Index. Index... Page 1. Welcome Letter... Page 2. Insurance Directory... Page 3. Timely Filing Requirements for Initial Claim Submission...

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1 40 Exchange Place Suite 1705 New York, NY P: F: Policies and Procedures Index Remittance 6/23/14 Index Index Page 1 Welcome Letter Page 2 Insurance Directory.... Page 3 Timely Filing Requirements for Initial Claim Submission... Page 4 Modifiers and Guidelines... Page 5 HIP Policies and Procedures Page 6 HIP Preapproval Codes.. Page 7 Emblem Code MLTC Plan Specifications and Power Wheelchair Authorization Requirements... Page 8 GHI Participation. Page 10 WellCare Billing Guidelines Page 11 QualCare Billing Guidelines Page 12 CenterLight Exclusive Codes... Page 13 Empire HealthChoice Provisions and Fee Schedule Page 14 Fidelis Care Authorization Requirements..Page 26 Healthfirst modifications to DMEPOS claims payment policies. Page 32 1

2 Policies and Procedures Dear Integra Provider, Please find below a list of the correct procedures and required policies that are necessary to ensure correct authorization/pre-certification and the timely filing of claims and payments. As a member of Integra Partners it is essential to our business and yours that we work together to most efficiently interact with our health plans and patients 1. Contacting Health Plans by Phone: When contacting by phone always introduce yourself as a provider of Integra Partners. Provide the representative with Integra Partners tax-id and/or appropriate provider ID indicated in the attached file called the Payor/Provider ID Contact List. 2. Contacting Health Plans by fax: Only use the forms provided by Integra Partners (for copies administration@accessintegra.com or access our secure website). o Complete all fields on the forms for members and your facility. Be sure to always use the Integra Fax cover sheet with the contact person s full name (first/last) 3. Claim submission: All patients must be entered into the billing system found at (Provider Login at the top of the page) prior to requesting anything from the health plan. o If the patient is not in the billing system, Integra will not be able to make you aware of any authorizations or denials etc. Every bill/claim requires copies to Integra of signed patient consent forms, doctor prescription, LMN and any other patient documentation. These should be sent to consents@accessintegra.com or faxed to o You are contractually required to provide all documentation to Integra. Failure to provide documentation can result in on-payment of claims. 4. Bills are not to be deleted by a provider. Any bills that might need to be removed from the system should be identified to Integra for removal. If you have any questions please feel free to contact customer services at (718) Sincerely, Integra Partners 2

3 40 Exchange Place Suite 1705 New York, NY P: F: Tax ID NPI Insurance Company Provider ID Phone# Access Medicare As provided by Integra (877) Aetna PPO PPO (888) Aetna HMO HMO (800) Affinity (866) Amerigroup (NY ONLY) (800) Anthem BCBS (CT, NH, ME) 12DME0967NY01 (800) Archcare (800) (Member Services) (800) (Clinical Services) CenterLight As provided by Integra As provided by Integra Connecticare (thru HIP) (800) Easy Choice of NY (formerly Atlantis Health Plans) 9A1232 (866) Empire BlueCross BlueShield G30061 (800) (Eligibility) (800) (Pre Cert) Fidelis Care New York (888) GHI PPO/EmblemHealth (NO DME**) (800) ( Eligibility) (800) ( Pre Cert) GHI HMO/EmblemHealth (NO DME**) (877) GuildNet (NO DME**) (212) Hamaspik (855) HealthPlus (866) (Medicare) (800) (Medicaid) HealthCare Partners (NO DME**) (800) HealthFirst NY (888) HealthFirst NJ (800) HHH Choices Gold (855) (Eligibility) (855) (Authorizations) (718) (MLTC) HIP/EmblemHealth of New York P WEBSITE Independence Care Systems (212) Iron Workers Local MagnaCare (212) Island Group (800) Local 1199 NBF (NO DME**) Effective Jan 1, 2007 (888) Local 138 MagnaCare (800) Local 239 nited HealthCare (516) Local 338 nited HealthCare (516) Local 42 Blue Cross Blue Shield (631) Local 707 MagnaCare (516) Local 804 MagnaCare (718) Local (800) MagnaCare (877) MetroPlus MST HAVE MEDICAID AND NYC DCA LICENSE ON FILE (800) WITH INTEGRA Montefiore CMO PRV (914) MultiPlan (800) PHCS (Guardian) See Back of Members Ins.Card Procura (800) QualCare, Inc. Tech Health (800) (877) Touchstone Health (NO DME**) (888) SA MCO (800) VNS G02 Type S12 (866) VillageCare VCM2011 INTEGRAIPA000 (800) Vytra (thru HIP) (866) WellCare of NY (NY Providers ONLY) YOR OFFICE MST BE (800) (Medicare) As provided by Integra APPROVED BY WELLCARE OF NY AND PROVIDED WITH AN (800) (Medicaid) INDIVIDAL PROVIDER ID# ** A, B, E OR K CODES ARE NOT BILLABLE TO THIS PLAN. DIABETIC SHOES, INSERTS AND STOCKINGS MAY BE COVERED, SBJECT TO PLAN** 3

4 Access Medicare Aetna Affinity Amergroup Anthem Atlantis BCBS Federal Plan Plan Name BCBS Western New York Empire BCBS CenterLight Fidelis GHI HMO PPO Guildnet Timely Filing Requirements for Initial Claim Submission Effective May Days 45 Days 90 Days 120 Days 180 Days 360 Days 1 Year American Plan Administrators (APA) International Benefits Administrators (IBA) Local 14/14B Health Plus HealthCare Partners Healthfirst HHH Choices Gold HIP HMO PPO Connecticut Care Perfect Health Vytra Humana Local 1199 Magna Care Metro Plus Multiplan Montefiore CMO Neighborhood Health Qualcare Tech Health Touchstone (Care of Health Care Partners) VNS VillageCare WellCare Medicare WellCare Medicaid x x When Eligibility is Checked, Ask for the Timely Filing Requirement 4

5 Aetna HMO Empire BCBS Orthopedic Shoes Bilateral Services Prosthetic Codes Home N Primary GuildNet K modifier Required line by line K modifier required line by line Diabetic Shoes Place of Service Modifiers Fidelis Line by line K modifier required Helthfirst HealthPlus GHI GHI Network Access Plan MetroPlus MultiPlan VNS (Medicaid Plan Paper claims sent Paper claims sent Line by line Line by line Home Line by line Claim Submission HIP Primary EOB required paper claim to be sent Line by line K modifier required Only N and RR Home Line by line Line by line K modifier required Home Paper claims sent General Reminders: All patients must be entered into doc-tor.com prior to requesting anything from their insurance companies so any calls and/or faxes can be forwarded to the correct office If the patient is not in doc-tor.com, Integra will not be able to make you aware of any authorizations, denials, etc. When billing claims, should you encounter a ZERO CHARGE (0.00), pleasecontact Integra Partners for assistance with you claim. All miscellaneous billing codes should have a COST INVOICE sent to Integra Partners with the member s name and bill # attached so that claim can be submitted with it. Multiplan claims require the claims submission address from the back fo the member s card. Please enter this address as a NOTE in doc-tor.com. Before billing claims, patient s eligibility AND coverage of benefits for the specific billing code and specific diagnosis codes being used must be verified. Select Insurance Plans ONLY from the HOTLIST in doc-tor.com. If you do not see what you are looking for, please contact Integra Partners Integra Partners: Phone: administration@acessintegra.com claims@accessintegra.com consents@accessintegra.com Bill entry corrections, copies of Integra documents, copies of pre auths/denials, doc-tor.com entries and software Issues or questions Claim status, cost Invoices and detailed LMN/Clinicals Patient consents from providers to Integra 5

6 HIP POLICIES & PROCEDRES HIP Website Access There are NO calls to be made to HIP. Below is your access to the HIP website where you will verify the patient s eligibility, coverage of benefits and which managing entity responsible for the patient. PLEASE NOTE THAT MEMBERS MST HAVE DME COVERAGE FOR ANY SERVICES TO BE RPOVIDED THIS INCLDES O&P SERVICES. Site address: Select PROVIDER sername: Password: integra integra2 Codes that HIP DOES NOT REQIRE ATH Please see attachment of the NEW HIP **NO NOTIFICATION NEEDED** from EmblemHealth for Please refer to this list prior to servicing your patients. Any CPT codes being used and billed must be an ACTIVE code for the date of service. HIP Fee Rate HIP is reimbursed at 65% of Medicare Fee Schedule. HIP Managing Entities HIP patients may have different Managing Entities such as HealthCare Partners, Montefiore/CMO, Vytra, Connecticare and more. Patients must have DME Coverage HIP managing entities such as HealthCare Partners and Montefiore/CMO ALWAYS REQIRE AN ATHORIZATION PRIOR TO DATE OF SERVICE. ***However, please be advised, Integra has NO DME Service with HealthCare Partners, therefore, regardless of authorization DME is NOT Covered by HealthCare Partners. Make sure your claims go to the appropriate Managing Entity and the authorization is requested thru the same Managing Entity so the claim can be paid correctly. Finally, the Managing Entities may have different timely filing requirements. Make sure that you know what they each require. If you need further help on how HIP Insurance Plan s policies and procedures, feel free to contact Integra HIP Specialist for further assistance. 6

7 Prior Approval List for GHI HMO (O and P only), HIP, EmblemHealth EPO (underwriter must be GHI), and Vytra HMO/ASO Below are the 2013 HIP HCPCS Procedure and Supply codes that require prior approval E0170 E0697 E2372 K0860 L3225 L5610 L6010 L6882 L8659 E0193 E0745 E2373 K0861 L3740 L5611 L6020 L6883 L8681 E0194 E0747 E2376 K0862 L3765 L5613 L6025 L6884 L8683 E0217 E0748 E2377 K0863 L3766 L5614 L6050 L6885 L8685 E0251 E0760 E2402 K0864 L3900 L5616 L6055 L6900 L8686 E0255 E0764 K0608 L0112 L3901 L5639 L6100 L6905 L8687 E0260 E0782 K0608 L0430 L3904 L5643 L6110 L6910 L8688 E0261 E0984 K0730 L0480 L3971 L5649 L6120 L6920 L8689 E0265 E0986 K0730 L0482 L3973 L5651 L6130 L6925 L8691 E0266 E1002 K0743 L0484 L3975 L5681 L6200 L6930 E0277 E1003 K0743 L0486 L3976 L5683 L6205 L6935 E0290 E1004 K0800 L0636 L3977 L5700 L6250 L6940 E0295 E1005 K0801 L0638 L3978 L5700 L6300 L6945 E0296 E1006 K0802 L0700 L4631 L5702 L6310 L6950 E0297 E1007 K0806 L0710 L5010 L5703 L6320 L6955 E0300 E1008 K0807 L0820 L5020 L5707 L6350 L6960 E0301 E1010 K0808 L0830 L5050 L5724 L6360 L6965 E0302 E1030 K0814 L1005 L5060 L5726 L6370 L6970 E0303 E1093 K0816 L1300 L5100 L5728 L6400 L6975 E0304 E1161 K0820 L1310 L5105 L5780 L6450 L7007 E0450 E1224 K0821 L1680 L5150 L5781 L6500 L7008 E0461 E1230 K0822 L1690 L5160 L5782 L6550 L7009 E0463 E1232 K0823 L1700 L5200 L5814 L6570 L7040 E0464 E1233 K0824 L1710 L5210 L5822 L6580 L7045 E0470 E1234 K0825 L1720 L5220 L5824 L6582 L7170 E0471 E1235 K0826 L1755 L5230 L5826 L6584 L7180 E0472 E1236 K0827 L1844 L5250 L5828 L6586 L7181 E0483 E1237 K0828 L1846 L5270 L5830 L6588 L7185 E0485 E1238 K0829 L1860 L5280 L5840 L6590 L7186 E0486 E1295 K0836 L2005 L5301 L5845 L6621 L7190 E0570 E1296 K0838 L2010 L5312 L5856 L6624 L7191 E0575 E1310 K0839 L2020 L5321 L5857 L6638 L7260 E0607 E1391 K0840 L2030 L5331 L5858 L6646 L7261 E0627 E1392 K0841 L2034 L5341 L5930 L6648 L7900 E0628 E1700 K0842 L2036 L5500 L5960 L6693 L8035 E0629 E2227 K0843 L2037 L5505 L5961 L6696 L8040 E0635 E2310 K0848 L2038 L5510 L5966 L6697 L8041 E0636 E2311 K0849 L2070 L5520 L5968 L6707 L8042 E0650 E2312 K0850 L2108 L5530 L5973 L6709 L8043 E0652 E2321 K0851 L2126 L5535 L5979 L6712 L8044 E0656 E2322 K0853 L2128 L5540 L5980 L6713 L8045 E0657 E2325 K0854 L2136 L5560 L5980 L6714 L8046 E0675 E2327 K0855 L2350 L5580 L5981 L6715 L8614 E0677 E2328 K0856 L2525 L5585 L5987 L6721 L8619 E0692 E2329 K0857 L2627 L5590 L5988 L6722 L8627 E0693 E2330 K0858 L2628 L5595 L5990 L6880 L8628 E0694 E2370 K0859 L3224 L5600 L6000 L6881 L8631

8 Emblem MLTC Code Specifications Emblem Code MLTC Plans Only Emblem Code MLTC Plans Only Emblem Code Code Does Not Require Auth A4367 K0603 A4624 A4368 K0604 A4629 A4458 K0605 A6258 A4495 K0730 A6402 A4500 S8265 A6531 A4510 S8270 A7005 A4554 S8421 A7015 A4570 S8424 A7032 A4670 S8427 E0100 A4932 S8428 E0110 A6530 S8999 E0135 A6535 T4521 E0143 A6538 T4522 E0147 A6540 T4523 E0148 A6541 T4524 E0154 A6543 T4529 E0163 A6544 T4530 E0165 A6549 T4533 E0168 A9282 T4535 E0181 E0220 T4537 E0185 E0240 T4539 E0619 E0241 T4540 E0621 E0243 T4543 E0630 E0244 T5001 E0705 E0245 V5266 E0730 E0246 E0731 E0274 E0910 E0445 E0971 E0641 E1031 E0642 E2601 E0700 E2602 E2291 E2603 E2292 E2604 E8002 E2605 K0601 L0150 K0602 L0625 8

9 Emblem Health: Authorization Request Requirements for Power Wheelchairs The K modifier must always be present on the record, as well as one from each category below for a total of 4 modifiers. Have you given the member the option to purchase or rent? What was their decision? o BR Beneficiary has elected to rent o BP Beneficiary has elected to purchase o B Beneficiary has not informed supplier of decision after 30 days Is the equipment new or used? o N New equipment o E sed equipment What months are being requested for authorization? o KH 1st month rental o KI 2nd and 3rd month rental o KJ 4th to 15th month rental 9

10 Participation with Group Health Incorporated (GHI) Effective June 1, 2012 Integra providers will no longer participate with GHI for DME. To be clear, this change only affects GHI s DME services and has no impact on O&P nor are there any changes to our relationship with HIP. Emblem s executive leadership has ensured Integra s continued participation with HIP for DME and with both HIP and GHI for O&P. What will change? As of June 1, 2012, Integra Participating Providers will not service GHI members for their DME needs. A list of the excluded codes is provided as an attachment for your reference. What will not Change? This has no impact on our other relationships with EmblemHealth. Integra Partners continues to service all HIP members for O&P / DME and GHI members for O&P as before. In addition, this has no impact on Integra s work with the Montefiore CMO or Healthcare Partners (HCP). What do I need to do? If you provide DME services to GHI members, visits after June 1, 2012 will no longer be covered. Emblem will be providing instructions for how to handle rental or recurring payment patients and we will communicate these instructions when we receive them. It is important that you exercise the highest standards of professionalism and attentiveness during this transition as we will be working diligently to earn this contract back. I recognize how important Emblem is to our network and how hard you work to service these members. Integra s goal is to support your work and allow you to focus on delivering the highest quality patient care. I am personally committed to this goal and will work diligently to regain this important contract for the Integra providers. 10

11 Wellcare Billing Guidelines All authorization requests must be faxed or ed to Integra, using your provider Wellcare ID#. DO NOT SE INTEGRA PARTNERS INFORMATION. Fax to (718) to: To Check Status of an authorization: Call (718) Once you have ALL your completed patient documentation, including Delivery Ticket, you must then send Via Fax or it to Integra. Fax to (718) to: Please only contact your Insurance Representative for Claims related issues as they will not be able to assist with any authorization Requests or Status of Authorization. Please do not send any patient documentation to Individual insurance Representative unless they ask for you to send it to them directly. Please note our Contract with Wellcare is based on the MEDICARE fee schedule. Wellcare Medicare patients are reimbursed at 73% of the Medicare Fee Schedule Wellcare Medicaid patients are reimbursed at 73% of the Medicare Fee schedule. IF Wellcare Medicaid patients service is not a listed code on Medicare Fee schedule, it will then process at 90% of the Medicaid Fee Schedule. Please be cautious as some items are only available as rentals even if it is a Medicaid patient. Example: E0570 is only available as a Rental. Please note the Place of Service is Always 12. K MODIFIER REQIRED PER WELLCARE GIDELINES Per CMS guidelines the K represents that all Criteria has been met, which includes all patient documentation to be on file. This is one reason it is most important to send all your documents to Consents. When billing Wellcare you are required to include the K Modifier on all Services, except for disposable items. Example: Diapers. If you do not bill with K modifier your claim will be denied, and your claims payment delayed. Wellcare Medicare When billing for a Purchase you must bill using the N and the K modifiers. When billing for a Rental you must bill using the RR KH and K. Please note the monthly modifiers are as follows: KH 1 st month rental KI 2 nd and 3 rd month rental KJ 4 th month and up rental Wellcare Medicaid Same rules as Medicare, ECEPT, you do not bill with a monthly modifier. Our contract is based on the Medicare Fee Schedule even which holds true even if the patient has a Medicaid plan. If the code you are using is only listed as a Rental, then you must bill the code as a Rental. Billing for Bilateral Services, you must NOT bill as Two units. They must be applied to separate lines. Example: A5500 RT K 1 unit 11

12 A5500 LT K 1 unit QualCare Inc. Exhibit A QualCare, Inc. PPO/Worker s Compensation Durable Medical Equipment Fee Schedule For Integra Partners IPA, LLC Effective: May 1, % discount off par 2000 Medicare allowable for all DME and Respiratory except as specified. 30% off par 2000 Medicare for all CPAP and BIPAP units and supplies Purchase price of CPAP $ Purchase price of BIPAP $ Specialty masks will reimbursed at Provider cost plus 20% (purchase invoice required) 100% of par 2000 Medicare of all HCPCS A Codes except for wound care 30% off par 2000 Medicare for all wound care supplies 30% off par 2000 NJ Medicare for all Orthotics and Prosthetics *All Medicare capped rental items will be deemed purchased upon 15 months of consecutive rental *The outright purchase of Medicare capped rentals is the sum of 13 months of consecutive rental *When Medicare capped rental items are purchased prior to 15 months of consecutive rental, the purchase price is determined by subtracting the cumulative rental cost from the total 15 month cumulative amount *Prices for approved custom equipment will be individually negotiated on a case by case basis *All approved items which are not covered by Medicare or if specific code is not available will be reimbursed at 40% off usual and customary amount 12

13 *NEW* Integra Codes for CenterLight Only Effective 05/31/2013 CenterLight Code Integra New Code w/ Modifier Description ABG E1399,Z1 Attends Belted nder Garment BIOF E1399,Z2 BIOFREEZE MAI E1399,Z3 Maxi Pads NECIB E1399,Z4 NESTLE CARNATION INSTANT BREAKFAST PPP E1399,Z5 Incontinent Pad T4525 T4525 Pull-ps (S) T4526 T4526 Pull-ps (M) T4527 T4527 Pull-ps (L) T4528 T4528 Pull-ps (L) TLG E1399,Z6 ADLT DISPBL INCONT BRF/DIAPER -LG WIPE E1399,Z7 Attends Wipes Z4713 E1399,Z8 Handheld shower head K0739 K0739 Labor Code for Grab Bar Installation 13

14 I. SPECIFIC REIMBRSEMENT TERMS PLAN FEE SCHEDLE EMPIRE HEALTHCHOICE HMO, INC. EMPIRE HEALTHCHOICE ASSRANCE, INC. MEDICAL EQIPMENT PROVIDER FEE SCHEDLE Remittance September 1, 2013 For Covered Services provided by or on behalf of Provider to a Covered Person who is enrolled in a product and/or program that is supported by a network designated listed in Exhibit B, Provider agrees to accept the lesser of Provider's charges or the applicable plan fee schedule. With the exception of Not Otherwise Classified Codes (NOC), codes not listed may be payable if such fee is listed on the fee schedule available on the provider portal or obtained from Empire Blue Cross Blue Shield. II. GENERAL PROVISIONS Billing Form and Claims Submission Requirements. Provider shall submit all claims on a CMS 1500 claim form or its successor. Provider shall submit all Procedure Codes in accordance with the reporting guidelines and instructions contained in applicable Procedure Code official publications. In addition, updates to Empire's claims processing filters and edits, as a result of changes in reporting guidelines and instructions, shall take place automatically and do not require any notice, disclosure or amendment to Provider. Claim Submissions for Pharmaceuticals. Provider agrees that the NDC must be listed on each claim that includes federal legend drugs. Coding pdates. Procedure Codes used to define specific rates will be updated from time to time as they are revised to reflect new, deleted or replacement codes. Empire shall use best efforts to update all applicable Procedure Codes when they are released by the applicable authority. Any such replacement or new code will be reimbursed at the applicable Empire Rate. Claims processed prior to the implementation of the revised codes shall not be automatically reprocessed. In addition, claims with codes which have been deleted will be rejected. Not Otherwise Classified Codes (NOC) and/or Individual Consideration Codes (IC). Empire reserves the right to price NOC and/or IC codes individually, and may require the submission of medical records prior to the adjudication of such claims. NOC and/or IC claims will be paid according to Empire's policy and procedures. Dismissing a Covered Person. If Provider believes that a reasonable provider/patient relationship cannot be established or maintained between Provider and a Covered Person as a result of the Covered Person's: a) Display of hostility or improper behavior towards Provider, Provider staff, or other patients; b) nreasonable refusal to cooperate with Provider's diagnosis or treatment or refusal to follow Provider's instructions; c) Failure to pay applicable coinsurance, copayment, visit fees or penalties; or d) Making unreasonable or unnecessary demands on Provider or Provider's staff, then Provider may refuse to accept such Covered Person as a patient or terminate the Covered Person as a patient. Written notice of any such refusal and/or termination must be promptly sent to Empire. Provider will continue to provide care for the Covered Person until care has been transitioned to a new provider. 14

15 Open Access Covered Person. Provider agrees that Covered Persons who are enrolled under an HMO Benefit Plan are not required Covered Person to obtain a referral from his/her Provider in order to receive Covered Services from Network/Participating Providers. Code Fee Code Fee Code Fee Code Fee Code Fee Schedule Schedule Schedule Schedule A4206 $0.15 A4394 $1.81 A4405 $2.38 A4366 $0.91 A4562 $31.06 A4208 $0.15 A4395 $0.03 A4406 $4.02 A4367 $4.79 A4565 $4.25 A4209 $0.15 A4396 $28.34 A4407 $6.13 A4368 $0.18 A4595 $16.70 A4210 $1.28 A4397 $2.97 A4408 $6.91 A4369 $1.75 A4600 $21.25 A4211 $0.20 A4398 $9.67 A4409 $4.35 A4371 $2.56 A4601 $ A4212 $6.80 A4399 $7.82 A4410 $6.33 A4372 $2.93 A4604N $38.51 A4213 $0.31 A4400 $29.08 A4411 $3.57 A4373 $4.40 A4605N $14.62 A4215 $0.14 A4402 $1.20 A4412 $1.89 A4375 $12.03 A4606 $17.06 A4216 $0.25 A4404 $1.18 A4413 $3.85 A4376 $33.31 A4608 $36.05 A4217 $1.05 A4313 $11.11 A4414 $3.45 A4377 $3.00 A4611N $ A4218 $0.37 A4314 $15.93 A4415 $4.20 A4378 $21.53 A4611RR $12.12 A4221 $13.12 A4315 $16.63 A4416 $1.93 A4379 $10.51 A4612N $49.56 A4222 $27.09 A4316 $17.89 A4417 $2.60 A4380 $26.13 A4612RR $4.99 A4230 $7.86 A4320 $3.33 A4418 $1.27 A4381 $3.23 A4613N $86.53 A4231 $4.04 A4321 $8.10 A4419 $1.22 A4382 $17.23 A4613RR $10.09 A4232 $2.22 A4322 $1.88 A4420 $1.75 A4383 $19.73 A4614 $16.65 A4233N $0.50 A4326 $6.80 A4422 $0.08 A4384 $6.73 A4615 $0.48 A4234N $2.17 A4327 $28.11 A4423 $1.30 A4385 $3.57 A4616 $0.05 A4235N $1.40 A4328 $5.68 A4424 $3.33 A4387 $4.20 A4617 $2.07 A4236N $1.00 A4330 $4.15 A4425 $2.51 A4388 $3.05 A4618N $5.29 A4244 $2.13 A4331 $2.13 A4426 $1.91 A4389 $4.35 A4618RR $0.71 A4245 $3.19 A4332 $0.08 A4427 $1.95 A4390 $6.73 A4619N $0.73 A4246 $6.59 A4333 $1.39 A4428 $4.56 A4391 $4.95 A4620 $0.41 A4247 $3.61 A4334 $3.11 A4429 $5.78 A4392 $5.73 A4623 $3.90 A4248 $1.38 A4336 $0.83 A4430 $5.96 A4393 $6.33 A4624N $1.57 A4250 $15.21 A4338 $7.72 A4431 $4.35 A4625 $4.12 A5112 $21.47 A4252 $3.15 A4340 $17.22 A4432 $2.51 A4626 $2.25 A5113 $2.80 A4253N $17.00 A4344 $10.09 A4433 $2.34 A4627 $8.08 A5114 $6.26 A4255 $2.35 A4346 $11.75 A4434 $2.63 A4628N $2.51 A5121 $4.44 A4256 $6.03 A4349 $1.27 A4435 $3.99 A4629 $3.24 A5122 $7.97 A4257 $7.65 A4351 $1.02 A4455 $0.85 A4630N $1.00 A5126 $0.78 A4258 $11.37 A4352 $3.44 A4456 $0.16 A4633N $ A5131 $10.11 A4259 $7.64 A4353 $4.20 A4458 $2.38 A4635N $3.42 A5200 $7.91 A4265 $2.14 A4354 $7.43 A4461 $2.07 A4635RR $0.44 A5500 $60.02 A4280 $3.25 A4355 $5.35 A4463 $7.98 A4510 $18.06 A4636N $2.44 A4281 $3.20 A4356 $27.15 A4465 $8.50 A4520 $0.64 A4636RR $0.29 A4282 $9.35 A4357 $6.52 A4466 $27.50 A4550 $19.30 A4637N $1.23 A4284 $4.25 A4358 $4.00 A4470 $3.42 A4554 $0.17 A4637RR $0.18 A4285 $4.25 A4360 $0.28 A4481 $0.24 A4556 $8.12 A4638N $5.42 A4286 $3.19 A4361 $10.93 A4483 $4.50 A4557 $14.11 A4638RR $

16 A4310 $4.63 A4362 $2.42 A4490 $18.79 A4558 $3.24 A4639N $ A4311 $9.35 A4363 $1.41 A4495 $15.90 A4559 $0.61 A4640N $42.34 A4312 $10.73 A4364 $1.87 A4500 $14.45 A4561 $12.46 A4640RR $4.07 Code Fee Code Fee Code Fee Code Fee Code Fee A4657 $0.21 A6011 $1.37 A6241 $1.54 A6456 $0.79 A7031N $36.70 A4660 $26.04 A6021 $13.03 A6242 $3.76 A6457 $0.71 A7032N $19.00 A4663 $4.25 A6022 $13.03 A6243 $7.63 A6501 $ A7033N $15.78 A4670 $63.75 A6023 $ A6244 $23.57 A6502 $95.00 A7034N $58.50 A4927 $4.25 A6024 $3.84 A6245 $4.36 A6503 $ A7035N $19.00 A4930 $0.34 A6025 $4.78 A6246 $5.95 A6504 $ A7036N $10.49 A5051 $1.45 A6154 $8.90 A6247 $14.27 A6505 $ A7037N $14.52 A5052 $1.04 A6196 $4.56 A6248 $10.97 A6506 $ A7038N $2.13 A5053 $1.15 A6197 $10.19 A6250 $5.57 A6507 $98.00 A7039N $7.00 A5054 $1.25 A6198 $12.46 A6251 $1.23 A6508 $ A7040 $28.44 A5055 $0.99 A6199 $3.28 A6252 $2.02 A6509 $ A7041 $53.44 A5056 $3.20 A6203 $2.08 A6253 $3.93 A6510 $ A7042 $ A5057 $6.58 A6204 $3.86 A6254 $0.75 A6511 $ A7043 $20.24 A5061 $2.38 A6206 $2.78 A6255 $1.88 A6513 $ A7044N $69.69 A5062 $1.55 A6207 $4.55 A6256 $2.30 A6545 $ A7045N $11.00 A5063 $1.89 A6208 $5.56 A6257 $0.92 A6550 $24.00 A7045RR $1.10 A5071 $4.03 A6209 $4.64 A6258 $2.67 A7000N $6.26 A7046N $11.24 A5072 $2.46 A6210 $12.35 A6259 $6.78 A7001N $22.13 A7501 $93.64 A5073 $2.13 A6211 $18.21 A6260 $7.49 A7002N $2.68 A7502 $44.60 A5081 $2.31 A6212 $6.01 A6266 $1.19 A7003N $1.91 A7503 $10.11 A5082 $7.08 A6213 $7.35 A6402 $0.07 A7004N $1.26 A7504 $0.62 A5083 $0.37 A6214 $6.38 A6403 $0.27 A7005N $21.44 A7505 $4.18 A5093 $1.25 A6215 $0.83 A6404 $6.38 A7006N $6.64 A7506 $0.31 A5102 $16.82 A6216 $0.03 A6407 $1.17 A7007N $3.21 A7507 $2.22 A5105 $28.53 A6217 $0.39 A6410 $0.23 A7008N $7.66 A7508 $2.56 A6218 $0.33 A6411 $1.70 A7009N $29.24 A7509 $1.26 B4155 $0.71 A6219 $0.59 A6412 $0.26 A7010N $16.41 A7520 $42.33 B4157 $2.49 A6220 $1.60 A6413 $0.06 A7011 $0.85 A7521 $41.96 B4158 $1.06 A6221 $2.20 A6441 $0.42 A7012N $2.63 A7522 $40.26 B4159 $1.06 A6222 $1.32 A6442 $0.11 A7013N $0.58 A7523 $7.23 B4160 $1.11 A6223 $1.50 A6443 $0.18 A7014N $3.12 A7524 $69.12 B4161 $1.87 A6224 $2.24 A6444 $0.38 A7015N $1.30 A7525 $1.84 B4162 $2.47 A6228 $2.37 A6445 $0.20 A7016N $5.04 A7526 $3.01 B9000N $ A6229 $2.24 A6446 $0.25 A7017N $93.22 A7527 $3.25 B9000RR $64.45 A5501 $ A6231 $2.90 A6447 $0.42 A7017RR $9.32 A8000N $ A5503 $29.34 A6232 $4.27 A6448 $0.72 A7018 $0.27 A8000RR $10.73 A5504 $29.34 A6233 $11.90 A6449 $1.09 A7020N $2.62 A8001N $ A5505 $29.34 A6234 $4.05 A6450 $1.80 A7025N $ A8001RR $

17 A5506 $29.34 A6235 $10.43 A6451 $2.70 A7026N $19.23 A8002N $ A5507 $29.34 A6236 $16.90 A6452 $3.66 A7027N $ A8002RR $15.34 A5512 $24.49 A6237 $4.90 A6453 $0.38 A7028N $33.13 A8003N $ A5513 $36.55 A6238 $14.13 A6454 $0.48 A7029N $13.54 A8003RR $15.34 A6010 $19.20 A6240 $7.59 A6455 $0.86 A7030N $94.30 A8004N $26.70 Code Fee Code Fee Code Fee Code Fee Code Fee A8004RR $2.67 E0105RR $3.28 E0157RR $4.64 E0198RR $14.82 E0271RR $11.32 A9274 $22.65 EOllON $51.89 E0158N $17.00 E0199N $21.43 E0272N $ A9275 $21.97 E0110RR $5.19 E0158RR $1.70 E0199RR $2.14 E0272RR $11.66 A9276 $9.29 E0111N $35.61 E0159N $10.30 E0200N $61.50 E0274 $38.25 A9277 $ E0111RR $3.56 E0159RR $1.03 E0200RR $6.15 E0275N $10.24 A9278 $ E0112N $24.74 E0160N $22.11 E0202RR $48.56 E0275RR $1.02 A9281 $14.45 E0112RR $2.47 E0160RR $2.21 E0203 $ E0276N $8.90 A9283 $38.11 E0113N $14.13 E0161N $17.53 E0205N $ E0276RR $0.89 B4034 $3.10 E0113RR $1.41 E0161RR $1.75 E0205RR $15.08 E0277RR $ B4035 $5.78 E0114N $31.56 E0162N $97.44 E0210N $25.35 E0280N $22.02 B4036 $4.49 E0114RR $3.21 E0162RR $9.74 E0210RR $2.54 E0280RR $2.20 B4081 $14.50 E0116N $18.55 E0163N $73.75 E0215N $54.95 E0290RR $43.08 B4082 $10.50 E0116RR $1.86 E0163RR $7.37 E0215RR $5.49 E0291RR $31.30 B4083 $1.62 E0117N $ E0165RR $12.43 E0217N $ E0292RR $48.44 B4087 $25.00 E0117RR $12.89 E0167N $8.03 E0217RR $38.51 E0293RR $41.22 B4088 $25.27 E0118 $ E0167RR $0.80 E0218 $ E0294RR $72.57 B4100 $0.39 E0130N $40.49 E0168N $ E0221 $83.30 E0295RR $70.75 B4102 $4.56 E0130RR $4.05 E0168RR $10.09 E0225N $ E0296RR $94.64 B4103 $4.56 E0135N $38.81 E0170RR $ E0225RR $30.15 E0297RR $81.00 B4104 $1.28 E0135RR $3.88 E0171RR $19.35 E0235RR $13.39 E0300N $1, B4149 $1.01 E0140N $ E0175N $44.29 E0236RR $34.33 E0300RR $ B4150 $0.39 E0140RR $20.79 E0175RR $4.43 E0239N $ E0301RR $ B4152 $0.32 E0141N $63.51 E0181RR $17.42 E0239RR $34.90 E0302RR $ B4153 $1.18 E0141RR $6.35 E0182RR $17.51 E0240 $84.37 E0303RR $ B4154 $0.70 E0143N $49.00 E0184N $ E0241 $25.50 E0304RR $ E014RR $4.90 E0184RR $13.02 E0243 $36.55 E0305RR $9.52 E0485N $ E0144N $ E0185N $ E0244 $29.75 E0310N $97.92 E0485RR $12.10 E0144RR $18.35 E0185RR $21.39 E0245 $29.75 E0310RR $9.79 E0486N $1, E0147N $ E0186RR $13.59 E0246 $44.95 E0316RR $ E0486RR $ E0147RR $33.13 E0187RR $15.53 E0247 $66.49 E0325N $6.77 E0487 $ E0148N $70.00 E0188N $17.67 E0248 $ E0325RR $0.68 E0500RR $76.34 E0148RR $7.00 E0188RR $1.77 E0249N $77.34 E0326N $7.03 E0550RR $34.93 E0149N $99.92 E0189N $34.75 E0249RR $7.73 E0326RR $0.70 E0555 $3.95 E0149RR $9.99 E0189RR $3.47 E0250RR $56.34 E0328 $4, E0560N $ B9002N $ E0153N $46.40 E0190 $21.55 E0251RR $42.69 E0329 $3, B9002RR $62.55 E0153RR $4.64 E0191N $6.75 E0255RR $67.71 E0370 $

18 B9004N $1, E0154N $40.00 E0191RR $0.67 E0256RR $48.04 E0371RR $ B9004RR $ E0154RR $4.00 E0193RR $ E0260RR $67.75 E0372RR $ B9006N $1, E0155N $17.27 E0194RR $2, E0261RR $65.86 E0373RR $ B9006RR $ E0155RR $1.73 E0196RR $21.73 E0265RR $ E0424RR $86.58 E0100N $14.10 E0156N $14.00 E0197N $ E0266RR $ E0431RR $18.00 E0100RR $1.41 E0156RR $1.40 E0197RR $14.82 E0270 $ E0433RR $38.72 E0105N $32.85 E0157N $46.42 E0198N $ E0271N $ E0434RR $18.00 Code Fee Code Fee Code Fee Code Fee Code Fee E0439RR $86.58 E0575RR $71.48 E0651N $ E0730N $ E0935RR $17.63 E0441 $38.73 E0580N $80.35 E0651RR $67.97 E0731N $ E0936 $12.17 E0442 $38.73 E0580RR $8.03 E0652N $3, E0740N $ E0940RR $19.91 E0443 $38.73 E0585RR $24.38 E0652RR $ E0740RR $40.56 E0941RR $29.08 E0444 $38.73 E0600RR $31.85 E0655N $79.87 E0744RR $71.03 E0942N $13.33 E0445 $1, E0601RR $41.40 E0655RR $7.99 E0745RR $69.44 E0942RR $1.33 E0450RR $ E0602N $26.32 E0656N $ E0762N $ E0944N $30.68 E0455 $ E0602RR $2.63 E0656RR $42.82 E0762RR $85.29 E0944RR $3.07 E0457N $ E0603 $ E0657N $ E0765N $65.26 E0945N $29.64 E0457RR $47.67 E0604 $ E0657RR $40.16 E0765RR $6.53 E0945RR $2.96 E0459RR $39.47 E0605N $18.38 E0660N $ E0776N $54.27 E0946RR $39.56 E0460RR $ E0605RR $1.84 E0660RR $11.82 E0776RR $5.43 E0947N $ E0461RR $ E0606RR $15.96 E0665N $ E0779RR $12.39 E0947RR $40.55 E0462RR $ E0607N $40.09 E0665RR $10.14 E0780N $7.68 E0948N $ E0463RR $1, E0607RR $4.01 E0666N $ E0781RR $ E0948RR $39.23 E0464RR $1, E0610N $ E0666RR $10.22 E0784RR $ E0950N $64.00 E0470RR $ E0610RR $18.52 E0667N $ E0791RR $ E0950RR $6.40 E0471RR $ E0615N $ E0667RR $23.96 E0830 $ E0951N $11.00 E0472RR $ E0615RR $37.14 E0668N $ E0840N $49.00 E0951RR $1.10 E0480RR $30.56 E0617RR $ E0668RR $32.70 E0840RR $4.90 E0952N $12.59 E0481 $7, E0618RR $ E0669N $ E0849N $ E0952RR $1.26 E0482RR $ E0619RR $ E0669RR $13.57 E0849RR $34.46 E0955N $ E0483RR $ E0620N $ E0670N $1, E0850N $70.25 E0955RR $12.50 E0484N $25.68 E0620RR $52.46 E0670RR $ E0850RR $7.03 E0956N $65.90 E0484RR $2.57 E0621N $64.19 E0671N $ E0855N $ E0956RR $6.59 E0621RR $6.42 E0671RR $30.73 E0855RR $33.61 E0957N $92.22 E0994RR $1.37 E0627N $ E0672N $ E0856N $ E0957RR $9.22 E0995N $20.33 E0627RR $22.56 E0672RR $23.88 E0856RR $10.30 E0958RR $33.86 E0995RR $2.03 E0628N $ E0673N $ E0860N $25.77 E0959N $34.36 E1002N $2, E0628RR $22.56 E0673RR $19.85 E0860RR $2.58 E0959RR $3.44 E1002RR $ E0629N $ E0675RR $ E0870N $77.78 E0960N $60.00 E1003N $2, E0629RR $22.12 E0691N $ E0870RR $7.78 E0960RR $6.00 E1003RR $ E0630RR $68.13 E0691RR $76.38 E0880N $83.96 E0961N $16.30 E1004N $3, E0635RR $81.83 E0692N $ E0880RR $8.40 E0961RR $1.63 E1004RR $

19 E0560RR $10.29 E0636RR $ E0692RR $95.91 E0890N $80.52 E0966N $55.37 E0561N $61.68 E0637 $1, E0693N $1, E0890RR $8.06 E0966RR $5.54 E0561RR $6.17 E0638 $ E0693RR $ E0900N $85.68 E0967N $50.96 E0562N $ E0639 $1, E0694N $3, E0900RR $8.57 E0967RR $5.10 E0562RR $13.94 E0640 $1, E0694RR $ E0910RR $10.95 E0968RR $13.91 E0565RR $42.44 E0641 $1, E0705N $36.86 E0911RR $28.73 E0969N $ E0570RR $9.65 E0642 $1, E0705RR $3.69 E0912RR $65.99 E0969RR $12.15 E0572RR $26.49 E0650N $ E0710 $13.58 E0920RR $30.85 E0971N $27.03 E0574RR $28.01 E0650RR $53.30 E0720N $ E0930RR $30.55 E0971RR $2.70 Code Fee Code Fee Code Fee Code Fee Code Fee E0973N $51.00 E1009RR $86.44 E1140 $ E2219RR $3.25 E1270RR $61.24 E0973RR $5.10 E1010N $ E1150RR $63.28 E2220N $22.13 E1280RR $ E0974N $60.82 E1010RR $76.47 E1160RR $48.49 E2220RR $2.21 E1295RR $94.22 E0974RR $6.08 E1011N $ E1161N $1, E2221N $19.82 E1296N $ E0978N $22.93 E1011RR $29.20 E1161RR $ E2221RR $1.98 E1296RR $38.14 E0978RR $2.29 E1014N $ E1170RR $69.29 E2222N $16.34 E1297N $81.14 E0980N $25.65 E1014RR $28.33 E1171RR $62.18 E2222RR $1.63 E1297RR $8.11 E0980RR $2.56 E1015N $88.97 E1172RR $75.99 E2224N $76.07 E1298N $ E0981N $31.53 E1015RR $8.90 E1180RR $78.61 E2224RR $7.61 E1298RR $32.86 E0981RR $3.15 E1016N $83.10 E1190RR $90.81 E2225N $13.50 E1310N $1, E0982N $34.44 E1016RR $8.31 E1195RR $97.45 E2225RR $1.35 E1310RR $ E0982RR $3.44 E1017N $ E1200RR $67.50 E2226N $29.43 E1353 $18.95 E0983RR $ E1017RR $15.00 E1221RR $36.86 E2226RR $2.94 E1355 $14.27 E0984N $1, E1018N $ E1222RR $52.58 E2227N $1, E1372N $ E0984RR $ E1018RR $15.00 E1223RR $57.41 E2227RR $ E1372RR $11.34 E0985N $ E1020N $ E1224RR $62.94 E2228N $ E1390RR $86.58 E0985RR $15.74 E1020RR $15.52 E1225RR $30.10 E2228RR $72.63 E1391RR $86.58 E0986N $3, E1028N $ E1226N $ E2231N $ E1392RR $38.72 E0986RR $ E1028RR $12.70 E1226RR $35.17 E2231RR $11.94 E1405RR $ E0988RR $ E1029N $ E1227N $ E2291 $ E1406RR $ E0990N $65.00 E1029RR $24.71 E1227RR $21.53 E2292 $ E1700N $3, E0990RR $6.50 E1030N $ E1228RR $21.73 E2293 $ E1700RR $ E0992N $60.70 E1030RR $77.91 E1230N $1, E2294 $ E1701 $75.68 E0992RR $6.07 E1031RR $33.78 E1230RR $ E2300 $1, E1702 $16.10 E0994N $13.68 E1035RR $ E1231N $1, E2301 $3, E1800RR $ E1036RR $ E2210RR $0.44 E1231RR $ E2310N $ E1801RR $ E1037RR $72.55 E2211N $28.50 E1232N $1, E2310RR $78.25 E1802RR $ E1038RR $12.05 E2211RR $2.85 E1232RR $ E2311N $1, E1805RR $ E1039RR $22.87 E2212N $4.56 E1233N $1, E2311RR $ E1806RR $82.16 E1050RR $79.00 E2212RR $0.46 E1233RR $ E2312N $1, E1810RR $ E1060RR $97.80 E2213N $23.60 E1234N $1, E2312RR $ E1811RR $ E1070RR $84.97 E2213RR $2.36 E1234RR $ E2313N $ E1812RR $66.70

20 E1083RR $61.08 E2214N $28.71 E1235N $1, E2313RR $24.84 E1815RR $ E1084RR $76.10 E2214RR $2.87 E1235RR $ E2321N $1, E1816RR $ E1005N $3, E1085 $ E2215N $7.45 E1236N $1, E2321RR $ E1005RR $ E1086 $ E2215RR $0.75 E1236RR $ E2322N $ E1006N $4, E1087RR $98.17 E2216N $45.00 E1237N $1, E2322RR $94.29 E1006RR $ E1088RR $ E2216RR $4.50 E1237RR $ E2323N $46.24 E1007N $5, E1092RR $99.69 E2217N $45.00 E1238N $1, E2323RR $4.62 E1007RR $ E1093RR $85.74 E2217RR $4.50 E1238RR $ E2324N $29.30 E1008N $5, E1100RR $80.53 E2218N $45.00 E1240RR $79.91 E2324RR $2.93 E1008RR $ E1110RR $78.86 E2218RR $4.50 E1250 $ E2325N $ E1009N $ E1130 $ E2219N $32.47 E1260 $ E2325RR $90.05 Code Fee Code Fee Code Fee Code Fee Code Fee E2326N $ E2000RR $34.72 E2370N $ E2395RR $3.50 E2613N $ E2326RR $23.21 E2100N $ E2370RR $46.08 E2396N $39.00 E2613RR $26.20 E2327N $1, E2100RR $38.54 E2371N $ E2396RR $3.90 E2614N $ E2327RR $ E2101N $ E2371RR $10.08 E2397N $ E2614RR $35.30 E2328N $3, E2101RR $11.31 E2372N $75.00 E2397RR $32.12 E2615N $ E2328RR $ E2120RR $ E2372RR $7.50 E2402RR $65.00 E2615RR $30.25 E2329N $1, E2201N $ E2373N $ E2500N $ E2616N $ E2329RR $ E2201RR $25.70 E2373RR $54.53 E2500RR $33.24 E2616RR $38.55 E2330N $2, E2202N $ E2374N $ E2502N $1, E2617 $ E2330RR $ E2202RR $35.50 E2374RR $35.70 E2502RR $ E2619N $34.31 E2331 $1, E2203N $ E2375N $ E2504N $1, E2619RR $3.43 E2340N $ E2203RR $31.90 E2375RR $57.27 E2504RR $ E2620N $ E2340RR $27.80 E2204N $ E2376N $ E2506N $1, E2620RR $35.49 E2341N $ E2204RR $60.50 E2376RR $89.74 E2506RR $ E2621N $ E2341RR $41.70 E2205N $25.34 E2377N $ E2508N $3, E2621RR $37.25 E2342N $ E2205RR $2.53 E2377RR $32.47 E2508RR $ E2622N $ E2342RR $34.75 E2206N $30.10 E2381N $49.00 E2510N $5, E2622RR $20.98 E2343N $ E2206RR $3.01 E2381RR $4.90 E2510RR $ E2623N $ E2343RR $55.67 E2207N $33.63 E2382N $13.89 E2511N $ E2623RR $26.70 E2351N $ E2207RR $3.36 E2382RR $1.39 E2511RR $40.50 E2624N $ E2351RR $46.71 E2208N $65.98 E2383N $97.54 E2512N $ E2624RR $21.15 E2359N $ E2208RR $6.60 E2383RR $9.75 E2512RR $48.00 E2625N $ E2359RR $16.00 E2209N $71.64 E2384N $52.50 E2601N $35.00 E2625RR $26.77 E2360N $87.14 E2209RR $7.16 E2384RR $5.25 E2601RR $3.50 E2626N $ E2360RR $8.72 E2210N $4.38 E2385N $33.10 E2602N $71.85 E2626RR $56.70 E2361N $93.25 E2385RR $3.31 E2602RR $7.19 E2627N $ K0039N $41.42 E2361RR $9.33 E2386N $93.00 E2603N $91.00 E2627RR $90.52 K0039RR $4.14 E2362N $71.35 E2386RR $9.30 E2603RR $9.10 E2628N $ K0040N $48.00 E2362RR $7.13 E2387N $38.00 E2604N $ E2628RR $68.17 K0040RR $4.80 E2363N $ E2387RR $3.80 E2604RR $12.21 E2629N $ K0041N $

21 E2363RR $12.15 E2388N $33.69 E2605N $ E2629RR $86.26 K0041RR $4.66 E2364N $87.14 E2388RR $3.37 E2605RR $17.45 E2630N $ K0042N $28.00 E2364RR $8.72 E2389N $18.30 E2606N $ E2630RR $60.32 K0042RR $2.80 E2365N $67.00 E2389RR $1.83 E2606RR $26.58 E2631N $ K0043N $15.00 E1818RR $ E2365RR $6.70 E2390N $28.61 E2607N $ E2631RR $24.13 E1820N $85.00 E2366N $ E2390RR $2.86 E2607RR $17.80 E2632N $ E1820RR $5.72 E2366RR $14.80 E2391N $13.70 E2608N $ E2632RR $15.34 E1821N $81.64 E2367N $ E2391RR $1.37 E2608RR $22.50 E2633N $ E1821RR $8.16 E2367RR $25.46 E2392N $35.00 E2610 $ E2633RR $13.03 E1825RR $ E2368N $ E2392RR $3.50 E2611N $ E8000 $ E1830RR $ E2368RR $33.50 E2394N $50.00 E2611RR $15.00 E8001 $ E1840RR $ E2369N $ E2394RR $5.00 E2612N $ E8002 $ E1841RR $ E2369RR $29.30 E2395N $35.00 E2612RR $25.86 G0249 $ Code Fee Code Fee Code Fee Code Fee Code Fee K0001R $23.90 K0050N $24.97 K0730RR $ K0849R $ L0466 $ R K0002R $50.71 K0050RR $2.50 K0733N $23.30 R K0850R $ L0468 $ R K0003R $35.00 K0051N $40.43 K0733RR $2.33 R K0851R $ L0470 $ R K0004R $49.50 K0051RR $4.04 K0738RR $38.72 R K0852R $ L0472 $ R K0005N $1, K0052N $59.20 K0739 $13.60 R K0853R $ L0480 $ K0005R $ K0052RR $5.92 K0740 $13.60 R K0854R $1, L0482 $1,062.3 R K0006R $75.17 K0053N $73.85 K0800N $ R K0855R $1, L $1,217.4 R K0007R $ K0053RR $7.39 K0800RR $78.80 R K0856R $ L $1,291.7 R K0010R $ K0056N $81.72 K0801N $1,350.0 R K0857R $ L $ R K0011R $ K0056RR $8.17 K0801RR 0 $ R K0858R $ L0490 $ R K0012R $ K0065N $39.64 K0802N $1,576.9 R K0859R $ L0491 $ R K0015N $ K0065RR $3.96 K0802RR 5 $ R K0860R $1, L0492 $ K0015R $11.10 K0069N $75.00 K0806N $ R K0861R $ L0621 $63.17 R K0017N $39.27 K0069RR $7.50 K0806RR $96.15 R K0862R $ L0622 $ K0017R $3.93 K0070N $ K0807N $1,458.9 R K0863R $1, L0623 $39.00 R K0018N $21.95 K0070RR $13.77 K0807RR 1 $ R K0864R $ L0624 $ K0018R $2.19 K0071N $97.41 K0808N $2,257.2 R K0868 $4, L0625 $36.06 R K0019N $11.00 K0071RR $9.74 K0808RR 6 $ K0877 $4, L0626 $51.03 K0019R $1.10 K0072N $58.63 K0813RR $ K0884 $10, L0627 $ R K0020N $35.80 K0072RR $5.86 K0814RR $ K0891 $7, L0628 $54.95 K0020R $3.58 K0073N $31.03 K0815RR $ L0112 $ L0629 $ R K0037N $37.01 K0073RR $3.10 K0816RR $ L0113 $ L0630 $ K0037R $3.70 K0077N $39.19 K0820RR $ L0120 $18.18 L0631 $ R K0038N $18.65 K0077RR $3.92 K0821RR $ L0130 $ L0632 $1,078.6 K0038R $1.86 K0098N $20.93 K0822RR $ L0140 $43.86 L $ R K0098R $2.09 K0823RR $ L0150 $74.05 L0634 $ L1240 $53.19 R K0105N $88.66 K0824RR $ L0160 $ L0635 $ L1250 $49.50 K0105R R $8.87 K0825RR $ L0170 $ L0636 $ L1260 $

22 K0195R $9.62 K0826RR $ L0172 $86.98 L0637 $ L1270 $53.08 R K0455R $ K0827RR $ L0174 $ L0638 $ L1280 $59.10 R K0552 $1.96 K0828RR $ L0180 $ L0639 $ L1290 $53.85 K0601N $0.94 K0829RR $ L0190 $ L0640 $ L1300 $1,144.4 K0602N $2.96 K0831 $3,627.2 L0200 $ L0700 $1, L $1,177.5 K0603N $0.48 K0835RR 3 $ L0220 $83.90 L0710 $1, L $88.28 K0043R $1.50 K0604N $3.65 K0836RR $ L0430 $ L0810 $1,767.1 R K0044N $12.78 K0605N $8.76 K0837RR $ L0450 $ L $1,479.8 K0044R $1.28 K0607N $ K0838RR $ L0452 $ L $2,148.3 R K0045N $43.60 K0607RR $17.32 K0839RR $ L0454 $ L $ K0045R $4.36 K0608N $ K0840RR $ L0456 $ L0861 $ R K0046N $15.00 K0608RR $10.81 K0841RR $ L0458 $ L0970 $78.30 K0046R $1.50 K0609 $ K0842RR $ L0460 $ L0972 $70.50 R K0047N $58.77 K0672 $68.68 K0843RR $ L0462 $ L0974 $ K0047R R $5.88 K0730N $1, K0848RR $ L0464 $ L0976 $ Code Fee Code Fee Code Fee Code Fee Code Fee L0978 $ L1690 $1, L2030 $ L2310 $84.28 L2750 $57.27 L0980 $11.97 L1700 $1, L2030 $ L2320 $ L2755 $85.52 L0982 $11.16 L1710 $1, L2034 $1, L2330 $ L2760 $41.63 L0984 $41.01 L1720 $ L2035 $ L2335 $ L2768 $85.28 L1000 $1, L1730 $ L2036 $1, L2340 $ L2780 $46.37 L1001 $1, L1755 $1, L2037 $1, L2350 $ L2785 $21.71 L1005 $2, L1810 $67.50 L2038 $ L2360 $ L2795 $58.21 L1010 $45.98 L1820 $88.83 L2040 $ L2370 $ L2800 $73.08 L1020 $59.94 L1830 $59.93 L2050 $ L2375 $77.41 L2810 $53.51 L1025 $85.43 L1831 $ L2060 $ L2380 $84.34 L2820 $59.49 L1030 $43.59 L1832 $ L2070 $92.13 L2385 $91.77 L2830 $64.36 L1040 $53.45 L1834 $ L2080 $ L2387 $ L2840 $29.94 L1050 $57.04 L1836 $87.33 L2090 $ L2390 $75.00 L2850 $42.42 L1060 $65.52 L1840 $ L2106 $ L2395 $ L3000 $ L1070 $62.37 L1843 $ L2108 $ L2397 $77.00 L3001 $86.56 L1080 $37.92 L1844 $1, L2112 $ L2405 $57.06 L3002 $ L1085 $ L1845 $ L2114 $ L2415 $79.50 L3003 $ L1090 $62.80 L1846 $ L2116 $ L2425 $93.82 L3010 $ L1100 $ L1847 $ L2126 $ L2430 $93.82 L3020 $ L1110 $ L1850 $ L2128 $1, L2492 $69.86 L3030 $49.94 L1120 $27.21 L1860 $ L2132 $ L2500 $ L3031 $45.00 L1200 $1, L1900 $ L2134 $ L2510 $ L3040 $30.80 L1210 $ L1902 $54.69 L2136 $ L2520 $ L3050 $30.80 L1220 $ L1904 $ L2180 $80.23 L2525 $ L3060 $48.28 L1230 $ L2184 $84.86 L2182 $62.79 L2526 $ L3070 $20.80 L1906 $82.39 L2186 $ L2530 $ L3080 $20.80 L3620 $

23 L1907 $ L2188 $ L2540 $ L3090 $26.66 L3630 $65.77 L1910 $ L2190 $59.83 L2550 $ L3100 $28.30 L3640 $28.30 L1920 $ L2192 $ L2570 $ L3140 $58.28 L3650 $39.76 L1930 $ L2200 $32.57 L2580 $ L3150 $53.28 L3660 $72.69 L1932 $ L2210 $46.05 L2600 $ L3170 $33.31 L3670 $83.20 L1940 $ L2220 $56.11 L2610 $ L3224 $40.29 L3671 $ L1945 $ L2230 $52.58 L2620 $ L3225 $46.41 L3674 $ L1950 $ L1951 $ L2622 $ L3300 $34.13 L3675 $ L1610 $30.08 L1960 $ L2232 $64.05 L2624 $ L3310 $53.28 L1620 $91.79 L1970 $ L2240 $57.29 L2627 $1, L3330 $ L1630 $ L1971 $ L2250 $ L2628 $1, L3332 $48.28 L1640 $ L1980 $ L2260 $ L2630 $ L3334 $24.97 L1650 $ L1990 $ L2265 $80.69 L2640 $ L3340 $55.79 L1652 $ L2000 $ L2270 $36.79 L2650 $82.22 L3350 $14.98 L1660 $ L2005 $2, L2275 $85.92 L2660 $ L3360 $23.31 L1680 $ L2010 $ L2280 $ L2670 $ L3370 $32.46 L1685 $ L2020 $ L2300 $ L2680 $ L3380 $32.46 Code Fee Code Fee Code Fee Code Fee Code Fee L3390 $32.46 L3765 $ L4030 $ L5410 $ L5644 $ L3400 $26.66 L3766 $ L4040 $ L5420 $1, L5645 $ L3410 $60.77 L3806 $ L4045 $ L5430 $ L5646 $ L3420 $35.79 L3807 $ L4050 $ L5450 $ L5647 $ L3430 $ L3808 $ L4055 $ L5460 $ L5648 $ L3440 $49.94 L3900 $ L4060 $ L5500 $ L5649 $1, L3450 $69.09 L3901 $1, L4070 $ L5505 $1, L5650 $ L3455 $26.66 L3904 $1, L4080 $69.30 L5510 $1, L5651 $ L3460 $22.47 L3905 $ L4090 $61.87 L5520 $1, L5652 $ L3465 $38.30 L3906 $ L4100 $71.46 L5530 $1, L5653 $ L3470 $40.78 L3908 $40.17 L4110 $58.09 L5535 $1, L5654 $ L3480 $40.78 L3912 $63.58 L4130 $ L5540 $1, L5655 $ L3500 $19.14 L3913 $ L4350 $61.25 L5560 $1, L5656 $ L3510 $19.14 L3915 $ L4360 $ L5570 $1, L5658 $ L3520 $20.80 L3917 $62.92 L4370 $ L5580 $1, L5661 $ L3530 $20.80 L3919 $ L4386 $ L5585 $1, L5665 $ L3540 $33.31 L3921 $ L4392 $15.37 L5590 $1, L5666 $51.09 L3550 $5.83 L3923 $58.32 L4394 $11.22 L5595 $2, L5668 $73.70 L3560 $14.98 L3925 $33.09 L4396 $ L5600 $3, L5670 $ L3570 $55.79 L3927 $20.83 L4398 $50.47 L5610 $1, L5671 $ L3580 $42.52 L3929 $52.41 L4631 $1, L5611 $1, L5672 $ L3590 $34.96 L3931 $ L5000 $ L5613 $1, L5673 $ L3595 $27.47 L3933 $ L5010 $ L5614 $1, L5676 $ L3600 $49.94 L3935 $ L5020 $1, L5616 $ L5677 $ L3610 $65.77 L3956 $76.00 L5050 $1, L5617 $ L5678 $

24 L3960 $ L5060 $2, L5618 $ L5679 $ l5812 $ L3961 $1, L5100 $1, L5620 $ L5680 $ L5814 $2, L3962 $ L5105 $2, L5622 $ L5681 $ L5816 $ L3967 $1, L5150 $2, $2, L5624 $ L5682 $ l5818 $ L3971 $1, L5160 $2, L5626 $ L5683 $ l5822 $1, L3973 $1, L5200 $2, L5628 $ L5684 $35.13 l5824 $1, L3975 $1, L5210 $1, L5629 $ L5685 $84.00 l5826 $2, L3976 $1, L5220 $2, L5630 $ L5686 $37.28 l5828 $2, L3977 $1, L5230 $2, L5631 $ L5688 $44.58 l5830 $1, L3702 $ L3978 $1, L5250 $3, L5632 $ L5690 $71.42 L3710 $82.87 L3980 $ L5270 $3, L5634 $ l5692 $96.99 L3720 $ L3982 $ L5280 $3, L5636 $ L5694 $ L3730 $ L3984 $ L5301 $1, L5637 $ l5695 $ L3740 $ L3995 $22.44 L5312 $2, L5638 $ L5696 $ L3760 $ L4000 $ L5321 $2, L5639 $ l5697 $58.60 L3762 $64.05 L4002 $26.86 L5331 $3, L5640 $ l5698 $76.13 L3763 $ L4010 $ L5341 $3, L5642 $ L5699 $ L3764 $ L4020 $ L5400 $ L5643 $1, L5700 $1, Code Fee Code Fee Code Fee Code Fee Code Fee L5701 $2, l5920 $ L6310 $2, L6646 $2, L6880 $16, l5702 $3, l5925 $ L6320 $1, L6647 $ L6881 $2, L5703 $1, l5930 $2, L6350 $2, L6648 $2, L6882 $2, L5704 $ l5940 $ L6360 $2, L6650 $ L6883 $1, L5705 $ l5950 $ L6370 $1, L6655 $54.83 L6884 $1, l5706 $ l5960 $ L6380 $ L6660 $67.07 L6885 $2, L5707 $ l5961 $3, L6382 $1, L6665 $33.62 L6890 $ L5710 $ l5962 $ L6384 $1, L6670 $35.07 L6895 $ L5711 $ l5964 $ L6386 $ L6672 $ L6900 $1, L5712 $ l5966 $ L6388 $ L6675 $87.65 L6905 $1, l5714 $ L5968 $2, L6400 $1, L6676 $88.52 L6910 $1, L5716 $ l5970 $ L6450 $2, L6677 $ L6915 $ L5718 $ L5971 $ L $2, L6680 $ L6920 $4, L5722 $ l5972 $ L6550 $2, L6682 $ L6925 $5, L5724 $1, l5973 $11, L6570 $3, L6684 $ L6930 $4, l5726 $1, l5974 $ L6580 $1, L6686 $ L6935 $5, L5728 $1, l5975 $ L6582 $1, L6687 $ L6940 $6, L5780 $ l5976 $ L6584 $1, L6688 $ L6945 $7, L5781 $2, l5978 $ L6586 $1, L6689 $ L6950 $7, l5782 $2, l5979 $1, L6588 $2, L6690 $ L6955 $8, l5785 $ l5980 $2, L6590 $1, L6691 $ L6960 $8, l5790 $ l5981 $2, L6600 $ L6692 $ L6965 $10, l5795 $ l5982 $ l6605 $ L6693 $1, L6970 $10, l5810 $ l5984 $ L6610 $ L6694 $ L6975 $11,