68
$ 1,529.68
L1951
$ 1,350.26
$ 1,350.26
L1960
$ 1,138.34
$ 1,138.34
L1970
$ 1,190.29
$ 1,190.29
L1971
$ 753.61
$ 753.61
L1980
$ 753.70
$ 753.70
L1990
$ 915.43
$ 915.43
L2000
$ 2,083.03
$ 2,083.03
L2005
$ 6,588.25
$ 6,588.25
L2006
$ 53,532.25
$ 53,532.25
L2010
$ 1,898.88
$ 1,898.88
L2020
$ 2,397.98
$ 2,397.98
L2030
$ 2,080.46
$ 2,080.46
L2034
$ 3,221.15
$ 3,221.15
L2035
$ 278.50
$ 278.50
L2036
$ 3,416.74
$ 3,416.74
L2037
$ 3,420.61
$ 3,420.61
L2038
$ 2,513.63
$ 2,513.63
L2040
$ 273.48
$ 273.48
L2050
$ 978.29
$ 978.29
L2060
$ 1,192.35
$ 1,192.35
L2070
$ 228.34
$ 228.34
L2080
$ 738.67
$ 738.67
L2090
$ 900.52
$ 900.52
L2106
$ 1,396.33
$ 1,396.33
L2108
$ 2,029.30
$ 2,029.30
L2112
$ 884.06
$ 884.06
L2114
$ 1,192.03
$ 1,192.03
L2116
$ 1,462.01
$ 1,462.01
L2126
$ 2,110.11
$ 2,110.11
L2128
$ 3,314.47
$ 3,314.47
L2132
$ 1,280.51
$ 1,280.51
L2134
$ 1,986.28
$ 1,986.28
L2136
$ 2,428.68
$ 2,428.68
L2180
$ 240.51
$ 240.51
L2182
$ 164.64
$ 164.64
L2184
$ 190.81
$ 190.81
L2186
$ 231.88
$ 231.88
L2188
$ 461.29
$ 461.29
L2190
$ 134.51
$ 134.51
L2192
$ 732.26
$ 732.26
L2200
$ 97.64
$ 97.64
L2210
$ 138.04
$ 138.04
L2220
$ 168.18
$ 168.18
L2230
$ 157.57
$ 157.57
L2232
$ 160.02
$ 160.02
L2240
$ 171.77
$ 171.77
L2250
$ 729.72
$ 729.72
L2260
$ 411.68
$ 411.68
L2265
$ 241.86
$ 241.86
L2270
$ 110.29
$ 110.29
L2275
$ 240.90
$ 240.90
L2280
$ 929.92
$ 929.92
L2300
$ 552.94
$ 552.94
L2310
$ 252.64
$ 252.64
L2320
$ 422.55
$ 422.55
L2330
$ 806.40
$ 806.40
L2335
$ 466.54
$ 466.54
L2340
$ 917.85
$ 917.85
L2350
$ 1,829.94
$ 1,829.94
L2360
$ 105.11
$ 105.11
L2370
$ 527.18
$ 527.18
L2375
$ 232.05
$ 232.05
L2380
$ 252.84
$ 252.84
L2385
$ 275.07
$ 275.07
L2387
$ 339.86
$ 339.86
L2390
$ 224.81
$ 224.81
L2395
$ 294.50
$ 294.50
L2397
$ 203.55
$ 203.55
L2405
$ 140.17
$ 140.17
L2415
$ 195.27
$ 195.27
L2425
$ 230.45
$ 230.45
L2430
$ 230.45
$ 230.45
L2492
$ 182.11
$ 182.11
L2500
$ 647.89
$ 647.89
L2510
$ 1,491.74
$ 1,491.74
L2520
$ 946.09
$ 946.09
L2525
$ 2,336.92
$ 2,336.92
L2526
$ 1,304.42
$ 1,304.42
L2530
$ 482.52
$ 482.52
L2540
$ 868.27
$ 868.27
L2550
$ 589.83
$ 589.83
L2570
$ 978.18
$ 978.18
L2580
$ 953.13
$ 953.13
L2600
$ 421.79
$ 421.79
L2610
$ 498.75
$ 498.75
L2620
$ 549.11
$ 549.11
L2622
$ 629.78
$ 629.78
L2624
$ 680.06
$ 680.06
L2627
$ 2,640.47
$ 2,640.47
L2628
$ 2,580.54
$ 2,580.54
L2630
$ 508.54
$ 508.54
L2640
$ 690.14
$ 690.14
L2650
$ 205.95
$ 205.95
L2660
$ 382.76
$ 382.76
L2670
$ 314.09
$ 314.09
L2680
$ 291.58
$ 291.58
L2750
$ 128.73
$ 128.73
L2755
$ 210.11
$ 210.11
L2760
$ 124.78
$ 124.78
L2768
$ 209.45
$ 209.45
L2780
$ 138.99
$ 138.99
L2785
$ 65.09
$ 65.09
L2795
$ 174.51
$ 174.51
L2800
$ 219.06
$ 219.06
L2810
$ 160.40
$ 160.40
L2820
$ 178.35
$ 178.35
L2830
$ 192.93
$ 192.93
L2840
$ 67.30
$ 67.30
L2850
$ 115.29
$ 115.29
L2861
$ 631.57
$ 631.57
L3000
$ 505.05
$ 505.05
L3001
$ 212.66
$ 212.66
L3002
$ 259.67
$ 259.67
L3003
$ 280.20
$ 280.20
L3010
$ 280.20
$ 280.20
L3020
$ 318.96
$ 318.96
L3030
$ 122.71
$ 122.71
L3031
$ 196.92
$ 196.92
L3040
$ 75.66
$ 75.66
L3050
$ 75.66
$ 75.66
L3060
$ 118.57
$ 118.57
L3070
$ 51.07
$ 51.07
L3080
$ 51.07
$ 51.07
L3090
$ 65.45
$ 65.45
L3100
$ 69.51
$ 69.51
L3140
$ 143.16
$ 143.16
L3150
$ 130.87
$ 130.87
L3160
$ 177.73
$ 177.73
L3170
$ 81.82
$ 81.82
L3201
$ 66.37
$ 66.37
L3202
$ 75.81
$ 75.81
L3203
$ 72.25
$ 72.25
L3204
$ 73.46
$ 73.46
L3206
$ 75.81
$ 75.81
L3207
$ 65.18
$ 65.18
L3209
$ 45.02
$ 45.02
L3211
$ 45.02
$ 45.02
L3213
$ 122.04
$ 122.04
L3215
$ 97.19
$ 97.19
L3216
$ 119.29
$ 119.29
L3217
$ 165.83
$ 165.83
L3219
$ 184.83
$ 184.83
L3221
$ 142.14
$ 142.14
L3222
$ 195.58
$ 195.58
L3224
$ 120.76
$ 120.76
L3225
$ 138.92
$ 138.92
L3230
$ 522.31
$ 522.31
L3250
$ 484.86
$ 484.86
L3252
$ 355.53
$ 355.53
L3253
$ 118.45
$ 118.45
L3254
$ 35.55
$ 35.55
L3255
$ 35.55
$ 35.55
L3257
$ 71.08
$ 71.08
L3260
$ 47.42
$ 47.42
L3265
$ 35.55
$ 35.55
L3300
$ 83.83
$ 83.83
L3310
$ 130.87
$ 130.87
L3320
$ 171.82
$ 171.82
L3330
$ 909.93
$ 909.93
L3332
$ 118.57
$ 118.57
L3334
$ 61.36
$ 61.36
L3340
$ 137.06
$ 137.06
L3350
$ 36.83
$ 36.83
L3360
$ 57.26
$ 57.26
L3370
$ 79.69
$ 79.69
L3380
$ 79.69
$ 79.69
L3390
$ 79.69
$ 79.69
L3400
$ 65.45
$ 65.45
L3410
$ 149.25
$ 149.25
L3420
$ 87.95
$ 87.95
L3430
$ 257.64
$ 257.64
L3440
$ 122.71
$ 122.71
L3450
$ 169.75
$ 169.75
L3455
$ 65.45
$ 65.45
L3460
$ 55.16
$ 55.16
L3465
$ 94.04
$ 94.04
L3470
$ 100.17
$ 100.17
L3480
$ 100.17
$ 100.17
L3485
$ 42.66
$ 42.66
L3500
$ 47.03
$ 47.03
L3510
$ 47.03
$ 47.03
L3520
$ 51.07
$ 51.07
L3530
$ 51.07
$ 51.07
L3540
$ 81.82
$ 81.82
L3550
$ 14.28
$ 14.28
L3560
$ 36.83
$ 36.83
L3570
$ 137.06
$ 137.06
L3580
$ 104.29
$ 104.29
L3590
$ 85.88
$ 85.88
L3595
$ 67.45
$ 67.45
L3600
$ 122.71
$ 122.71
L3610
$ 161.53
$ 161.53
L3620
$ 122.71
$ 122.71
L3630
$ 161.53
$ 161.53
L3640
$ 69.51
$ 69.51
L3650
$ 119.18
$ 119.18
L3660
$ 183.34
$ 183.34
L3670
$ 227.25
$ 227.25
L3671
$ 1,318.51
$ 1,318.51
L3674
$ 1,729.59
$ 1,729.59
L3675
$ 256.79
$ 256.79
L3677
$ 108.07
$ 108.07
L3678
$ 118.47
$ 118.47
L3702
$ 422.51
$ 422.51
L3710
$ 208.61
$ 208.61
L3720
$ 1,314.45
$ 1,314.45
L3730
$ 1,811.59
$ 1,811.59
L3740
$ 2,147.78
$ 2,147.78
L3760
$ 731.72
$ 731.72
L3761
$ 731.72
$ 731.72
L3762
$ 157.33
$ 157.33
L3763
$ 1,233.99
$ 1,233.99
L3764
$ 1,419.04
$ 1,419.04
L3765
$ 1,876.21
$ 1,876.21
L3766
$ 1,986.77
$ 1,986.77
L3806
$ 664.69
$ 664.69
L3807
$ 365.89
$ 365.89
L3808
$ 665.48
$ 665.48
L3809
$ 365.89
$ 365.89
L3891
$ 266.60
$ 266.60
L3900
$ 2,387.76
$ 2,387.76
L3901
$ 2,939.09
$ 2,939.09
L3904
$ 5,885.08
$ 5,885.08
L3905
$ 1,451.11
$ 1,451.11
L3906
$ 794.08
$ 794.08
L3908
$ 120.40
$ 120.40
L3912
$ 190.58
$ 190.58
L3913
$ 396.30
$ 396.30
L3915
$ 777.80
$ 777.80
L3916
$ 777.80
$ 777.80
L3917
$ 154.64
$ 154.64
L3918
$ 154.64
$ 154.64
L3919
$ 396.30
$ 396.30
L3921
$ 470.01
$ 470.01
L3923
$ 131.11
$ 131.11
L3924
$ 131.11
$ 131.11
L3925
$ 96.14
$ 96.14
L3927
$ 51.16
$ 51.16
L3929
$ 157.09
$ 157.09
L3930
$ 157.09
$ 157.09
L3931
$ 350.83
$ 350.83
L3933
$ 312.16
$ 312.16
L3935
$ 323.23
$ 323.23
L3956
$ 126.67
$ 126.67
L3960
$ 1,476.93
$ 1,476.93
L3961
$ 2,458.39
$ 2,458.39
L3962
$ 1,441.90
$ 1,441.90
L3967
$ 2,902.54
$ 2,902.54
L3971
$ 2,755.20
$ 2,755.20
L3973
$ 2,902.54
$ 2,902.54
L3975
$ 2,458.39
$ 2,458.39
L3976
$ 2,458.39
$ 2,458.39
L3977
$ 2,755.20
$ 2,755.20
L3978
$ 2,902.54
$ 2,902.54
L3980
$ 621.28
$ 621.28
L3981
$ 1,472.84
$ 1,472.84
L3982
$ 750.22
$ 750.22
L3984
$ 691.70
$ 691.70
L3995
$ 57.44
$ 57.44
L4000
$ 2,618.53
$ 2,618.53
L4002
$ 35.55
$ 35.55
L4010
$ 1,378.26
$ 1,378.26
L4020
$ 1,768.90
$ 1,768.90
L4030
$ 1,036.87
$ 1,036.87
L4040
$ 838.31
$ 838.31
L4045
$ 673.67
$ 673.67
L4050
$ 847.84
$ 847.84
L4055
$ 549.01
$ 549.01
L4060
$ 652.67
$ 652.67
L4070
$ 577.95
$ 577.95
L4080
$ 178.01
$ 178.01
L4090
$ 169.54
$ 169.54
L4100
$ 214.21
$ 214.21
L4110
$ 174.16
$ 174.16
L4130
$ 1,018.89
$ 1,018.89
L4205
$ 48.86
$ 48.86
L4210
$ 177.76
$ 177.76
L4350
$ 183.57
$ 183.57
L4360
$ 497.59
$ 497.59
L4361
$ 497.59
$ 497.59
L4370
$ 290.78
$ 290.78
L4386
$ 254.88
$ 254.88
L4387
$ 254.88
$ 254.88
L4392
$ 37.20
$ 37.20
L4394
$ 27.10
$ 27.10
L4396
$ 265.26
$ 265.26
L4397
$ 265.26
$ 265.26
L4398
$ 122.15
$ 122.15
L4631
$ 3,026.00
$ 3,026.00
L5000
$ 986.16
$ 986.16
L5010
$ 2,213.93
$ 2,213.93
L5020
$ 4,335.95
$ 4,335.95
L5050
$ 4,369.27
$ 4,369.27
L5060
$ 6,043.11
$ 6,043.11
L5100
$ 4,411.65
$ 4,411.65
L5105
$ 7,600.80
$ 7,600.80
L5150
$ 7,683.37
$ 7,683.37
L5160
$ 8,357.05
$ 8,357.05
L5200
$ 6,585.40
$ 6,585.40
L5210
$ 4,858.84
$ 4,858.84
L5220
$ 6,034.88
$ 6,034.88
L5230
$ 8,323.29
$ 8,323.29
L5250
$ 11,352.24
$ 11,352.24
L5270
$ 11,252.79
$ 11,252.79
L5280
$ 11,140.28
$ 11,140.28
L5301
$ 5,002.09
$ 5,002.09
L5312
$ 6,465.93
$ 6,465.93
L5321
$ 7,191.11
$ 7,191.11
L5331
$ 9,556.40
$ 9,556.40
L5341
$ 11,057.77
$ 11,057.77
L5400
$ 2,603.89
$ 2,603.89
L5410
$ 685.61
$ 685.61
L5420
$ 3,325.71
$ 3,325.71
L5430
$ 926.93
$ 926.93
L5450
$ 668.53
$ 668.53
L5460
$ 894.80
$ 894.80
L5500
$ 2,798.47
$ 2,798.47
L5505
$ 3,805.52
$ 3,805.52
L5510
$ 2,886.77
$ 2,886.77
L5520
$ 3,144.46
$ 3,144.46
L5530
$ 3,779.09
$ 3,779.09
L5535
$ 3,710.32
$ 3,710.32
L5540
$ 3,957.46
$ 3,957.46
L5560
$ 3,857.67
$ 3,857.67
L5570
$ 4,229.30
$ 4,229.30
L5580
$ 5,133.31
$ 5,133.31
L5585
$ 4,546.15
$ 4,546.15
L5590
$ 5,259.66
$ 5,259.66
L5595
$ 8,809.74
$ 8,809.74
L5600
$ 9,728.60
$ 9,728.60
L5610
$ 4,021.14
$ 4,021.14
L5611
$ 3,252.00
$ 3,252.00
L5613
$ 5,361.99
$ 5,361.99
L5614
$ 2,718.37
$ 2,718.37
L5615
$ 11,756.18
$ 11,756.18
L5616
$ 2,315.78
$ 2,315.78
L5617
$ 901.31
$ 901.31
L5618
$ 473.86
$ 473.86
L5620
$ 479.95
$ 479.95
L5622
$ 622.06
$ 622.06
L5624
$ 682.29
$ 682.29
L5626
$ 896.38
$ 896.38
L5628
$ 793.23
$ 793.23
L5629
$ 521.49
$ 521.49
L5630
$ 904.12
$ 904.12
L5631
$ 721.00
$ 721.00
L5632
$ 387.79
$ 387.79
L5634
$ 665.55
$ 665.55
L5636
$ 418.11
$ 418.11
L5637
$ 629.61
$ 629.61
L5638
$ 1,064.78
$ 1,064.78
L5639
$ 2,453.07
$ 2,453.07
L5640
$ 1,273.19
$ 1,273.19
L5642
$ 1,016.68
$ 1,016.68
L5643
$ 2,554.05
$ 2,554.05
L5644
$ 969.22
$ 969.22
L5645
$ 1,482.08
$ 1,482.08
L5646
$ 899.09
$ 899.09
L5647
$ 1,740.42
$ 1,740.42
L5648
$ 1,080.37
$ 1,080.37
L5649
$ 3,144.60
$ 3,144.60
L5650
$ 1,068.12
$ 1,068.12
L5651
$ 1,970.65
$ 1,970.65
L5652
$ 715.43
$ 715.43
L5653
$ 1,069.05
$ 1,069.05
L5654
$ 668.63
$ 668.63
L5655
$ 580.33
$ 580.33
L5656
$ 811.61
$ 811.61
L5658
$ 617.68
$ 617.68
L5661
$ 1,234.31
$ 1,234.31
L5665
$ 1,120.28
$ 1,120.28
L5666
$ 153.15
$ 153.15
L5668
$ 220.95
$ 220.95
L5670
$ 593.70
$ 593.70
L5671
$ 1,088.32
$ 1,088.32
L5672
$ 517.26
$ 517.26
L5673
$ 1,285.82
$ 1,285.82
L5676
$ 792.85
$ 792.85
L5677
$ 1,078.77
$ 1,078.77
L5678
$ 86.87
$ 86.87
L5679
$ 1,071.49
$ 1,071.49
L5680
$ 523.29
$ 523.29
L5681
$ 2,119.00
$ 2,119.00
L5682
$ 1,368.30
$ 1,368.30
L5683
$ 2,119.00
$ 2,119.00
L5684
$ 105.31
$ 105.31
L5685
$ 206.33
$ 206.33
L5686
$ 101.85
$ 101.85
L5688
$ 133.66
$ 133.66
L5690
$ 214.10
$ 214.10
L5692
$ 290.72
$ 290.72
L5694
$ 396.93
$ 396.93
L5695
$ 356.80
$ 356.80
L5696
$ 404.81
$ 404.81
L5697
$ 175.64
$ 175.64
L5698
$ 225.11
$ 225.11
L5699
$ 407.95
$ 407.95
L5700
$ 5,991.78
$ 5,991.78
L5701
$ 7,439.28
$ 7,439.28
L5702
$ 9,505.83
$ 9,505.83
L5703
$ 3,950.09
$ 3,950.09
L5704
$ 1,000.65
$ 1,000.65
L5705
$ 1,642.80
$ 1,642.80
L5706
$ 1,628.20
$ 1,628.20
L5707
$ 2,314.61
$ 2,314.61
L5710
$ 786.91
$ 786.91
L5711
$ 1,142.46
$ 1,142.46
L5712
$ 942.77
$ 942.77
L5714
$ 819.35
$ 819.35
L5716
$ 1,594.64
$ 1,594.64
L5718
$ 1,993.15
$ 1,993.15
L5722
$ 1,780.51
$ 1,780.51
L5724
$ 3,164.74
$ 3,164.74
L5726
$ 3,236.38
$ 3,236.38
L5728
$ 5,206.21
$ 5,206.21
L5780
$ 2,504.99
$ 2,504.99
L5781
$ 6,445.57
$ 6,445.57
L5782
$ 6,795.08
$ 6,795.08
L5785
$ 901.36
$ 901.36
L5790
$ 1,451.25
$ 1,451.25
L5795
$ 1,831.24
$ 1,831.24
L5810
$ 1,065.22
$ 1,065.22
L5811
$ 1,595.71
$ 1,595.71
L5812
$ 1,236.84
$ 1,236.84
L5814
$ 5,982.77
$ 5,982.77
L5816
$ 1,860.73
$ 1,860.73
L5818
$ 2,101.13
$ 2,101.13
L5822
$ 2,794.39
$ 2,794.39
L5824
$ 3,355.34
$ 3,355.34
L5826
$ 5,030.76
$ 5,030.76
L5828
$ 6,002.70
$ 6,002.70
L5830
$ 4,151.69
$ 4,151.69
L5840
$ 6,623.20
$ 6,623.20
L5845
$ 2,887.37
$ 2,887.37
L5848
$ 1,732.28
$ 1,732.28
L5850
$ 209.92
$ 209.92
L5855
$ 675.71
$ 675.71
L5856
$ 38,671.61
$ 38,671.61
L5857
$ 13,722.20
$ 13,722.20
L5858
$ 29,939.35
$ 29,939.35
L5859
$ 23,373.41
$ 23,373.41
L5910
$ 594.31
$ 594.31
L5920
$ 870.69
$ 870.69
L5925
$ 715.68
$ 715.68
L5926
$ 1,246.41
$ 1,246.41
L5930
$ 5,422.26
$ 5,422.26
L5940
$ 874.85
$ 874.85
L5950
$ 1,276.67
$ 1,276.67
L5960
$ 1,581.94
$ 1,581.94
L5961
$ 8,418.26
$ 8,418.26
L5962
$ 1,286.04
$ 1,286.04
L5964
$ 1,851.37
$ 1,851.37
L5966
$ 2,400.23
$ 2,400.23
L5968
$ 5,853.99
$ 5,853.99
L5970
$ 419.27
$ 419.27
L5971
$ 419.27
$ 419.27
L5972
$ 771.09
$ 771.09
L5973
$ 28,319.09
$ 28,319.09
L5974
$ 509.85
$ 509.85
L5975
$ 746.80
$ 746.80
L5976
$ 1,225.31
$ 1,225.31
L5978
$ 638.50
$ 638.50
L5979
$ 4,946.26
$ 4,946.26
L5980
$ 6,925.35
$ 6,925.35
L5981
$ 5,375.19
$ 5,375.19
L5982
$ 1,264.87
$ 1,264.87
L5984
$ 1,246.41
$ 1,246.41
L5985
$ 454.92
$ 454.92
L5986
$ 1,386.46
$ 1,386.46
L5987
$ 11,588.57
$ 11,588.57
L5988
$ 3,218.17
$ 3,218.17
L5990
$ 2,922.58
$ 2,922.58
L5991
$ 15,756.22
$ 15,756.22
L6000
$ 2,907.10
$ 2,907.10
L6010
$ 3,235.13
$ 3,235.13
L6020
$ 3,016.23
$ 3,016.23
L6026
$ 7,604.97
$ 7,604.97
L6050
$ 4,143.06
$ 4,143.06
L6055
$ 5,313.34
$ 5,313.34
L6100
$ 3,447.78
$ 3,447.78
L6110
$ 4,465.09
$ 4,465.09
L6120
$ 5,070.03
$ 5,070.03
L6130
$ 5,663.95
$ 5,663.95
L6200
$ 5,968.89
$ 5,968.89
L6205
$ 7,286.26
$ 7,286.26
L6250
$ 5,875.38
$ 5,875.38
L6300
$ 8,151.46
$ 8,151.46
L6310
$ 6,639.54
$ 6,639.54
L6320
$ 3,739.05
$ 3,739.05
L6350
$ 8,505.39
$ 8,505.39
L6360
$ 6,968.99
$ 6,968.99
L6370
$ 4,443.88
$ 4,443.88
L6380
$ 2,122.62
$ 2,122.62
L6382
$ 2,670.33
$ 2,670.33
L6384
$ 3,462.62
$ 3,462.62
L6386
$ 878.64
$ 878.64
L6388
$ 897.06
$ 897.06
L6400
$ 5,076.89
$ 5,076.89
L6450
$ 6,188.50
$ 6,188.50
L6500
$ 5,625.90
$ 5,625.90
L6550
$ 8,343.16
$ 8,343.16
L6570
$ 9,576.35
$ 9,576.35
L6580
$ 2,932.61
$ 2,932.61
L6582
$ 2,258.47
$ 2,258.47
L6584
$ 3,666.59
$ 3,666.59
L6586
$ 3,118.96
$ 3,118.96
L6588
$ 5,306.25
$ 5,306.25
L6590
$ 4,661.96
$ 4,661.96
L6600
$ 410.41
$ 410.41
L6605
$ 405.23
$ 405.23
L6610
$ 364.27
$ 364.27
L6611
$ 663.29
$ 663.29
L6615
$ 300.62
$ 300.62
L6616
$ 106.44
$ 106.44
L6620
$ 627.06
$ 627.06
L6621
$ 3,684.67
$ 3,684.67
L6623
$ 1,052.62
$ 1,052.62
L6624
$ 6,066.93
$ 6,066.93
L6625
$ 1,163.65
$ 1,163.65
L6628
$ 786.10
$ 786.10
L6629
$ 287.32
$ 287.32
L6630
$ 353.65
$ 353.65
L6632
$ 106.61
$ 106.61
L6635
$ 385.38
$ 385.38
L6637
$ 703.67
$ 703.67
L6638
$ 4,028.50
$ 4,028.50
L6640
$ 459.65
$ 459.65
L6641
$ 329.67
$ 329.67
L6642
$ 427.52
$ 427.52
L6645
$ 698.46
$ 698.46
L6646
$ 5,080.85
$ 5,080.85
L6647
$ 836.44
$ 836.44
L6648
$ 5,240.16
$ 5,240.16
L6650
$ 740.59
$ 740.59
L6655
$ 164.36
$ 164.36
L6660
$ 200.83
$ 200.83
L6665
$ 81.37
$ 81.37
L6670
$ 104.93
$ 104.93
L6672
$ 368.91
$ 368.91
L6675
$ 250.47
$ 250.47
L6676
$ 265.34
$ 265.34
L6677
$ 477.88
$ 477.88
L6680
$ 507.61
$ 507.61
L6682
$ 505.44
$ 505.44
L6684
$ 762.65
$ 762.65
L6686
$ 1,291.68
$ 1,291.68
L6687
$ 957.33
$ 957.33
L6688
$ 1,037.09
$ 1,037.09
L6689
$ 1,182.66
$ 1,182.66
L6690
$ 1,370.00
$ 1,370.00
L6691
$ 753.79
$ 753.79
L6692
$ 1,223.56
$ 1,223.56
L6693
$ 4,573.42
$ 4,573.42
L6694
$ 1,285.82
$ 1,285.82
L6695
$ 1,071.49
$ 1,071.49
L6696
$ 2,119.00
$ 2,119.00
L6697
$ 2,119.00
$ 2,119.00
L6698
$ 1,088.32
$ 1,088.32
L6703
$ 589.76
$ 589.76
L6704
$ 1,281.34
$ 1,281.34
L6706
$ 708.19
$ 708.19
L6707
$ 2,704.14
$ 2,704.14
L6708
$ 1,830.14
$ 1,830.14
L6709
$ 2,650.77
$ 2,650.77
L6711
$ 1,083.05
$ 1,083.05
L6712
$ 1,994.08
$ 1,994.08
L6713
$ 2,516.79
$ 2,516.79
L6714
$ 2,131.71
$ 2,131.71
L6715
$ 5,085.89
$ 5,085.89
L6721
$ 3,788.81
$ 3,788.81
L6722
$ 3,266.26
$ 3,266.26
L6805
$ 694.85
$ 694.85
L6810
$ 357.18
$ 357.18
L6880
$ 38,489.01
$ 38,489.01
L6881
$ 6,585.87
$ 6,585.87
L6882
$ 4,995.69
$ 4,995.69
L6883
$ 2,820.82
$ 2,820.82
L6884
$ 4,884.61
$ 4,884.61
L6885
$ 6,968.99
$ 6,968.99
L6890
$ 372.15
$ 372.15
L6895
$ 916.30
$ 916.30
L6900
$ 3,291.95
$ 3,291.95
L6905
$ 3,212.36
$ 3,212.36
L6910
$ 3,129.49
$ 3,129.49
L6915
$ 1,324.90
$ 1,324.90
L6920
$ 12,234.39
$ 12,234.39
L6925
$ 13,962.90
$ 13,962.90
L6930
$ 11,387.11
$ 11,387.11
L6935
$ 13,225.42
$ 13,225.42
L6940
$ 14,412.69
$ 14,412.69
L6945
$ 16,749.59
$ 16,749.59
L6950
$ 16,364.57
$ 16,364.57
L6955
$ 19,598.80
$ 19,598.80
L6960
$ 20,969.21
$ 20,969.21
L6965
$ 24,346.88
$ 24,346.88
L6970
$ 25,785.21
$ 25,785.21
L6975
$ 30,489.97
$ 30,489.97
L7007
$ 5,646.63
$ 5,646.63
L7008
$ 9,492.59
$ 9,492.59
L7009
$ 5,761.35
$ 5,761.35
L7040
$ 4,626.15
$ 4,626.15
L7045
$ 2,652.33
$ 2,652.33
L7170
$ 9,621.77
$ 9,621.77
L7180
$ 59,455.03
$ 59,455.03
L7181
$ 64,546.66
$ 64,546.66
L7185
$ 9,823.98
$ 9,823.98
L7186
$ 14,515.17
$ 14,515.17
L7190
$ 12,868.02
$ 12,868.02
L7191
$ 15,167.49
$ 15,167.49
L7259
$ 6,620.43
$ 6,620.43
L7360
$ 398.61
$ 398.61
L7362
$ 423.67
$ 423.67
L7364
$ 779.44
$ 779.44
L7366
$ 1,007.05
$ 1,007.05
L7367
$ 627.17
$ 627.17
L7368
$ 813.02
$ 813.02
L7400
$ 493.74
$ 493.74
L7401
$ 552.75
$ 552.75
L7402
$ 596.92
$ 596.92
L7403
$ 593.22
$ 593.22
L7404
$ 895.40
$ 895.40
L7405
$ 1,171.03
$ 1,171.03
L7510
$ 135.06
$ 135.06
L7520
$ 71.11
$ 71.11
L7600
$ 137.45
$ 137.45
L7700
$ 201.78
$ 201.78
L7900
$ 733.52
$ 733.52
L7902
$ 50.83
$ 50.83
L8000
$ 79.88
$ 79.88
L8001
$ 202.09
$ 202.09
L8002
$ 265.75
$ 265.75
L8010
$ 105.50
$ 105.50
L8015
$ 96.57
$ 96.57
L8020
$ 343.01
$ 343.01
L8030
$ 626.70
$ 626.70
L8031
$ 626.70
$ 626.70
L8032
$ 63.11
$ 63.11
L8035
$ 5,901.85
$ 5,901.85
L8040
$ 4,219.75
$ 4,219.75
L8041
$ 5,086.48
$ 5,086.48
L8042
$ 5,715.15
$ 5,715.15
L8043
$ 6,400.98
$ 6,400.98
L8044
$ 7,086.79
$ 7,086.79
L8045
$ 4,454.17
$ 4,454.17
L8046
$ 4,572.15
$ 4,572.15
L8047
$ 2,343.14
$ 2,343.14
L8300
$ 184.56
$ 184.56
L8310
$ 291.40
$ 291.40
L8320
$ 116.94
$ 116.94
L8330
$ 108.01
$ 108.01
L8400
$ 34.44
$ 34.44
L8410
$ 44.42
$ 44.42
L8415
$ 39.30
$ 39.30
L8417
$ 121.16
$ 121.16
L8420
$ 42.55
$ 42.55
L8430
$ 45.70
$ 45.70
L8435
$ 42.38
$ 42.38
L8440
$ 91.49
$ 91.49
L8460
$ 145.82
$ 145.82
L8465
$ 80.04
$ 80.04
L8470
$ 14.60
$ 14.60
L8480
$ 17.43
$ 17.43
L8485
$ 23.62
$ 23.62
L8500
$ 1,082.96
$ 1,082.96
L8501
$ 198.23
$ 198.23
L8505
$ 117.43
$ 117.43
L8507
$ 67.47
$ 67.47
L8509
$ 175.91
$ 175.91
L8510
$ 407.06
$ 407.06
L8511
$ 117.17
$ 117.17
L8512
$ 3.47
$ 3.47
L8513
$ 8.37
$ 8.37
L8514
$ 151.89
$ 151.89
L8515
$ 101.65
$ 101.65
L8600
$ 1,116.82
$ 1,116.82
L8603
$ 719.52
$ 719.52
L8605
$ 1,153.80
$ 1,153.80
L8606
$ 373.62
$ 373.62
L8607
$ 69.08
$ 69.08
L8609
$ 10,495.90
$ 10,495.90
L8610
$ 960.48
$ 960.48
L8612
$ 1,305.47
$ 1,305.47
L8613
$ 484.60
$ 484.60
L8614
$ 32,368.91
$ 32,368.91
L8615
$ 726.54
$ 726.54
L8616
$ 169.23
$ 169.23
L8617
$ 147.81
$ 147.81
L8618
$ 42.22
$ 42.22
L8619
$ 13,895.76
$ 13,895.76
L8621
$ 1.01
$ 1.01
L8622
$ 0.52
$ 0.52
L8623
$ 104.22
$ 104.22
L8624
$ 259.80
$ 259.80
L8625
$ 304.22
$ 304.22
L8627
$ 11,803.22
$ 11,803.22
L8628
$ 2,092.55
$ 2,092.55
L8629
$ 288.43
$ 288.43
L8630
$ 552.85
$ 552.85
L8631
$ 3,672.10
$ 3,672.10
L8641
$ 580.97
$ 580.97
L8642
$ 568.41
$ 568.41
L8658
$ 500.82
$ 500.82
L8659
$ 3,108.57
$ 3,108.57
L8670
$ 913.46
$ 913.46
L8678
$ 17.00
$ 36.36
L8679
$ 14,114.11
$ 14,114.11
L8680
$ 858.84
$ 858.84
L8681
$ 1,770.26
$ 1,770.26
L8682
$ 10,084.21
$ 10,084.21
L8683
$ 8,876.43
$ 8,876.43
L8684
$ 1,292.45
$ 1,292.45
L8689
$ 2,778.75
$ 2,778.75
L8690
$ 7,663.46
$ 7,663.46
L8691
$ 2,774.23
$ 2,774.23
L8692
$ 7,656.99
$ 7,656.99
L8693
$ 2,442.69
$ 2,442.69
L8694
$ 1,521.31
$ 1,521.31
L8695
$ 26.81
$ 26.81
L8696
$ 349.15
$ 349.15
Q0035
$ 24.30
$ 24.30
Q0081
$ 287.78
$ 287.78
Q0083
BR
BR
Q0091
$ 60.97
$ 60.97
Q0092
$ 35.76
$ 35.76
Q0111
$ 24.86
$ 24.86
Q0112
$ 8.16
$ 8.16
Q0113
$ 5.98
$ 5.98
Q0114
$ 13.64
$ 13.64
Q0115
$ 35.00
$ 35.00
Q0477
$ 1,249.77
$ 1,249.77
Q0478
$ 296.04
$ 296.04
Q0479
$ 19,283.78
$ 19,283.78
Q0480
$ 139,999.87
$ 139,999.87
Q0481
$ 23,408.10
$ 23,408.10
Q0482
$ 7,331.86
$ 7,331.86
Q0483
$ 30,204.02
$ 30,204.02
Q0484
$ 5,865.54
$ 5,865.54
Q0485
$ 566.27
$ 566.27
Q0486
$ 471.34
$ 471.34
Q0487
$ 549.89
$ 549.89
Q0489
$ 26,185.22
$ 26,185.22
Q0490
$ 1,132.66
$ 1,132.66
Q0491
$ 1,780.66
$ 1,780.66
Q0492
$ 143.43
$ 143.43
Q0493
$ 408.51
$ 408.51
Q0494
$ 345.67
$ 345.67
Q0495
$ 6,728.93
$ 6,728.93
Q0496
$ 2,415.13
$ 2,415.13
Q0497
$ 754.15
$ 754.15
Q0498
$ 827.48
$ 827.48
Q0499
$ 268.86
$ 268.86
Q0500
$ 49.21
$ 49.21
Q0501
$ 822.67
$ 822.67
Q0502
$ 1,047.37
$ 1,047.37
Q0503
$ 2,094.81
$ 2,094.81
Q0504
$ 1,105.38
$ 1,105.38
Q0506
$ 1,375.95
$ 1,375.95
Q0507
BR
BR
Q0508
BR
BR
Q0509
BR
BR
Q0510
$ 52.64
$ 52.64
Q0511
$ 25.26
$ 25.26
Q0512
$ 16.70
$ 16.70
Q0513
$ 138.74
$ 138.74
Q0514
$ 69.34
$ 69.34
Q0515
BR
BR
Q0516
BR
BR
Q0517
BR
BR
Q0518
BR
BR
Q1004
BR
BR
Q1005
BR
BR
Q3031
BR
BR
Q4001
$ 83.59
$ 83.59
Q4002
$ 315.85
$ 315.85
Q4003
$ 60.02
$ 60.02
Q4004
$ 207.80
$ 207.80
Q4005
$ 22.13
$ 22.13
Q4006
$ 49.87
$ 49.87
Q4007
$ 11.06
$ 11.06
Q4008
$ 24.92
$ 24.92
Q4009
$ 14.78
$ 14.78
Q4010
$ 33.24
$ 33.24
Q4011
$ 7.36
$ 7.36
Q4012
$ 16.66
$ 16.66
Q4013
$ 26.91
$ 26.91
Q4014
$ 45.36
$ 45.36
Q4015
$ 13.47
$ 13.47
Q4016
$ 22.67
$ 22.67
Q4017
$ 15.54
$ 15.54
Q4018
$ 24.78
$ 24.78
Q4019
$ 7.78
$ 7.78
Q4020
$ 12.45
$ 12.45
Q4021
$ 11.51
$ 11.51
Q4022
$ 20.78
$ 20.78
Q4023
$ 5.78
$ 5.78
Q4024
$ 10.40
$ 10.40
Q4025
$ 64.50
$ 64.50
Q4026
$ 201.49
$ 201.49
Q4027
$ 32.28
$ 32.28
Q4028
$ 100.80
$ 100.80
Q4029
$ 49.35
$ 49.35
Q4030
$ 129.91
$ 129.91
Q4031
$ 24.65
$ 24.65
Q4032
$ 64.96
$ 64.96
Q4033
$ 46.05
$ 46.05
Q4034
$ 114.46
$ 114.46
Q4035
$ 23.02
$ 23.02
Q4036
$ 57.27
$ 57.27
Q4037
$ 28.04
$ 28.04
Q4038
$ 70.34
$ 70.34
Q4039
$ 14.07
$ 14.07
Q4040
$ 35.17
$ 35.17
Q4041
$ 34.15
$ 34.15
Q4042
$ 58.30
$ 58.30
Q4043
$ 17.08
$ 17.08
Q4044
$ 29.19
$ 29.19
Q4045
$ 19.82
$ 19.82
Q4046
$ 31.88
$ 31.88
Q4047
$ 9.87
$ 9.87
Q4048
$ 15.96
$ 15.96
Q4049
$ 3.60
$ 3.60
Q5001
$ 105.39
$ 105.39
Q5002
$ 311.67
$ 311.67
Q5003
$ 1.36
$ 1.36
Q5005
$ 1,126.05
$ 1,126.05
Q5006
$ 1,354.39
$ 1,354.39
Q5007
BR
BR
Q5008
BR
BR
Q5009
BR
BR
Q5010
BR
BR
Q9950
$ 26.47
$ 26.47
Q9951
$ 2.20
$ 2.20
Q9953
$ 157.64
$ 157.64
Q9954
$ 22.08
$ 22.08
Q9955
$ 409.88
$ 409.88
Q9956
$ 59.02
$ 59.02
Q9957
$ 59.02
$ 59.02
Q9958
$ 0.12
$ 0.12
Q9959
$ 2.27
$ 2.27
Q9960
$ 0.91
$ 0.91
Q9961
$ 0.39
$ 0.39
Q9962
$ 0.91
$ 0.91
Q9963
$ 0.29
$ 0.29
Q9964
$ 0.91
$ 0.91
Q9965
$ 1.91
$ 1.91
Q9966
$ 0.52
$ 0.52
Q9967
$ 0.16
$ 0.16
Q9968
$ 50.44
$ 50.44
Q9969
$ 13.52
$ 13.52
S9122
S9123
S9124
S9125
S9126
S9127
S9128
S9129
S9131
V2020
$ 137.19
$ 137.19
V2025
$ 153.17
$ 153.17
V2100
$ 64.29
$ 64.29
V2101
$ 86.17
$ 86.17
V2102
$ 104.51
$ 104.51
V2103
$ 61.38
$ 61.38
V2104
$ 64.93
$ 64.93
V2105
$ 71.20
$ 71.20
V2106
$ 85.19
$ 85.19
V2107
$ 91.70
$ 91.70
V2108
$ 87.18
$ 87.18
V2109
$ 97.99
$ 97.99
V2110
$ 83.93
$ 83.93
V2111
$ 98.92
$ 98.92
V2112
$ 103.84
$ 103.84
V2113
$ 102.96
$ 102.96
V2114
$ 111.54
$ 111.54
V2115
$ 155.41
$ 155.41
V2118
$ 155.13
$ 155.13
V2121
$ 165.65
$ 165.65
V2200
$ 96.07
$ 96.07
V2201
$ 116.90
$ 116.90
V2202
$ 107.90
$ 107.90
V2203
$ 104.51
$ 104.51
V2204
$ 106.06
$ 106.06
V2205
$ 104.71
$ 104.71
V2206
$ 117.66
$ 117.66
V2207
$ 114.23
$ 114.23
V2208
$ 125.83
$ 125.83
V2209
$ 118.08
$ 118.08
V2210
$ 125.93
$ 125.93
V2211
$ 152.94
$ 152.94
V2212
$ 143.57
$ 143.57
V2213
$ 133.73
$ 133.73
V2214
$ 151.24
$ 151.24
V2215
$ 185.99
$ 185.99
V2218
$ 178.53
$ 178.53
V2219
$ 73.07
$ 73.07
V2220
$ 69.05
$ 69.05
V2221
$ 193.26
$ 193.26
V2299
$ 106.76
$ 106.76
V2300
$ 118.83
$ 118.83
V2301
$ 146.31
$ 146.31
V2302
$ 134.57
$ 134.57
V2303
$ 128.20
$ 128.20
V2304
$ 133.00
$ 133.00
V2305
$ 133.41
$ 133.41
V2306
$ 134.48
$ 134.48
V2307
$ 144.07
$ 144.07
V2308
$ 140.50
$ 140.50
V2309
$ 170.13
$ 170.13
V2310
$ 143.70
$ 143.70
V2311
$ 175.91
$ 175.91
V2312
$ 196.06
$ 196.06
V2313
$ 218.96
$ 218.96
V2314
$ 203.24
$ 203.24
V2315
$ 252.15
$ 252.15
V2318
$ 320.94
$ 320.94
V2319
$ 81.49
$ 81.49
V2320
$ 85.97
$ 85.97
V2321
$ 239.22
$ 239.22
V2399
$ 236.95
$ 236.95
V2410
$ 196.18
$ 196.18
V2430
$ 236.43
$ 236.43
V2499
$ 42.73
$ 42.73
V2500
$ 144.28
$ 144.28
V2501
$ 226.95
$ 226.95
V2502
$ 332.05
$ 332.05
V2503
$ 230.51
$ 230.51
V2510
$ 194.00
$ 194.00
V2511
$ 313.50
$ 313.50
V2512
$ 363.96
$ 363.96
V2513
$ 333.94
$ 333.94
V2520
$ 171.12
$ 171.12
V2521
$ 297.95
$ 297.95
V2522
$ 386.61
$ 386.61
V2523
$ 247.10
$ 247.10
V2524
$ 198.04
$ 198.04
V2525
$ 165.73
$ 165.73
V2530
$ 365.99
$ 365.99
V2531
$ 872.26
$ 872.26
V2600
$ 169.82
$ 169.82
V2623
$ 1,963.98
$ 1,963.98
V2624
$ 99.90
$ 99.90
V2625
$ 708.26
$ 708.26
V2626
$ 436.52
$ 436.52
V2627
$ 2,114.42
$ 2,114.42
V2628
$ 499.25
$ 499.25
V2629
$ 2,962.32
$ 2,962.32
V2630
$ 195.33
$ 195.33
V2631
$ 195.33
$ 195.33
V2632
$ 195.33
$ 195.33
V2700
$ 95.84
$ 95.84
V2702
$ 24.28
$ 24.28
V2710
$ 132.85
$ 132.85
V2715
$ 25.44
$ 25.44
V2718
$ 62.47
$ 62.47
V2730
$ 44.81
$ 44.81
V2744
$ 26.92
$ 26.92
V2745
$ 17.44
$ 17.44
V2750
$ 39.23
$ 39.23
V2755
$ 27.26
$ 27.26
V2756
$ 5.43
$ 5.43
V2760
$ 35.04
$ 35.04
V2761
$ 53.16
$ 53.16
V2762
$ 96.01
$ 96.01
V2770
$ 42.70
$ 42.70
V2780
$ 27.41
$ 27.41
V2781
$ 163.02
$ 163.02
V2782
$ 103.71
$ 103.71
V2783
$ 116.90
$ 116.90
V2784
$ 76.03
$ 76.03
V2786
$ 100.48
$ 100.48
V2787
$ 669.75
$ 669.75
V2788
$ 1,119.26
$ 1,119.26
V2790
$ 645.40
$ 645.40
V2797
$ 29.65
$ 29.65
V2799
BR
BR
V5008
$ 95.89
$ 95.89
V5010
$ 143.72
$ 143.72
V5011
$ 287.78
$ 287.78
V5014
$ 181.99
$ 181.99
V5020
$ 143.72
$ 143.72
V5030
$ 2,250.74
$ 2,250.74
V5040
$ 3,033.46
$ 3,033.46
V5050
$ 1,777.29
$ 1,777.29
V5060
$ 2,014.24
$ 2,014.24
V5090
$ 414.86
$ 414.86
V5100
$ 2,547.51
$ 2,547.51
V5110
$ 481.10
$ 481.10
V5120
$ 1,895.82
$ 1,895.82
V5130
$ 2,843.89
$ 2,843.89
V5140
$ 4,382.92
$ 4,382.92
V5150
$ 82.88
$ 82.88
V5160
$ 829.67
$ 829.67
V5181
$ 1,777.73
$ 1,777.73
V5200
$ 414.86
$ 414.86
V5211
$ 4,147.35
$ 4,147.35
V5215
$ 3,903.20
$ 3,903.20
V5221
$ 4,203.21
$ 4,203.21
V5240
$ 592.26
$ 592.26
V5241
$ 474.29
$ 474.29
V5247
$ 2,125.86
$ 2,125.86
V5248
$ 4,265.81
$ 4,265.81
V5250
$ 4,087.45
$ 4,087.45
V5251
$ 3,555.54
$ 3,555.54
V5252
$ 3,614.52
$ 3,614.52
V5253
$ 4,264.01
$ 4,264.01
V5254
$ 2,961.85
$ 2,961.85
V5255
$ 2,962.32
$ 2,962.32
V5256
$ 2,962.32
$ 2,962.32
V5257
$ 2,962.32
$ 2,962.32
V5258
$ 5,791.77
$ 5,791.77
V5259
$ 4,493.26
$ 4,493.26
V5260
$ 4,029.31
$ 4,029.31
V5261
$ 5,924.62
$ 5,924.62
V5262
$ 2,013.33
$ 2,013.33
V5263
$ 4,441.92
$ 4,441.92
V5264
$ 112.59
$ 112.59
V5265
$ 44.55
$ 44.55
V5266
$ 1.30
$ 1.30
V5268
$ 295.99
$ 295.99
V5270
$ 355.43
$ 355.43
V5275
$ 88.70
$ 88.70
V5281
$ 59.43
$ 59.43
V5282
$ 2,960.96
$ 2,960.96
V5284
$ 88.70
$ 88.70
V5288
$ 1,143.14
$ 1,143.14
V5290
$ 592.33
$ 592.33
V5299
BR
BR
V5336
$ 199.99
$ 199.99
V5362
$ 134.27
$ 134.27
V5363
$ 140.94
$ 140.94
V5364
$ 202.26
$ 202.26
HOME HEALTHCARE GUIDELINES
Information regarding publications incorporated by reference
				  is found in the Introduction of the Fee Schedule.
The following Commission guidelines are in addition to the
				  CPT® guidelines and the Center for Medicare
				  & Medicaid Services' (CMS) HCPCS codes and descriptions and represent
				  additional guidance from the Commission relative to services unique or uniquely
				  utilized in Workers' Compensation. To the extent that a conflict may exist
				  between an incorporated portion of the CPT®
				  publication or a HCPCS code and a code, guideline, identifier, or modifier
				  unique to Arizona, then the Arizona code, guideline, identifier, or modifier
				  shall control. Codes that are unique to Arizona are preceded by an AZ
				  identifier and numbered in the following format: AZxxx.
GENERAL GUIDANCE:
1. The determination that the injury/illness or condition is
				  work related must be made by the payer and home health services shall be
				  authorized as medically necessary.
2. All nursing services and personal care services shall have
				  prior authorization by the payer.
3. A description of needed nursing or other attendant care
				  must accompany the request for authorization.
4. Rates and reimbursement guidelines shall be predetermined
				  in writing.
5. Except when governed by a separate contract or network
				  that governs fees pursuant to A.R.S. §
									23-908(J)(1),
				  reasonably required supplies shall be reimbursed based on the HCPCS Guidelines.
				  This includes supplies dispensed prior to the execution of an agreement and
				  during times when preauthorization of services is in process.
6. Submission of invoices and reimbursement for invoices
				  shall be made in accordance with A.R.S. §
									23-1062.01 (See Section B of the
				  Introduction).
ARIZONA SPECIFIC CODES GUIDELINES
Information regarding publications incorporated by reference
				  is found in the Introduction Section of the Fee Schedule.
The following Commission guidelines are in addition to the
				  CPT® guidelines and represent additional
				  guidance from the Commission relative to services uniquely utilized in Workers'
				  Compensation in Arizona. To the extent that a conflict may exist between an
				  incorporated portion of the CPT® and a code,
				  guideline, identifier, or modifier unique to Arizona, then the Arizona code,
				  guideline, identifier or modifier shall control. Codes that are unique to
				  Arizona are preceded by an AZ identifier and numbered in the following format:
				  AZxxx.
A. PEER TO PEER CONSULTATION: Medical providers may bill for
				  Peer-to-Peer consultations by using Arizona state specific codes AZ001 and
				  AZ002. Determination of the proper code is based on time spent in discussion
				  and review.
AZ001 Peer-to-Peer interprofessional telephone consultations
				  between treating physician or medical provider and Peer Reviewer; 5-10 minutes
				  of medical consultative discussion and review
AZ002 Peer-to-Peer interprofessional telephone consultations
				  between treating physician or medical provider and Peer Reviewer; 11-30 minutes
				  of medical consultative discussion and review
B. NURSE CASE MANAGER MEETING: Medical providers may bill for
				  meeting with a nurse case manager (NCM) by using Arizona state specific codes
				  AZ003 and AZ004. Determination of the proper code is based on patient presence
				  during the meeting.
AZ003 Meeting with NCM with patient.
AZ003 may be billed if time is spent discussing a patient's
				  treatment plan or other related information with the NCM when the patient is
				  present. This should not be billed if there is no interaction with the NCM who
				  is present during the time that a service, which is billed using a separate
				  CPT® code, is performed. The documentation must
				  include:
* The name of the NCM.
* The name of the organization the NCM is representing
* The purpose of the interaction
AZ004 Meeting with NCM without patient
AZ004 may be billed if time is spent discussing a patient's
				  treatment plan or other related information with the NCM when the patient is
				  not present. The documentation must include:
* The name of the NCM.
* The name of the organization the NCM is
				  representing.
* The purpose of the interaction.
It is not appropriate for the payer on a per billing basis to
				  require a healthcare provider to provide unnecessarily detailed documentation
				  to justify payment. A healthcare provider is required to comply with A.R.S.
				  §
									23-1062.01 when submitting a
				  bill.
C. SPECIAL REPORTS: Medical providers may bill for completion
				  of workers' compensation insurance forms by using Arizona state specific code
				  AZ005 when the request is submitted by the Commission, the payer or third-party
				  administrator of the payer, or the Special Fund of the Commission and limited
				  to one billing of code AZ005 per thirtyday period. The applicable form must be
				  attached to the billing.
AZ005 Completion of workers' compensation insurance forms
				  (i.e. return-to-work status, work restrictions, supportive care restrictions)
				  which are requested or required either by the Commission, the applicable payer
				  (insurance, self-insured employer, or the Special Fund of the Commission), or a
				  third-party administrator of the applicable payer, not to exceed more than one
				  billing in a thirty (30) day period. The applicable form must be attached to
				  the billing.
D. TRAVEL REIMBURSEMENT: Medical providers may bill for
				  collection and handling performed outside of a physician's office or
				  laboratory.
AZ026 Mileage charge for collection and handling service
				  performed outside of the physician's office or laboratory, within a radius of 7
				  miles.
AZ027 Mileage charge for collection and handling service
				  performed outside of the physician's office or laboratory, per mile over 7
				  miles.
AZ028 When more than one patient is seen, apportion mileage
				  charge among total number of patients.
AZ030 Mileage round trip: each mile in excess of 8 miles of
				  travel by physician.
AZ031 Within large metropolitan areas a travel time basis may
				  be appropriate. Code AZ031 would apply to Arizona's major metropolitan areas,
				  to include Phoenix, Tucson, Flagstaff, Kingman, and Yuma. This code would only
				  be used when travel times are 45 minutes or more.
E. EXPERT TESTIMONY: Medical testimony by personal appearance
				  or deposition of a physician is reported using Arizona specific code AZ099.
				  Reimbursement for time spent providing testimony at hearing is described in
				  Section I of the Introduction Section of the Fee Schedule.
ARIZONA PHYSICIANS' FEE SCHEDULE
Arizona Specific Codes 2024
Code
Category
Description
FY24 NF RBRVS Rate
FY24 FAC RBRVS
							 Rate
AZ001 00
AZ Specific Codes
Peer-to-Peer interprofessional telephone
							 consultations between treating physician or medical provider and Peer Reviewer;
							 5-10 minutes of medical consultative discussion and review.
75.00
75.00
AZ002 00
AZ Specific Codes
Peer-to-Peer interprofessional telephone
							 consultations between treating physician or medical provider and Peer Reviewer;
							 11-30 minutes of medical consultative discussion and review.
100.00
100.00
AZ003 00
AZ Specific Codes
Meeting with NCM with patient.
75.00
75.00
AZ004 00
AZ Specific Codes
Meeting with NCM without patient.
100.00
100.00
AZ005 00
AZ Specific Codes
Completion of workers' compensation insurance forms
							 (i.e. return-to-work status, work restrictions, supportive care restrictions)
							 which are requested or required by the Commission, the applicable payer
							 (insurance, selfinsured employer, or the Special Fund of the Commission), or a
							 third party administrator of the applicable payer, not to exceed more than one
							 billing in a thirty (30) day period. The applicable form must be attached to
							 the billing.
40.00
40.00
AZ026 00
AZ Specific Codes
Mileage charge, within a radius of 7 miles, for a
							 collection and handling service performed outside the physician's office or
							 laboratory.
BR
BR
AZ027 00
AZ Specific Codes
Over 7 miles, per mile.
BR
BR
AZ028 00
AZ Specific Codes
When more than one patient seen, apportion mileage
							 charge among total number of patients.
BR
BR
AZ030 00
AZ Specific Codes
Mileage round-trip: each mile in excess of 8 miles of
							 travel by physician.
BR
BR
AZ031 00
AZ Specific Codes
Within large metropolitan areas a travel time basis
							 may be appropriate. Code AZ031 00 would apply to Arizona's major metropolitan
							 areas, to include Phoenix, Tucson, Flagstaff, Kingman and Yuma. This code would
							 only be used when travel times are 45 minutes or more.
BR
BR
AZ099 00
AZ Specific Codes
Expert testimony at hearing, for the initial hour (or
							 any portion thereof), prorated for each additional 20 minute increment (or any
							 portion thereof).
150.00
150.00
1 It should be noted that the law
				  governing directed care is not limited to "medical doctors," but instead
				  applies to medical, surgical, and hospital benefits.
See
A.R.S. §
									23-1070. The phrase, "medical,
				  surgical, and hospital benefits" is defined in A.R.S. § 23- 1062(A), which
				  states: "Promptly, upon notice to the employer, every injured employee shall
				  receive medical, surgical and hospital benefits or other treatment, nursing,
				  medicine, surgical supplies, crutches and other apparatus, including artificial
				  members, reasonably required at the time of the injury, and during the period
				  of disability. Such benefits shall be termed 'medical, surgical and hospital
				  benefits.'"
1 A.R.S. §
									32-1963.01(A) 
				  states: "If a medical practitioner prescribes a brand name drug and does not
				  indicate an intent to prevent substitution as prescribed in subsection E of
				  this section, a pharmacist may fill the prescription with a generic equivalent
				  drug."
2 A.R.S. §
									32-1963.01(E) 
				  states: "A prescription generated in this state must be dispensed as written
				  only if the prescriber writes or clearly displays 'DAW', 'dispense as written',
				  'do not substitute' or 'medically necessary' or any statement by the prescriber
				  that clearly indicates an intent to prevent substitution on the face of the
				  prescription form. A prescription from out of state or from agencies of the
				  United States government must be dispensed as written only if the prescriber
				  writes or clearly displays 'do not substitute', 'dispense as written' or
				  'medically necessary' or any statement by the prescriber that clearly indicates
				  an intent to prevent substitution on the face of the prescription form."
3 A.R.S. §
									32-1963.01(L) 
				  states, in part:
2. "Brand name drug" means a drug with a proprietary name
				  assigned to it by the manufacturer or distributor.
4. "Generic equivalent" or "generically equivalent" means a
				  drug that has an identical amount of the same active chemical ingredients in
				  the same dosage form, that meets applicable standards of strength, quality and
				  purity according to the United States pharmacopeia or other nationally
				  recognized compendium and that, if administered in the same amounts, will
				  provide comparable therapeutic effects. Generic equivalent or generically
				  equivalent does not include a drug that is listed by the United States food and
				  drug administration as having unresolved bioequivalence concerns according to
				  the administration's most recent publication of approved drug products with
				  therapeutic equivalence evaluations.
4 Dispensing pursuant to Section
				  VII is subject to the Arizona Opioid Epidemic Act, which imposes statutory
				  limits on the prescribing and dispensing of schedule II opioids. For more
				  information about the Arizona Opioid Epidemic Act, please see the FAQs
				  published by the Arizona State Board of Pharmacy, available at
https://drive.google.com/file/d/1JCIs8VwtdJ1T-DyGfJN3WWUm4KhDMXe-/view
.
5 Section VII sets forth
				  reimbursement guidelines for medications dispensed in settings that are not
				  accessible to the general public in Arizona's worker's compensation system and
				  does not interfere with a medical practitioner's ability to dispense
				  medications pursuant to A.R.S. §
									32-1491 or seek payment from
				  sources unrelated to workers' compensation.