department of corrections (doc) durable medical equipment ...€¦ · procedure code modifier doc...

Procedure Code ModifierDOC Allowed

Amount

A4217 AU 3.47$

A4221 00 22.01$

A4222 00 42.81$

A4233 NU 0.58$

A4234 NU 2.50$

A4235 NU 1.06$

A4236 NU 1.19$

A4253 NU 10.41$

A4255 00 4.55$

A4256 KL 10.90$

A4257 00 14.10$

A4258 KL 17.20$

A4259 KL 11.48$

A4280 00 5.74$

A4435 00 6.38$

A4450 AU 0.09$

A4450 AV 0.09$

A4450 AW 0.12$

A4452 AU 0.40$

A4452 AV 0.40$

A4452 AW 0.44$

A4561 00 22.06$

A4562 00 54.92$

A4595 00 24.29$

A4604 NU 54.22$

A4605 NU 18.13$

A4608 00 55.41$

A4614 00 26.29$

A4615 00 0.80$

A4616 00 0.07$

A4617 00 3.43$

A4618 NU 8.47$

A4618 RR 0.97$

A4618 UE 6.33$

A4619 NU 1.98$

A4620 00 0.70$

A4624 NU 2.91$

A4628 NU 4.03$

Department of Corrections (DOC)

Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Fee

Effective 1/1/2016

CPT® codes and descriptions only are copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply.

DOC DME, Prosthetics, Orthotics, and Supplies, Effective 1/1/2016

Page | 1


Amount

A4630 NU 6.90$

A4633 NU 45.36$

A4635 NU 5.66$

A4635 RR 0.74$

A4635 UE 3.76$

A4636 NU 3.47$

A4636 RR 0.35$

A4636 UE 2.56$

A4637 NU 1.68$

A4637 RR 0.20$

A4637 UE 1.27$

A4638 NU -$

A4638 RR -$

A4638 UE -$

A4639 NU By Report

A4639 RR 31.76$

A4640 NU 55.68$

A4640 RR 5.56$

A4640 UE 41.77$

A5056 00 5.16$

A5057 00 10.62$

A5120 AU 0.26$

A5120 AV 0.23$

A5500 00 70.29$

A5501 00 210.83$

A5503 00 34.55$

A5504 00 34.55$

A5505 00 34.55$

A5506 00 34.55$

A5507 00 34.55$

A5508 00 By Report

A5510 00 By Report

A5512 00 28.67$

A5513 00 42.79$

A6531 AW 47.83$

A6532 AW 67.39$

A6545 AW 94.17$

A6550 00 24.89$

A7000 NU 8.44$

A7001 NU 36.56$

A7002 NU 4.23$

A7003 NU 2.50$



Page | 2


Amount

A7004 NU 1.69$

A7005 NU 27.82$

A7006 NU 10.13$

A7007 NU 4.76$

A7008 NU 12.16$

A7009 NU 46.48$

A7010 NU 23.16$

A7012 NU 3.90$

A7013 NU 0.82$

A7014 NU 4.60$

A7015 NU 1.91$

A7016 NU 8.01$

A7017 NU 147.28$

A7017 RR 14.73$

A7017 UE 110.46$

A7018 00 0.39$

A7020 NU 16.01$

A7025 NU By Report

A7025 RR 48.09$

A7026 NU 31.78$

A7027 NU 175.74$

A7028 NU 47.82$

A7029 NU 19.59$

A7030 NU 140.60$

A7031 NU 52.98$

A7032 NU 29.88$

A7033 NU 21.71$

A7034 NU 87.23$

A7035 NU 28.98$

A7036 NU 14.27$

A7037 NU 27.11$

A7038 NU 3.70$

A7039 NU 10.79$

A7040 00 43.64$

A7041 00 82.02$

A7044 NU 103.49$

A7045 NU 15.74$

A7045 RR 1.57$

A7045 UE 11.81$

A7046 NU 16.22$

A7047 NU 133.66$

A8000 NU 169.54$



Page | 3


Amount

A8000 RR 16.95$

A8000 UE 127.18$

A8001 NU 169.54$

A8001 RR 16.95$

A8001 UE 127.18$

A8002 NU -$

A8002 RR -$

A8002 UE -$

A8003 NU -$

A8003 RR -$

A8003 UE -$

A8004 NU -$

A8004 RR -$

A8004 UE -$

B4034 00 4.89$

B4035 00 9.23$

B4036 00 6.54$

B4081 00 19.19$

B4082 00 14.20$

B4083 00 2.17$

B4087 00 32.20$

B4088 00 34.53$

B4149 00 1.36$

B4150 00 0.57$

B4152 00 0.47$

B4153 00 1.67$

B4154 00 1.02$

B4155 00 0.88$

B4164 00 -$

B4168 00 -$

B4176 00 -$

B4178 00 -$

B4180 00 -$

B4185 00 -$

B4189 00 -$

B4193 00 -$

B4197 00 -$

B4199 00 -$

B4216 00 -$

B4220 00 -$

B4222 00 -$

B4224 00 -$



Page | 4


Amount

B5000 00 -$

B5100 00 -$

B9000 NU 1,005.88$

B9000 RR 95.51$

B9000 UE 754.41$

B9000 MS 47.76$

B9002 NU 983.81$

B9002 RR 96.41$

B9002 UE 737.86$

B9002 MS 53.50$

B9004 NU -$

B9004 RR -$

B9004 UE -$

B9004 MS -$

B9006 NU -$

B9006 RR -$

B9006 UE -$

B9006 MS -$

E0100 NU 23.30$

E0100 RR 6.56$

E0100 UE 18.57$

E0105 NU 54.30$

E0105 RR 9.80$

E0105 UE 41.85$

E0110 NU 85.78$

E0110 RR 17.67$

E0110 UE 64.31$

E0111 NU 58.87$

E0111 RR 9.31$

E0111 UE 45.44$

E0112 NU 40.91$

E0112 RR 10.99$

E0112 UE 31.20$

E0113 NU 23.37$

E0113 RR 4.84$

E0113 UE 17.53$

E0114 NU 49.20$

E0114 RR 9.47$

E0114 UE 36.92$

E0116 NU 26.32$

E0116 RR 5.98$

E0116 UE 19.72$



Page | 5


Amount

E0117 NU By Report

E0117 RR 21.29$

E0117 UE By Report

E0130 NU 56.82$

E0130 RR 9.62$

E0130 UE 43.59$

E0135 NU 61.77$

E0135 RR 10.40$

E0135 UE 46.56$

E0140 NU 299.39$

E0140 RR 29.94$

E0140 UE 224.54$

E0141 NU 90.32$

E0141 RR 14.20$

E0141 UE 67.75$

E0143 NU 85.11$

E0143 RR 11.53$

E0143 UE 63.74$

E0144 NU By Report

E0144 RR 27.88$

E0144 UE By Report

E0147 NU 452.32$

E0147 RR 45.24$

E0147 UE 339.25$

E0148 NU 100.36$

E0148 RR 10.04$

E0148 UE 75.26$

E0149 NU 167.11$

E0149 RR 16.71$

E0149 UE 125.33$

E0153 NU 75.93$

E0153 RR 7.59$

E0153 UE 56.96$

E0154 NU 54.74$

E0154 RR 6.19$

E0154 UE 37.55$

E0155 NU 22.30$

E0155 RR 2.79$

E0155 UE 16.89$

E0156 NU 19.99$

E0156 RR 2.35$

E0156 UE 15.01$



Page | 6


Amount

E0157 NU 62.01$

E0157 RR 6.20$

E0157 UE 46.51$

E0158 NU 24.99$

E0158 RR 2.66$

E0158 UE 18.82$

E0159 NU 14.76$

E0159 RR 1.51$

E0159 UE 11.08$

E0160 NU 32.19$

E0160 RR 3.79$

E0160 UE 24.13$

E0161 NU 27.26$

E0161 RR 3.25$

E0161 UE 20.43$

E0162 NU 136.92$

E0162 RR 14.36$

E0162 UE 106.17$

E0163 NU 96.08$

E0163 RR 16.05$

E0163 UE 73.35$

E0165 RR 17.23$

E0167 NU 12.00$

E0167 RR 1.19$

E0167 UE 9.03$

E0168 NU 152.06$

E0168 RR 15.24$

E0168 UE 114.04$

E0170 RR 173.78$

E0171 RR 31.15$

E0175 NU 65.77$

E0175 RR 6.56$

E0175 UE 49.30$

E0181 RR 24.48$

E0182 RR 24.28$

E0184 NU 194.49$

E0184 RR 22.27$

E0184 UE 147.69$

E0185 NU 280.98$

E0185 RR 35.26$

E0185 UE 213.83$

E0186 RR 20.82$



Page | 7


Amount

E0187 RR 23.14$

E0188 NU 26.98$

E0188 RR 2.94$

E0188 UE 20.25$

E0189 NU 48.83$

E0189 RR 5.09$

E0189 UE 36.62$

E0191 NU 9.39$

E0191 RR 0.97$

E0191 UE 7.00$

E0193 RR 772.70$

E0194 RR 3,207.15$

E0196 RR 33.41$

E0197 NU 211.55$

E0197 RR 25.80$

E0197 UE 174.40$

E0198 NU By Report

E0198 RR 20.83$

E0198 UE By Report

E0199 NU 32.29$

E0199 RR 3.22$

E0199 UE 24.21$

E0200 NU 87.65$

E0200 RR 11.90$

E0200 UE 65.77$

E0202 RR 58.84$

E0205 NU 214.54$

E0205 RR 23.60$

E0205 UE 160.90$

E0210 NU 36.09$

E0210 RR 3.40$

E0210 UE 27.06$

E0215 NU 78.32$

E0215 RR 6.96$

E0215 UE 58.75$

E0217 NU 548.86$

E0217 RR 61.10$

E0217 UE 411.61$

E0225 NU 429.65$

E0225 RR 42.35$

E0225 UE 322.23$

E0235 RR 17.55$



Page | 8


Amount

E0236 RR 46.92$

E0239 NU 497.29$

E0239 RR 49.74$

E0239 UE 372.98$

E0249 NU 93.60$

E0249 RR 10.29$

E0249 UE 70.20$

E0250 RR 78.11$

E0251 RR 59.94$

E0255 RR 92.50$

E0256 RR 68.56$

E0260 RR 102.21$

E0261 RR 98.30$

E0265 RR 163.27$

E0266 RR 143.81$

E0271 NU 167.79$

E0271 RR 16.78$

E0271 UE 129.13$

E0272 NU 160.15$

E0272 RR 16.02$

E0272 UE 120.13$

E0275 NU 15.78$

E0275 RR 1.62$

E0275 UE 11.83$

E0276 NU 12.44$

E0276 RR 1.36$

E0276 UE 9.58$

E0277 RR 444.67$

E0280 NU 32.73$

E0280 RR 3.42$

E0280 UE 24.55$

E0290 RR 60.86$

E0291 RR 45.24$

E0292 RR 68.94$

E0293 RR 59.12$

E0294 RR 102.22$

E0295 RR 96.43$

E0296 RR 156.45$

E0297 RR 113.86$

E0300 NU By Report

E0300 RR 253.53$

E0300 UE By Report



Page | 9


Amount

E0301 RR 211.90$

E0302 RR 584.60$

E0303 RR 228.68$

E0304 RR 613.23$

E0305 RR 14.37$

E0310 NU 155.29$

E0310 RR 16.18$

E0310 UE 117.10$

E0316 RR 179.71$

E0325 NU 10.22$

E0325 RR 1.30$

E0325 UE 6.28$

E0326 NU 10.79$

E0326 RR 1.06$

E0326 UE 8.10$

E0371 RR 343.66$

E0372 RR 378.20$

E0373 RR 461.25$

E0424 RR 135.65$

E0431 RR 24.75$

E0433 RR 47.52$

E0434 RR 24.75$

E0439 RR 135.65$

E0441 00 68.17$

E0442 00 68.17$

E0443 00 66.02$

E0444 00 66.02$

E0446 00 By Report

E0462 RR 273.83$

E0465 RR 896.95$

E0466 RR 896.95$

E0470 RR 179.81$

E0471 RR 458.77$

E0472 RR 518.17$

E0480 RR 48.58$

E0482 RR 475.40$

E0483 RR 1,175.30$

E0484 NU 40.83$

E0484 RR 4.07$

E0484 UE 30.63$

E0485 NU -$

E0485 RR -$



Page | 10


Amount

E0485 UE -$

E0486 NU -$

E0486 RR -$

E0486 UE -$

E0500 RR 103.14$

E0550 RR 47.11$

E0560 NU 163.42$

E0560 RR 19.15$

E0560 UE 122.57$

E0561 NU 89.34$

E0561 RR 8.93$

E0561 UE 67.00$

E0562 NU 213.81$

E0562 RR 21.37$

E0562 UE 160.35$

E0565 RR 54.75$

E0570 RR 14.49$

E0572 RR 40.98$

E0574 RR 44.51$

E0575 RR 113.62$

E0580 NU 126.22$

E0580 RR 12.63$

E0580 UE 94.66$

E0585 RR 32.95$

E0600 RR 50.62$

E0601 RR 76.70$

E0602 NU 32.63$

E0602 RR 3.28$

E0602 UE 24.48$

E0605 NU 29.22$

E0605 RR 3.40$

E0605 UE 24.08$

E0606 RR 25.38$

E0607 NU 73.86$

E0607 RR 7.38$

E0607 UE 55.39$

E0610 NU 223.51$

E0610 RR 23.57$

E0610 UE 167.65$

E0615 NU 529.32$

E0615 RR 61.68$

E0615 UE 397.02$



Page | 11


Amount

E0617 RR 336.12$

E0618 RR 309.95$

E0619 RR -$

E0620 NU By Report

E0620 RR 96.65$

E0620 UE By Report

E0621 NU 94.41$

E0621 RR 9.24$

E0621 UE 71.01$

E0627 NU 324.41$

E0627 RR 32.44$

E0627 UE 243.30$

E0628 NU 335.14$

E0628 RR 33.52$

E0628 UE 251.34$

E0629 NU 328.88$

E0629 RR 32.89$

E0629 UE 246.65$

E0630 RR 91.12$

E0635 RR 118.36$

E0636 RR 1,107.26$

E0639 RR 118.44$

E0640 RR 118.44$

E0650 NU 796.20$

E0650 RR 87.80$

E0650 UE 597.15$

E0651 NU 1,015.31$

E0651 RR 101.53$

E0651 UE 761.50$

E0652 NU 5,332.78$

E0652 RR 579.22$

E0652 UE 3,999.58$

E0655 NU 119.32$

E0655 RR 12.01$

E0655 UE 89.60$

E0656 NU By Report

E0656 RR 63.88$

E0656 UE By Report

E0657 NU By Report

E0657 RR 60.01$

E0657 UE By Report

E0660 NU 176.60$



Page | 12


Amount

E0660 RR 18.38$

E0660 UE 132.45$

E0665 NU 140.25$

E0665 RR 15.55$

E0665 UE 105.20$

E0666 NU 152.67$

E0666 RR 15.73$

E0666 UE 114.52$

E0667 NU 357.93$

E0667 RR 40.42$

E0667 UE 268.45$

E0668 NU 488.50$

E0668 RR 48.21$

E0668 UE 366.39$

E0669 NU 202.66$

E0669 RR 20.28$

E0669 UE 152.03$

E0670 00 By Report

E0670 NU 1,389.68$

E0670 RR 148.77$

E0670 UE 1,042.21$

E0671 NU 459.18$

E0671 RR 45.94$

E0671 UE 344.37$

E0672 NU 356.77$

E0672 RR 35.69$

E0672 UE 267.60$

E0673 NU 296.46$

E0673 RR 29.65$

E0673 UE 222.38$

E0675 RR 425.12$

E0691 NU 993.40$

E0691 RR 99.33$

E0691 UE 745.05$

E0692 NU 1,247.44$

E0692 RR 124.73$

E0692 UE 935.57$

E0693 NU 1,537.74$

E0693 RR 153.78$

E0693 UE 1,153.30$

E0694 NU 4,894.46$

E0694 RR 489.44$



Page | 13


Amount

E0694 UE 3,670.87$

E0705 NU 49.43$

E0705 RR 5.45$

E0705 UE 36.62$

E0720 NU 285.50$

E0730 NU 296.20$

E0731 NU 318.48$

E0740 NU By Report

E0740 RR 57.82$

E0740 UE By Report

E0744 RR 101.23$

E0745 RR 98.96$

E0747 NU 4,329.25$

E0747 RR 430.20$

E0747 UE 3,216.55$

E0748 NU 4,301.21$

E0748 RR 430.10$

E0748 UE 3,225.91$

E0749 RR 307.16$

E0760 NU 3,574.23$

E0760 RR 357.43$

E0760 UE 2,680.65$

E0762 NU By Report

E0762 RR 103.32$

E0762 UE By Report

E0764 NU By Report

E0764 RR 1,223.43$

E0764 UE By Report

E0765 NU 93.01$

E0765 RR 9.31$

E0765 UE 69.78$

E0766 RR By Report

E0776 NU 148.01$

E0776 RR 17.20$

E0776 UE 109.89$

E0779 RR 18.18$

E0780 NU 11.41$

E0781 RR 262.38$

E0782 NU 4,746.41$

E0782 RR 474.66$

E0782 UE 3,559.80$

E0783 NU 9,050.69$



Page | 14


Amount

E0783 RR 905.09$

E0783 UE 6,788.03$

E0784 RR 439.88$

E0785 KF 522.36$

E0786 NU 8,828.39$

E0786 RR 882.82$

E0786 UE 6,621.30$

E0791 RR 312.56$

E0840 NU 80.99$

E0840 RR 18.05$

E0840 UE 60.72$

E0849 NU By Report

E0849 RR 56.98$

E0849 UE By Report

E0850 NU 116.13$

E0850 RR 15.95$

E0850 UE 87.11$

E0855 NU By Report

E0855 RR 55.56$

E0855 UE By Report

E0856 NU By Report

E0856 RR 17.01$

E0856 UE By Report

E0860 NU 42.24$

E0860 RR 6.12$

E0860 UE 31.67$

E0870 NU 128.59$

E0870 RR 14.83$

E0870 UE 96.87$

E0880 NU 138.79$

E0880 RR 21.79$

E0880 UE 105.05$

E0890 NU 133.10$

E0890 RR 36.30$

E0890 UE 107.22$

E0900 NU 141.65$

E0900 RR 30.54$

E0900 UE 106.27$

E0910 RR 14.21$

E0911 RR 44.19$

E0912 RR 98.72$

E0920 RR 47.17$



Page | 15


Amount

E0930 RR 50.50$

E0935 RR 25.14$

E0940 RR 27.31$

E0941 RR 40.78$

E0942 NU 21.94$

E0942 RR 2.60$

E0942 UE 16.43$

E0944 NU 47.17$

E0944 RR 5.10$

E0944 UE 35.37$

E0945 NU 49.00$

E0945 RR 4.91$

E0945 UE 37.92$

E0946 RR 65.41$

E0947 NU 569.88$

E0947 RR 69.11$

E0947 UE 427.40$

E0948 NU 648.48$

E0948 RR 64.82$

E0948 UE 457.37$

E0950 NU 86.69$

E0950 RR 8.68$

E0950 UE 65.02$

E0951 NU 15.70$

E0951 RR 1.60$

E0951 UE 11.77$

E0952 NU 16.64$

E0952 RR 1.70$

E0952 UE 12.49$

E0955 NU 163.39$

E0955 RR 16.35$

E0955 UE 122.54$

E0956 NU 86.23$

E0956 RR 8.62$

E0956 UE 64.67$

E0957 NU 122.17$

E0957 RR 12.22$

E0957 UE 91.63$

E0958 RR 44.54$

E0959 NU 45.46$

E0959 RR 4.56$

E0959 UE 34.10$



Page | 16


Amount

E0960 NU 79.49$

E0960 RR 7.96$

E0960 UE 59.63$

E0961 NU 24.65$

E0961 RR 2.79$

E0961 UE 16.21$

E0966 NU 72.77$

E0966 RR 7.23$

E0966 UE 54.58$

E0967 NU 68.93$

E0967 RR 6.90$

E0967 UE 51.69$

E0968 RR 19.31$

E0969 NU 173.16$

E0969 RR 17.14$

E0969 UE 129.88$

E0971 NU 40.51$

E0971 RR 4.06$

E0971 UE 30.40$

E0973 NU 72.99$

E0973 RR 7.86$

E0973 UE 54.75$

E0974 NU 78.65$

E0974 RR 8.13$

E0974 UE 59.23$

E0978 NU 32.60$

E0978 RR 2.96$

E0978 UE 24.16$

E0980 NU 36.54$

E0980 RR 3.41$

E0980 UE 25.57$

E0981 NU 41.68$

E0981 RR 4.21$

E0981 UE 31.42$

E0982 NU 45.83$

E0982 RR 4.58$

E0982 UE 34.38$

E0983 RR 276.31$

E0984 NU By Report

E0984 RR 211.20$

E0984 UE By Report

E0985 NU 213.95$



Page | 17


Amount

E0985 RR 21.40$

E0985 UE 160.46$

E0986 NU By Report

E0986 RR 537.76$

E0986 UE By Report

E0988 RR 330.93$

E0990 NU 80.88$

E0990 RR 9.63$

E0990 UE 62.15$

E0992 NU 91.65$

E0992 RR 9.01$

E0992 UE 68.74$

E0994 NU 19.48$

E0994 RR 1.80$

E0994 UE 14.62$

E0995 NU 26.83$

E0995 RR 2.69$

E0995 UE 20.11$

E1002 NU By Report

E1002 RR 364.46$

E1002 UE By Report

E1003 NU By Report

E1003 RR 409.80$

E1003 UE By Report

E1004 NU By Report

E1004 RR 452.43$

E1004 UE By Report

E1005 NU By Report

E1005 RR 492.26$

E1005 UE By Report

E1006 NU By Report

E1006 RR 604.91$

E1006 UE By Report

E1007 NU By Report

E1007 RR 785.57$

E1007 UE By Report

E1008 NU By Report

E1008 RR 795.09$

E1008 UE By Report

E1009 NU -$

E1009 RR -$

E1009 UE -$



Page | 18


Amount

E1010 NU By Report

E1010 RR 105.95$

E1010 UE By Report

E1011 NU -$

E1011 RR -$

E1011 UE -$

E1012 RR 94.99$

E1014 NU By Report

E1014 RR 40.38$

E1014 UE By Report

E1015 NU 121.49$

E1015 RR 12.14$

E1015 UE 91.11$

E1016 NU 113.59$

E1016 RR 11.37$

E1016 UE 85.19$

E1017 NU -$

E1017 RR -$

E1017 UE -$

E1018 NU -$

E1018 RR -$

E1018 UE -$

E1020 NU 210.92$

E1020 RR 21.08$

E1020 UE 158.19$

E1028 NU 164.72$

E1028 RR 16.47$

E1028 UE 123.54$

E1029 NU By Report

E1029 RR 34.93$

E1029 UE By Report

E1030 NU By Report

E1030 RR 109.66$

E1030 UE By Report

E1031 RR 48.79$

E1035 RR 648.65$

E1036 RR 921.74$

E1037 RR 109.66$

E1038 RR 16.99$

E1039 RR 35.01$

E1050 RR 112.58$

E1060 RR 137.34$



Page | 19


Amount

E1070 RR 121.09$

E1083 RR 87.05$

E1084 RR 108.45$

E1087 RR 135.63$

E1088 RR 166.68$

E1092 RR 142.08$

E1093 RR 122.18$

E1100 RR 114.75$

E1110 RR 99.25$

E1150 RR 90.18$

E1160 RR 69.10$

E1161 NU By Report

E1161 RR 261.57$

E1161 UE By Report

E1170 RR 83.94$

E1171 RR 88.61$

E1172 RR 108.30$

E1180 RR 95.23$

E1190 RR 129.43$

E1195 RR 138.88$

E1200 RR 96.19$

E1221 RR 45.70$

E1222 RR 74.94$

E1223 RR 81.82$

E1224 RR 89.71$

E1225 RR 42.56$

E1226 NU 489.38$

E1226 RR 49.82$

E1226 UE 367.01$

E1227 NU 306.78$

E1227 RR 30.69$

E1227 UE 230.11$

E1228 RR 30.57$

E1230 NU 2,500.44$

E1230 RR 209.03$

E1230 UE 1,977.54$

E1231 NU -$

E1231 RR -$

E1231 UE -$

E1232 NU By Report

E1232 RR 236.42$

E1232 UE By Report



Page | 20


Amount

E1233 NU By Report

E1233 RR 244.95$

E1233 UE By Report

E1234 NU By Report

E1234 RR 213.26$

E1234 UE By Report

E1235 NU By Report

E1235 RR 205.36$

E1235 UE By Report

E1236 NU By Report

E1236 RR 181.16$

E1236 UE By Report

E1237 NU By Report

E1237 RR 182.75$

E1237 UE By Report

E1238 NU By Report

E1238 RR 181.16$

E1238 UE By Report

E1240 RR 113.89$

E1270 RR 87.27$

E1280 RR 143.52$

E1295 RR 134.28$

E1296 NU 543.53$

E1296 RR 46.94$

E1296 UE 407.65$

E1297 NU 115.65$

E1297 RR 12.85$

E1297 UE 86.72$

E1298 NU 468.36$

E1298 RR 47.92$

E1298 UE 351.26$

E1310 NU 2,017.87$

E1310 RR 201.79$

E1310 UE 1,513.42$

E1353 00 31.31$

E1355 00 23.59$

E1372 NU 166.66$

E1372 RR 20.75$

E1372 UE 124.12$

E1390 RR 135.65$

E1391 RR 135.65$

E1392 RR 47.52$



Page | 21


Amount

E1405 RR 168.66$

E1406 RR 150.25$

E1700 NU By Report

E1700 RR 32.41$

E1700 UE By Report

E1701 00 11.72$

E1702 00 24.95$

E1800 RR 135.43$

E1801 RR 142.62$

E1802 RR 361.29$

E1805 RR 139.68$

E1806 RR 117.10$

E1810 RR 137.73$

E1811 RR 148.27$

E1812 RR 95.06$

E1815 RR 139.68$

E1816 RR 150.62$

E1818 RR 153.76$

E1820 NU 85.24$

E1820 RR 8.54$

E1820 UE 63.94$

E1821 NU 116.35$

E1821 RR 11.61$

E1821 UE 87.29$

E1825 RR 139.68$

E1830 RR 139.68$

E1831 RR 73.05$

E1840 RR 423.09$

E1841 RR 500.78$

E2000 RR 57.30$

E2100 NU 642.97$

E2100 RR 71.11$

E2100 UE 482.20$

E2101 NU 208.45$

E2101 RR 20.84$

E2101 UE 156.34$

E2120 RR 313.44$

E2201 NU 371.25$

E2201 RR 37.12$

E2201 UE 278.43$

E2202 NU 477.50$

E2202 RR 47.75$



Page | 22


Amount

E2202 UE 358.14$

E2203 NU 475.44$

E2203 RR 47.54$

E2203 UE 356.56$

E2204 NU 799.25$

E2204 RR 79.93$

E2204 UE 599.44$

E2205 NU 34.19$

E2205 RR 3.41$

E2205 UE 25.66$

E2206 NU 40.09$

E2206 RR 4.00$

E2206 UE 30.06$

E2207 NU 45.58$

E2207 RR 4.57$

E2207 UE 34.19$

E2208 NU 98.73$

E2208 RR 9.87$

E2208 UE 74.05$

E2209 NU 93.59$

E2209 RR 9.37$

E2209 UE 70.20$

E2210 NU 5.59$

E2210 RR 0.56$

E2210 UE 4.20$

E2211 NU 39.53$

E2211 RR 3.86$

E2211 UE 28.88$

E2212 NU 6.29$

E2212 RR 0.65$

E2212 UE 4.73$

E2213 NU 30.87$

E2213 RR 3.09$

E2213 UE 23.14$

E2214 NU 35.50$

E2214 RR 3.42$

E2214 UE 26.62$

E2215 NU 10.11$

E2215 RR 1.01$

E2215 UE 7.58$

E2216 NU -$

E2216 RR -$



Page | 23


Amount

E2216 UE -$

E2217 NU -$

E2217 RR -$

E2217 UE -$

E2218 NU -$

E2218 RR -$

E2218 UE -$

E2219 NU 42.53$

E2219 RR 4.55$

E2219 UE 31.90$

E2220 NU 29.67$

E2220 RR 2.59$

E2220 UE 22.49$

E2221 NU 26.81$

E2221 RR 2.70$

E2221 UE 20.12$

E2222 NU 22.15$

E2222 RR 2.20$

E2222 UE 16.62$

E2224 NU 90.42$

E2224 RR 10.12$

E2224 UE 67.82$

E2225 NU 18.52$

E2225 RR 1.85$

E2225 UE 13.88$

E2226 NU 39.54$

E2226 RR 3.95$

E2226 UE 29.65$

E2227 NU By Report

E2227 RR 206.82$

E2227 UE By Report

E2228 NU 994.07$

E2228 RR 99.40$

E2228 UE 745.56$

E2231 NU 154.07$

E2231 RR 15.41$

E2231 UE 115.55$

E2310 NU By Report

E2310 RR 105.93$

E2310 UE By Report

E2311 NU By Report

E2311 RR 214.14$



Page | 24


Amount

E2311 UE By Report

E2312 NU By Report

E2312 RR 222.94$

E2312 UE By Report

E2313 NU By Report

E2313 RR 35.43$

E2313 UE By Report

E2321 NU By Report

E2321 RR 143.90$

E2321 UE By Report

E2322 NU By Report

E2322 RR 131.60$

E2322 UE By Report

E2323 NU 64.35$

E2323 RR 6.43$

E2323 UE 48.26$

E2324 NU 41.61$

E2324 RR 4.15$

E2324 UE 31.20$

E2325 NU By Report

E2325 RR 125.74$

E2325 UE By Report

E2326 NU By Report

E2326 RR 32.69$

E2326 UE By Report

E2327 NU By Report

E2327 RR 244.88$

E2327 UE By Report

E2328 NU By Report

E2328 RR 463.38$

E2328 UE By Report

E2329 NU By Report

E2329 RR 166.22$

E2329 UE By Report

E2330 NU By Report

E2330 RR 320.63$

E2330 UE By Report

E2340 NU 396.17$

E2340 RR 39.63$

E2340 UE 297.16$

E2341 NU 594.30$

E2341 RR 59.42$



Page | 25


Amount

E2341 UE 445.73$

E2342 NU 495.25$

E2342 RR 49.52$

E2342 UE 371.45$

E2343 NU 792.41$

E2343 RR 79.23$

E2343 UE 594.30$

E2351 NU 659.43$

E2351 RR 65.94$

E2351 UE 494.58$

E2358 00 By Report

E2359 NU 181.55$

E2359 RR 18.16$

E2359 UE 136.15$

E2360 NU 107.58$

E2360 RR 10.29$

E2360 UE 80.71$

E2361 NU 118.97$

E2361 RR 11.90$

E2361 UE 89.24$

E2362 NU 95.58$

E2362 RR 9.56$

E2362 UE 71.68$

E2363 NU 155.74$

E2363 RR 15.57$

E2363 UE 116.80$

E2364 NU 106.64$

E2364 RR 10.19$

E2364 UE 80.00$

E2365 NU 89.64$

E2365 RR 8.96$

E2365 UE 67.24$

E2366 NU 204.51$

E2366 RR 20.49$

E2366 UE 153.39$

E2367 NU 362.49$

E2367 RR 36.25$

E2367 UE 271.87$

E2368 NU 443.49$

E2368 RR 44.35$

E2368 UE 332.63$

E2369 NU 390.67$



Page | 26


Amount

E2369 RR 39.08$

E2369 UE 293.00$

E2370 NU 645.20$

E2370 RR 64.52$

E2370 UE 483.90$

E2371 NU 134.66$

E2371 RR 13.47$

E2371 UE 101.00$

E2372 NU -$

E2372 RR -$

E2372 UE -$

E2373 NU By Report

E2373 RR 77.70$

E2373 UE By Report

E2374 NU By Report

E2374 RR 48.57$

E2374 UE By Report

E2375 NU 747.30$

E2375 RR 74.72$

E2375 UE 560.47$

E2376 NU By Report

E2376 RR 121.39$

E2376 UE By Report

E2377 NU By Report

E2377 RR 44.42$

E2377 UE By Report

E2378 00 By Report

E2378 NU By Report

E2378 RR 56.57$

E2378 UE By Report

E2381 NU 64.18$

E2381 RR 6.41$

E2381 UE 48.13$

E2382 NU 18.32$

E2382 RR 1.83$

E2382 UE 13.75$

E2383 NU 130.86$

E2383 RR 13.09$

E2383 UE 98.14$

E2384 NU 67.83$

E2384 RR 6.79$

E2384 UE 50.88$



Page | 27


Amount

E2385 NU 43.81$

E2385 RR 4.39$

E2385 UE 32.85$

E2386 NU 122.90$

E2386 RR 12.29$

E2386 UE 92.18$

E2387 NU 55.82$

E2387 RR 5.59$

E2387 UE 41.89$

E2388 NU 46.01$

E2388 RR 4.61$

E2388 UE 34.51$

E2389 NU 25.34$

E2389 RR 2.54$

E2389 UE 18.99$

E2390 NU 39.43$

E2390 RR 3.94$

E2390 UE 29.56$

E2391 NU 17.75$

E2391 RR 1.78$

E2391 UE 13.31$

E2392 NU 45.92$

E2392 RR 4.60$

E2392 UE 34.44$

E2394 NU 65.12$

E2394 RR 6.52$

E2394 UE 48.84$

E2395 NU 47.10$

E2395 RR 4.72$

E2395 UE 35.33$

E2396 NU 55.46$

E2396 RR 5.77$

E2396 UE 41.60$

E2397 NU 443.59$

E2397 RR 44.36$

E2397 UE 332.68$

E2402 RR 1,227.07$

E2500 NU 432.30$

E2500 RR 43.24$

E2500 UE 324.23$

E2502 NU 1,321.96$

E2502 RR 132.20$



Page | 28


Amount

E2502 UE 991.49$

E2504 NU 1,743.84$

E2504 RR 174.41$

E2504 UE 1,307.88$

E2506 NU 2,557.00$

E2506 RR 255.68$

E2506 UE 1,917.71$

E2508 NU 3,953.96$

E2508 RR 395.39$

E2508 UE 2,965.48$

E2510 NU 7,482.35$

E2510 RR 748.24$

E2510 UE 5,611.76$

E2511 NU -$

E2511 RR -$

E2511 UE -$

E2512 NU -$

E2512 RR -$

E2512 UE -$

E2601 NU 51.21$

E2601 RR 5.13$

E2601 UE 38.41$

E2602 NU 100.16$

E2602 RR 10.02$

E2602 UE 75.13$

E2603 NU 126.73$

E2603 RR 12.68$

E2603 UE 95.05$

E2604 NU 163.65$

E2604 RR 16.36$

E2604 UE 122.75$

E2605 NU 230.62$

E2605 RR 23.07$

E2605 UE 172.98$

E2606 NU 357.66$

E2606 RR 35.77$

E2606 UE 268.23$

E2607 NU 244.33$

E2607 RR 24.43$

E2607 UE 183.25$

E2608 NU 304.12$

E2608 RR 30.41$



Page | 29


Amount

E2608 UE 228.09$

E2611 NU 227.29$

E2611 RR 22.72$

E2611 UE 170.48$

E2612 NU 353.67$

E2612 RR 35.37$

E2612 UE 265.25$

E2613 NU 334.62$

E2613 RR 33.47$

E2613 UE 250.97$

E2614 NU 464.05$

E2614 RR 46.41$

E2614 UE 348.05$

E2615 NU 388.93$

E2615 RR 38.90$

E2615 UE 291.70$

E2616 NU 520.30$

E2616 RR 52.03$

E2616 UE 390.23$

E2619 NU 47.11$

E2619 RR 4.71$

E2619 UE 35.35$

E2620 NU 456.94$

E2620 RR 45.70$

E2620 UE 342.71$

E2621 NU 484.78$

E2621 RR 48.48$

E2621 UE 363.59$

E2622 NU 301.67$

E2622 RR 30.17$

E2622 UE 226.25$

E2623 NU 382.72$

E2623 RR 38.28$

E2623 UE 287.04$

E2624 NU 305.29$

E2624 RR 30.53$

E2624 UE 228.98$

E2625 NU 382.34$

E2625 RR 38.23$

E2625 UE 286.75$

E2626 NU 651.51$

E2626 RR 65.14$



Page | 30


Amount

E2626 UE 488.61$

E2627 NU 1,033.91$

E2627 RR 103.41$

E2627 UE 775.43$

E2628 NU 760.48$

E2628 RR 76.04$

E2628 UE 570.36$

E2629 NU 1,001.19$

E2629 RR 100.11$

E2629 UE 750.89$

E2630 NU 684.22$

E2630 RR 68.42$

E2630 UE 513.16$

E2631 NU 261.65$

E2631 RR 26.16$

E2631 UE 196.25$

E2632 NU 157.93$

E2632 RR 15.79$

E2632 UE 118.44$

E2633 NU 146.61$

E2633 RR 14.66$

E2633 UE 109.96$

K0001 RR 42.78$

K0002 RR 63.49$

K0003 RR 70.72$

K0004 RR 99.25$

K0005 NU 2,043.83$

K0005 RR 204.36$

K0005 UE 1,532.83$

K0006 RR 104.69$

K0007 RR 151.54$

K0009 RR 82.20$

K0010 RR 470.93$

K0011 RR 566.33$

K0012 RR 359.21$

K0015 NU 147.64$

K0015 RR 14.76$

K0015 UE 110.73$

K0017 NU 46.16$

K0017 RR 4.62$

K0017 UE 34.62$

K0018 NU 25.93$



Page | 31


Amount

K0018 RR 2.59$

K0018 UE 19.45$

K0019 NU 14.20$

K0019 RR 1.42$

K0019 UE 10.66$

K0020 NU 43.51$

K0020 RR 4.35$

K0020 UE 32.63$

K0037 NU 43.47$

K0037 RR 4.09$

K0037 UE 32.61$

K0038 NU 22.47$

K0038 RR 2.25$

K0038 UE 16.84$

K0039 NU 49.08$

K0039 RR 4.92$

K0039 UE 36.81$

K0040 NU 61.20$

K0040 RR 6.11$

K0040 UE 45.88$

K0041 NU 47.58$

K0041 RR 4.78$

K0041 UE 35.69$

K0042 NU 29.12$

K0042 RR 2.91$

K0042 UE 21.84$

K0043 NU 18.17$

K0043 RR 1.81$

K0043 UE 13.65$

K0044 NU 15.65$

K0044 RR 1.57$

K0044 UE 11.73$

K0045 NU 47.06$

K0045 RR 5.32$

K0045 UE 35.27$

K0046 NU 18.23$

K0046 RR 1.82$

K0046 UE 13.69$

K0047 NU 67.99$

K0047 RR 6.81$

K0047 UE 50.98$

K0050 NU 30.12$



Page | 32


Amount

K0050 RR 3.01$

K0050 UE 22.60$

K0051 NU 48.22$

K0051 RR 4.84$

K0051 UE 36.16$

K0052 NU 75.97$

K0052 RR 7.59$

K0052 UE 56.97$

K0053 NU 88.68$

K0053 RR 8.86$

K0053 UE 66.51$

K0056 NU 95.22$

K0056 RR 9.53$

K0056 UE 71.43$

K0065 NU 46.17$

K0065 RR 4.62$

K0065 UE 34.63$

K0069 NU 98.81$

K0069 RR 9.89$

K0069 UE 74.11$

K0070 NU 175.66$

K0070 RR 17.57$

K0070 UE 131.75$

K0071 NU 112.26$

K0071 RR 11.23$

K0071 UE 84.18$

K0072 NU 65.53$

K0072 RR 6.55$

K0072 UE 49.15$

K0073 NU 36.51$

K0073 RR 3.65$

K0073 UE 27.38$

K0077 NU 58.36$

K0077 RR 5.83$

K0077 UE 43.76$

K0098 NU 24.56$

K0098 RR 2.46$

K0098 UE 18.41$

K0105 NU 102.99$

K0105 RR 10.30$

K0105 UE 77.25$

K0195 RR 15.88$



Page | 33


Amount

K0455 RR 292.81$

K0552 00 2.75$

K0601 NU 1.20$

K0602 NU 6.84$

K0603 NU 0.61$

K0604 NU 6.57$

K0605 NU 15.74$

K0606 RR 2,783.98$

K0607 NU By Report

K0607 RR 21.48$

K0607 UE By Report

K0608 NU 133.99$

K0608 RR 13.43$

K0608 UE 100.50$

K0609 00 891.13$

K0609 KF 989.39$

K0672 00 81.97$

K0730 NU By Report

K0730 RR 190.59$

K0730 UE By Report

K0733 NU 27.44$

K0733 RR 2.75$

K0733 UE 20.59$

K0738 RR 47.52$

K0743 00 By Report

K0744 00 By Report

K0745 00 By Report

K0746 00 By Report

K0800 NU 1,041.11$

K0800 RR 104.12$

K0800 UE 780.83$

K0801 NU 1,811.89$

K0801 RR 181.17$

K0801 UE 1,358.91$

K0802 NU 2,050.65$

K0802 RR 205.06$

K0802 UE 1,537.98$

K0806 NU 1,391.75$

K0806 RR 139.17$

K0806 UE 1,043.82$

K0807 NU 2,132.76$

K0807 RR 213.28$



Page | 34


Amount

K0807 UE 1,599.58$

K0808 NU 3,298.44$

K0808 RR 329.84$

K0808 UE 2,473.83$

K0813 RR 312.43$

K0814 RR 362.97$

K0815 RR 396.81$

K0816 RR 385.00$

K0820 RR 329.67$

K0821 RR 380.72$

K0822 RR 449.20$

K0823 RR 432.02$

K0824 RR 567.45$

K0825 RR 508.63$

K0826 RR 799.67$

K0827 RR 667.59$

K0828 RR 887.70$

K0829 RR 832.73$

K0835 RR 456.11$

K0836 RR 473.04$

K0837 RR 559.19$

K0838 RR 498.48$

K0839 RR 731.13$

K0840 RR 1,113.40$

K0841 RR 495.88$

K0842 RR 495.60$

K0843 RR 593.54$

K0848 RR 755.28$

K0849 RR 726.16$

K0850 RR 876.10$

K0851 RR 842.37$

K0852 RR 1,012.27$

K0853 RR 1,039.86$

K0854 RR 1,377.59$

K0855 RR 1,301.34$

K0856 RR 810.71$

K0857 RR 826.96$

K0858 RR 1,005.86$

K0859 RR 959.28$

K0860 RR 1,436.99$

K0861 RR 812.01$

K0862 RR 1,005.86$



Page | 35


Amount

K0863 RR 1,436.99$

K0864 RR 1,710.03$

K0901 00 834.89$

K0902 00 756.66$

L0112 00 1,302.31$

L0113 00 275.67$

L0120 00 31.54$

L0130 00 175.47$

L0140 00 76.09$

L0150 00 101.32$

L0160 00 139.61$

L0170 00 677.20$

L0172 00 122.22$

L0174 00 257.33$

L0180 00 375.18$

L0190 00 527.85$

L0200 00 589.41$

L0220 00 117.43$

L0450 00 204.60$

L0452 00 -$

L0454 00 322.71$

L0455 00 322.71$

L0456 00 925.43$

L0457 00 925.43$

L0458 00 829.83$

L0460 00 934.02$

L0462 00 1,161.79$

L0464 00 1,383.09$

L0466 00 420.56$

L0467 00 420.56$

L0468 00 504.79$

L0469 00 504.79$

L0470 00 605.89$

L0472 00 430.25$

L0480 00 1,483.59$

L0482 00 1,512.02$

L0484 00 1,584.13$

L0486 00 1,680.68$

L0488 00 934.02$

L0490 00 263.23$

L0491 00 714.60$

L0492 00 470.02$



Page | 36


Amount

L0621 00 107.73$

L0622 00 285.89$

L0623 00 -$

L0624 00 -$

L0625 00 51.24$

L0626 00 72.52$

L0627 00 382.48$

L0628 00 78.07$

L0629 00 -$

L0630 00 150.70$

L0631 00 955.20$

L0632 00 -$

L0633 00 266.82$

L0634 00 -$

L0635 00 983.23$

L0636 00 1,281.98$

L0637 00 1,045.83$

L0638 00 1,227.21$

L0639 00 1,045.83$

L0640 00 973.66$

L0641 00 72.52$

L0642 00 382.48$

L0643 00 150.70$

L0648 00 955.20$

L0649 00 266.82$

L0650 00 1,045.83$

L0651 00 1,045.83$

L0700 00 1,802.14$

L0710 00 2,035.49$

L0810 00 2,450.88$

L0820 00 2,406.94$

L0830 00 3,376.07$

L0859 00 1,085.93$

L0861 00 200.55$

L0970 00 101.88$

L0972 00 91.74$

L0974 00 165.13$

L0976 00 174.50$

L0978 00 182.91$

L0980 00 16.55$

L0982 00 15.45$

L0984 00 60.94$



Page | 37


Amount

L0999 00 By Report

L1000 00 2,167.53$

L1001 00 -$

L1005 00 2,978.12$

L1010 00 62.05$

L1020 00 90.96$

L1025 00 111.16$

L1030 00 58.26$

L1040 00 86.02$

L1050 00 91.35$

L1060 00 100.45$

L1070 00 90.80$

L1080 00 56.12$

L1085 00 146.49$

L1090 00 88.60$

L1100 00 161.01$

L1110 00 266.43$

L1120 00 43.81$

L1200 00 1,862.21$

L1210 00 233.24$

L1220 00 241.59$

L1230 00 506.72$

L1240 00 73.98$

L1250 00 67.67$

L1260 00 71.43$

L1270 00 69.07$

L1280 00 80.00$

L1290 00 71.57$

L1300 00 1,505.82$

L1310 00 1,686.65$

L1499 00 By Report

L1600 00 114.87$

L1610 00 39.13$

L1620 00 125.83$

L1630 00 163.15$

L1640 00 430.27$

L1650 00 206.38$

L1652 00 331.68$

L1660 00 165.31$

L1680 00 1,448.13$

L1685 00 1,060.30$

L1686 00 824.54$



Page | 38


Amount

L1690 00 1,799.30$

L1700 00 1,464.03$

L1710 00 1,771.33$

L1720 00 1,235.66$

L1730 00 1,054.28$

L1755 00 1,411.30$

L1810 00 101.63$

L1812 00 101.63$

L1820 00 128.59$

L1830 00 99.67$

L1831 00 273.85$

L1832 00 541.94$

L1833 00 541.94$

L1834 00 691.96$

L1836 00 124.16$

L1840 00 948.11$

L1843 00 834.89$

L1844 00 1,875.44$

L1845 00 756.66$

L1846 00 1,139.67$

L1847 00 535.18$

L1848 00 535.18$

L1850 00 286.52$

L1860 00 1,169.47$

L1900 00 265.12$

L1902 00 87.25$

L1904 00 419.17$

L1906 00 107.20$

L1907 00 523.57$

L1910 00 301.52$

L1920 00 399.43$

L1930 00 246.27$

L1932 00 830.32$

L1940 00 473.57$

L1945 00 931.13$

L1950 00 885.27$

L1951 00 781.44$

L1960 00 494.09$

L1970 00 659.37$

L1971 00 436.14$

L1980 00 418.40$

L1990 00 505.57$



Page | 39


Amount

L2000 00 1,205.51$

L2005 00 3,812.84$

L2010 00 1,088.24$

L2020 00 1,387.79$

L2030 00 1,195.18$

L2034 00 1,886.87$

L2035 00 167.43$

L2036 00 2,133.54$

L2037 00 1,760.14$

L2038 00 1,482.75$

L2040 00 203.66$

L2050 00 430.66$

L2060 00 609.73$

L2070 00 119.88$

L2080 00 369.61$

L2090 00 521.16$

L2106 00 624.72$

L2108 00 1,068.21$

L2112 00 431.19$

L2114 00 529.12$

L2116 00 634.58$

L2126 00 1,067.41$

L2128 00 2,038.01$

L2132 00 719.07$

L2134 00 901.58$

L2136 00 1,054.17$

L2180 00 104.39$

L2182 00 96.06$

L2184 00 110.42$

L2186 00 154.50$

L2188 00 289.27$

L2190 00 77.85$

L2192 00 317.83$

L2200 00 56.50$

L2210 00 62.81$

L2220 00 86.26$

L2230 00 83.97$

L2232 00 92.60$

L2240 00 75.25$

L2250 00 422.32$

L2260 00 178.69$

L2265 00 104.98$



Page | 40


Amount

L2270 00 63.83$

L2275 00 139.42$

L2280 00 404.25$

L2300 00 299.24$

L2310 00 146.22$

L2320 00 234.30$

L2330 00 414.10$

L2335 00 221.70$

L2340 00 491.95$

L2350 00 896.10$

L2360 00 61.49$

L2370 00 244.52$

L2375 00 100.72$

L2380 00 111.72$

L2385 00 119.40$

L2387 00 181.02$

L2390 00 97.58$

L2395 00 139.47$

L2397 00 117.81$

L2405 00 81.11$

L2415 00 113.01$

L2425 00 133.38$

L2430 00 133.38$

L2492 00 94.25$

L2500 00 301.94$

L2510 00 736.54$

L2520 00 433.93$

L2525 00 1,156.69$

L2526 00 814.08$

L2530 00 218.68$

L2540 00 475.35$

L2550 00 279.33$

L2570 00 437.38$

L2580 00 488.93$

L2600 00 212.06$

L2610 00 255.56$

L2620 00 280.35$

L2622 00 273.36$

L2624 00 295.18$

L2627 00 1,528.12$

L2628 00 1,991.25$

L2630 00 233.16$



Page | 41


Amount

L2640 00 363.39$

L2650 00 142.63$

L2660 00 166.14$

L2670 00 157.20$

L2680 00 139.49$

L2750 00 87.54$

L2755 00 121.59$

L2760 00 55.31$

L2768 00 121.22$

L2780 00 80.44$

L2785 00 31.18$

L2795 00 93.89$

L2800 00 109.00$

L2810 00 69.62$

L2820 00 77.41$

L2830 00 83.74$

L2840 00 38.94$

L2850 00 55.19$

L2861 00 By Report

L2999 00 By Report

L3000 00 292.29$

L3001 00 123.08$

L3002 00 150.28$

L3003 00 162.15$

L3010 00 162.15$

L3020 00 184.61$

L3030 00 71.01$

L3031 00 118.43$

L3040 00 43.78$

L3050 00 43.78$

L3060 00 68.62$

L3070 00 29.55$

L3080 00 29.55$

L3090 00 37.87$

L3100 00 40.23$

L3140 00 82.85$

L3150 00 75.74$

L3160 00 By Report

L3170 00 47.36$

L3201 00 By Report

L3202 00 By Report

L3203 00 By Report



Page | 42


Amount

L3204 00 By Report

L3206 00 By Report

L3207 00 By Report

L3208 00 By Report

L3209 00 By Report

L3211 00 By Report

L3212 00 By Report

L3213 00 By Report

L3214 00 By Report

L3215 00 By Report

L3216 00 By Report

L3217 00 By Report

L3219 00 By Report

L3221 00 By Report

L3222 00 By Report

L3224 00 52.42$

L3225 00 60.30$

L3230 00 By Report

L3250 00 By Report

L3251 00 By Report

L3252 00 By Report

L3253 00 By Report

L3254 00 By Report

L3255 00 By Report

L3257 00 By Report

L3260 00 By Report

L3265 00 By Report

L3300 00 48.51$

L3310 00 75.74$

L3320 00 By Report

L3330 00 526.60$

L3332 00 68.62$

L3334 00 35.52$

L3340 00 79.31$

L3350 00 21.32$

L3360 00 33.13$

L3370 00 46.12$

L3380 00 46.12$

L3390 00 46.12$

L3400 00 37.87$

L3410 00 86.38$

L3420 00 50.90$



Page | 43


Amount

L3430 00 149.11$

L3440 00 71.01$

L3450 00 98.23$

L3455 00 37.87$

L3460 00 31.93$

L3465 00 54.44$

L3470 00 57.98$

L3480 00 57.98$

L3485 00 By Report

L3500 00 27.21$

L3510 00 27.21$

L3520 00 29.55$

L3530 00 29.55$

L3540 00 47.36$

L3550 00 8.26$

L3560 00 21.32$

L3570 00 79.31$

L3580 00 60.35$

L3590 00 49.70$

L3595 00 39.04$

L3600 00 71.01$

L3610 00 93.48$

L3620 00 71.01$

L3630 00 93.48$

L3640 00 40.23$

L3649 00 By Report

L3650 00 55.14$

L3660 00 89.65$

L3670 00 102.52$

L3671 00 763.06$

L3674 00 1,000.97$

L3675 00 148.61$

L3677 00 By Report

L3702 00 244.52$

L3710 00 107.83$

L3720 00 681.47$

L3730 00 916.84$

L3740 00 935.93$

L3760 00 423.48$

L3762 00 91.05$

L3763 00 626.07$

L3764 00 702.95$



Page | 44


Amount

L3765 00 1,085.82$

L3766 00 1,149.80$

L3806 00 384.67$

L3807 00 211.75$

L3808 00 305.14$

L3809 00 211.75$

L3891 00 By Report

L3900 00 1,270.31$

L3901 00 1,570.49$

L3904 00 2,554.41$

L3905 00 839.80$

L3906 00 361.49$

L3908 00 69.68$

L3912 00 110.30$

L3913 00 229.35$

L3915 00 450.13$

L3916 00 450.13$

L3917 00 89.48$

L3918 00 89.48$

L3919 00 229.35$

L3921 00 272.01$

L3923 00 83.40$

L3924 00 83.40$

L3925 00 54.13$

L3927 00 29.60$

L3929 00 82.62$

L3930 00 82.62$

L3931 00 163.15$

L3933 00 180.67$

L3935 00 187.07$

L3956 00 -$

L3960 00 720.83$

L3961 00 1,422.75$

L3962 00 778.96$

L3967 00 1,679.78$

L3971 00 1,594.52$

L3973 00 1,679.78$

L3975 00 1,422.75$

L3976 00 1,422.75$

L3977 00 1,594.52$

L3978 00 1,679.78$

L3980 00 269.66$



Page | 45


Amount

L3982 00 325.63$

L3984 00 313.36$

L3995 00 31.66$

L3999 00 By Report

L4000 00 1,291.22$

L4002 00 -$

L4010 00 713.45$

L4020 00 854.17$

L4030 00 588.99$

L4040 00 485.15$

L4045 00 294.97$

L4050 00 443.39$

L4055 00 241.74$

L4060 00 360.18$

L4070 00 296.94$

L4080 00 106.78$

L4090 00 107.23$

L4100 00 123.97$

L4110 00 100.79$

L4130 00 589.67$

L4205 00 By Report

L4210 00 By Report

L4350 00 87.76$

L4360 00 329.09$

L4361 00 329.09$

L4370 00 224.38$

L4386 00 147.53$

L4387 00 147.53$

L4392 00 21.53$

L4394 00 15.69$

L4396 00 153.53$

L4397 00 153.53$

L4398 00 70.69$

L4631 00 1,423.41$

L5000 00 479.83$

L5010 00 1,156.17$

L5020 00 2,144.14$

L5050 00 2,559.96$

L5060 00 3,396.99$

L5100 00 2,653.41$

L5105 00 3,744.87$

L5150 00 3,872.15$



Page | 46


Amount

L5160 00 4,724.15$

L5200 00 3,868.45$

L5210 00 3,072.61$

L5220 00 3,492.58$

L5230 00 4,671.11$

L5250 00 6,078.51$

L5270 00 6,512.34$

L5280 00 6,447.23$

L5301 00 2,660.58$

L5312 00 4,176.65$

L5321 00 4,110.15$

L5331 00 5,831.82$

L5341 00 6,086.82$

L5400 00 1,269.99$

L5410 00 488.18$

L5420 00 1,533.96$

L5430 00 478.81$

L5450 00 419.01$

L5460 00 554.78$

L5500 00 1,219.69$

L5505 00 1,651.78$

L5510 00 1,498.16$

L5520 00 1,365.68$

L5530 00 1,905.83$

L5535 00 1,968.56$

L5540 00 2,101.19$

L5560 00 2,052.77$

L5570 00 2,159.11$

L5580 00 2,473.40$

L5585 00 2,741.37$

L5590 00 2,399.94$

L5595 00 4,287.02$

L5600 00 5,403.50$

L5610 00 2,522.48$

L5611 00 1,675.48$

L5613 00 2,327.36$

L5614 00 1,573.20$

L5616 00 1,289.81$

L5617 00 521.62$

L5618 00 296.67$

L5620 00 281.70$

L5622 00 397.30$



Page | 47


Amount

L5624 00 357.69$

L5626 00 519.31$

L5628 00 574.17$

L5629 00 301.80$

L5630 00 480.96$

L5631 00 417.27$

L5632 00 281.16$

L5634 00 334.94$

L5636 00 298.52$

L5637 00 282.74$

L5638 00 523.91$

L5639 00 1,200.07$

L5640 00 794.80$

L5642 00 784.51$

L5643 00 1,696.84$

L5644 00 626.27$

L5645 00 757.74$

L5646 00 557.00$

L5647 00 755.42$

L5648 00 625.24$

L5649 00 1,911.26$

L5650 00 545.01$

L5651 00 1,140.48$

L5652 00 414.04$

L5653 00 679.29$

L5654 00 367.92$

L5655 00 329.68$

L5656 00 469.70$

L5658 00 460.40$

L5661 00 577.92$

L5665 00 486.25$

L5666 00 67.46$

L5668 00 106.55$

L5670 00 281.27$

L5671 00 629.83$

L5672 00 306.45$

L5673 00 680.26$

L5676 00 400.90$

L5677 00 510.34$

L5678 00 44.94$

L5679 00 566.88$

L5680 00 336.72$



Page | 48


Amount

L5681 00 1,226.33$

L5682 00 600.45$

L5683 00 1,226.33$

L5684 00 60.94$

L5685 00 119.41$

L5686 00 60.54$

L5688 00 66.28$

L5690 00 100.80$

L5692 00 148.10$

L5694 00 228.82$

L5695 00 154.88$

L5696 00 234.28$

L5697 00 101.65$

L5698 00 118.74$

L5699 00 233.44$

L5700 00 3,467.63$

L5701 00 4,213.90$

L5702 00 5,045.78$

L5703 00 2,326.99$

L5704 00 579.11$

L5705 00 950.73$

L5706 00 942.30$

L5707 00 1,339.52$

L5710 00 432.10$

L5711 00 584.97$

L5712 00 525.14$

L5714 00 397.22$

L5716 00 692.16$

L5718 00 865.13$

L5722 00 1,007.31$

L5724 00 1,525.28$

L5726 00 1,845.95$

L5728 00 2,456.69$

L5780 00 1,087.29$

L5781 00 3,730.25$

L5782 00 3,932.53$

L5785 00 589.42$

L5790 00 709.70$

L5795 00 1,019.65$

L5810 00 527.99$

L5811 00 692.61$

L5812 00 599.41$



Page | 49


Amount

L5814 00 3,462.42$

L5816 00 807.65$

L5818 00 911.99$

L5822 00 1,617.20$

L5824 00 1,456.38$

L5826 00 3,024.43$

L5828 00 2,681.82$

L5830 00 2,338.34$

L5840 00 3,833.05$

L5845 00 1,671.01$

L5848 00 1,002.52$

L5850 00 121.49$

L5855 00 391.05$

L5856 00 22,380.48$

L5857 00 7,941.46$

L5858 00 17,326.84$

L5859 00 14,334.62$

L5910 00 343.95$

L5920 00 503.89$

L5925 00 414.19$

L5930 00 3,138.02$

L5940 00 592.27$

L5950 00 851.32$

L5960 00 973.02$

L5961 00 4,607.30$

L5962 00 744.28$

L5964 00 1,071.45$

L5966 00 1,389.08$

L5968 00 3,387.88$

L5969 00 By Report

L5970 00 232.95$

L5971 00 232.95$

L5972 00 372.29$

L5973 00 16,389.16$

L5974 00 295.07$

L5975 00 432.19$

L5976 00 594.53$

L5978 00 336.01$

L5979 00 2,862.55$

L5980 00 3,849.98$

L5981 00 3,110.78$

L5982 00 725.71$



Page | 50


Amount

L5984 00 686.06$

L5985 00 263.28$

L5986 00 726.13$

L5987 00 6,706.67$

L5988 00 1,862.45$

L5990 00 1,691.39$

L5999 00 By Report

L6000 00 1,682.43$

L6010 00 1,872.27$

L6020 00 1,745.59$

L6050 00 2,061.82$

L6055 00 3,078.63$

L6100 00 2,220.85$

L6110 00 2,265.12$

L6120 00 2,848.32$

L6130 00 3,277.91$

L6200 00 3,364.02$

L6205 00 4,214.63$

L6250 00 3,137.18$

L6300 00 4,412.85$

L6310 00 3,663.02$

L6320 00 1,622.93$

L6350 00 4,959.73$

L6360 00 4,033.17$

L6370 00 1,928.86$

L6380 00 1,298.64$

L6382 00 1,528.80$

L6384 00 1,935.47$

L6386 00 438.38$

L6388 00 481.83$

L6400 00 2,458.68$

L6450 00 3,337.62$

L6500 00 3,375.76$

L6550 00 4,515.81$

L6570 00 5,033.83$

L6580 00 1,710.69$

L6582 00 1,359.43$

L6584 00 2,309.76$

L6586 00 1,974.03$

L6588 00 3,342.45$

L6590 00 3,079.79$

L6600 00 193.01$



Page | 51


Amount

L6605 00 182.10$

L6610 00 166.07$

L6611 00 383.86$

L6615 00 202.96$

L6616 00 73.96$

L6620 00 317.89$

L6621 00 2,132.44$

L6623 00 683.86$

L6624 00 3,511.12$

L6625 00 584.86$

L6628 00 549.24$

L6629 00 139.20$

L6630 00 204.67$

L6632 00 61.70$

L6635 00 179.44$

L6637 00 412.63$

L6638 00 2,331.42$

L6640 00 327.17$

L6641 00 163.09$

L6642 00 220.56$

L6645 00 376.49$

L6646 00 2,940.45$

L6647 00 484.07$

L6648 00 3,032.65$

L6650 00 324.70$

L6655 00 95.12$

L6660 00 100.69$

L6665 00 46.82$

L6670 00 48.42$

L6672 00 183.84$

L6675 00 114.05$

L6676 00 140.21$

L6677 00 276.56$

L6680 00 225.92$

L6682 00 287.44$

L6684 00 440.41$

L6686 00 631.40$

L6687 00 547.78$

L6688 00 670.78$

L6689 00 820.98$

L6690 00 870.68$

L6691 00 376.68$



Page | 52


Amount

L6692 00 531.08$

L6693 00 2,646.78$

L6694 00 680.26$

L6695 00 566.88$

L6696 00 1,226.33$

L6697 00 1,226.33$

L6698 00 629.83$

L6703 00 313.54$

L6704 00 595.13$

L6706 00 378.56$

L6707 00 1,335.54$

L6708 00 931.93$

L6709 00 1,336.39$

L6711 00 626.79$

L6712 00 1,154.04$

L6713 00 1,456.54$

L6714 00 1,233.68$

L6715 00 2,943.37$

L6721 00 2,192.71$

L6722 00 1,890.29$

L6805 00 401.67$

L6810 00 190.07$

L6880 00 22,274.81$

L6881 00 3,811.44$

L6882 00 2,891.15$

L6883 00 1,946.10$

L6884 00 2,659.34$

L6885 00 4,033.17$

L6890 00 176.35$

L6895 00 588.77$

L6900 00 1,844.00$

L6905 00 1,859.10$

L6910 00 1,525.83$

L6915 00 689.57$

L6920 00 7,389.73$

L6925 00 8,081.73$

L6930 00 8,017.77$

L6935 00 8,473.65$

L6940 00 9,599.56$

L6945 00 10,636.24$

L6950 00 10,026.43$

L6955 00 11,342.44$



Page | 53


Amount

L6960 00 12,353.21$

L6965 00 13,950.25$

L6970 00 13,850.91$

L6975 00 15,176.20$

L7007 00 3,313.25$

L7008 00 5,738.46$

L7009 00 3,583.29$

L7040 00 2,860.44$

L7045 00 1,534.98$

L7170 00 5,798.79$

L7180 00 34,793.81$

L7181 00 37,355.19$

L7185 00 6,090.90$

L7186 00 8,400.38$

L7190 00 7,566.78$

L7191 00 8,777.90$

L7360 00 252.05$

L7362 00 261.26$

L7364 00 494.87$

L7366 00 639.64$

L7367 00 362.97$

L7368 00 470.52$

L7400 00 285.74$

L7401 00 319.89$

L7402 00 345.45$

L7403 00 343.32$

L7404 00 518.19$

L7405 00 677.72$

L7499 00 By Report

L7510 00 By Report

L7520 00 By Report

L7600 00 By Report

L8000 00 39.20$

L8001 00 116.94$

L8002 00 153.80$

L8010 00 By Report

L8015 00 58.04$

L8020 00 228.80$

L8030 00 299.60$

L8031 00 299.60$

L8032 00 37.92$

L8035 00 3,415.59$



Page | 54


Amount

L8039 00 By Report

L8040 00 2,330.88$

L8040 KM 2,214.33$

L8040 KN 932.35$

L8041 00 2,809.66$

L8041 KM 2,669.14$

L8041 KN 1,123.87$

L8042 00 3,156.89$

L8042 KM 2,999.04$

L8042 KN 1,262.76$

L8043 00 3,535.72$

L8043 KM 3,358.94$

L8043 KN 1,414.29$

L8044 00 3,914.55$

L8044 KM 3,718.84$

L8044 KN 1,565.82$

L8045 00 2,457.32$

L8045 KM 2,334.44$

L8045 KN 982.91$

L8046 00 2,525.50$

L8046 KM 2,399.24$

L8046 KN 1,010.18$

L8047 00 1,294.31$

L8047 KM 1,229.60$

L8047 KN 517.73$

L8048 00 By Report

L8049 00 By Report

L8300 00 99.53$

L8310 00 139.41$

L8320 00 53.08$

L8330 00 46.88$

L8400 00 17.62$

L8410 00 25.12$

L8415 00 25.79$

L8417 00 70.11$

L8420 00 19.05$

L8430 00 21.76$

L8435 00 26.63$

L8440 00 39.72$

L8460 00 82.88$

L8465 00 46.32$

L8470 00 6.34$



Page | 55


Amount

L8480 00 11.65$

L8485 00 13.66$

L8499 00 By Report

L8500 00 741.41$

L8501 00 114.72$

L8505 00 By Report

L8507 00 39.05$

L8509 00 101.82$

L8510 00 235.57$

L8511 00 67.81$

L8512 00 2.02$

L8513 00 4.85$

L8514 00 87.91$

L8515 00 By Report

L8600 00 692.58$

L8603 00 418.33$

L8604 00 By Report

L8605 00 667.74$

L8606 00 212.13$

L8607 00 39.98$

L8609 00 6,074.30$

L8610 00 630.00$

L8612 00 687.79$

L8613 00 285.85$

L8614 00 17,840.41$

L8615 00 420.48$

L8616 00 97.94$

L8617 00 85.54$

L8618 00 24.45$

L8619 00 7,658.76$

L8621 00 0.58$

L8622 00 0.30$

L8623 00 60.30$

L8624 00 150.35$

L8627 00 6,460.66$

L8628 00 1,198.09$

L8629 00 166.93$

L8630 00 319.95$

L8631 00 2,023.92$

L8641 00 443.24$

L8642 00 291.69$

L8658 00 386.46$



Page | 56


Amount

L8659 00 1,799.03$

L8670 00 528.64$

L8679 00 8,081.02$

L8680 00 By Report

L8681 00 1,024.50$

L8682 00 5,773.75$

L8683 00 5,082.21$

L8684 00 752.20$

L8685 00 By Report

L8686 00 By Report

L8687 00 By Report

L8688 00 By Report

L8689 00 1,608.15$

L8690 00 4,435.09$

L8691 00 2,486.01$

L8692 00 By Report

L8693 00 1,413.66$

L8695 00 15.52$

L8699 00 By Report

L9900 00 By Report

Q0478 00 171.32$

Q0479 00 11,259.96$

Q0480 00 83,966.54$

Q0481 00 13,547.01$

Q0482 00 4,243.19$

Q0483 00 17,480.01$

Q0484 00 3,394.58$

Q0485 00 327.73$

Q0486 00 272.78$

Q0487 00 318.24$

Q0488 00 By Report

Q0489 00 15,154.22$

Q0490 00 655.51$

Q0491 00 1,030.52$

Q0492 00 83.01$

Q0493 00 236.41$

Q0494 00 200.05$

Q0495 00 3,894.24$

Q0496 00 1,397.71$

Q0497 00 436.45$

Q0498 00 478.89$

Q0499 00 155.59$



Page | 57


Amount

Q0500 00 28.47$

Q0501 00 476.11$

Q0502 00 606.16$

Q0503 00 1,212.33$

Q0504 00 639.72$

Q0506 00 796.31$

V2020 00 67.33$

V2100 00 42.53$

V2101 00 43.75$

V2102 00 55.14$

V2103 00 40.40$

V2104 00 41.59$

V2105 00 46.90$

V2106 00 50.32$

V2107 00 43.62$

V2108 00 42.56$

V2109 00 52.24$

V2110 00 46.46$

V2111 00 48.43$

V2112 00 53.66$

V2113 00 63.40$

V2114 00 69.05$

V2115 00 83.40$

V2118 00 78.70$

V2121 00 88.08$

V2200 00 60.52$

V2201 00 60.77$

V2202 00 66.83$

V2203 00 59.38$

V2204 00 59.67$

V2205 00 61.75$

V2206 00 62.24$

V2207 00 58.05$

V2208 00 56.95$

V2209 00 65.73$

V2210 00 74.54$

V2211 00 81.40$

V2212 00 82.02$

V2213 00 78.99$

V2214 00 82.93$

V2215 00 99.62$

V2218 00 104.27$



Page | 58


Amount

V2219 00 42.29$

V2220 00 34.29$

V2221 00 92.00$

V2300 00 71.70$

V2301 00 75.33$

V2302 00 77.88$

V2303 00 71.23$

V2304 00 65.83$

V2305 00 74.19$

V2306 00 76.13$

V2307 00 77.42$

V2308 00 85.86$

V2309 00 88.76$

V2310 00 84.77$

V2311 00 84.61$

V2312 00 87.13$

V2313 00 97.73$

V2314 00 102.07$

V2315 00 115.54$

V2318 00 139.31$

V2319 00 47.16$

V2320 00 56.31$

V2321 00 111.69$

V2410 00 100.75$

V2430 00 105.20$

V2500 00 102.92$

V2501 00 117.58$

V2502 00 144.85$

V2503 00 142.30$

V2510 00 131.92$

V2511 00 151.40$

V2512 00 178.90$

V2513 00 163.99$

V2520 00 By Report

V2521 00 172.43$

V2522 00 167.81$

V2523 00 146.03$

V2530 00 211.81$

V2531 00 504.81$

V2623 00 1,021.72$

V2624 00 77.09$

V2625 00 468.66$



Page | 59


Amount

V2626 00 252.63$

V2627 00 1,631.58$

V2628 00 385.25$

V2700 00 41.60$

V2710 00 60.89$

V2715 00 13.57$

V2718 00 27.11$

V2730 00 20.03$

V2744 00 17.25$

V2745 00 11.67$

V2750 00 18.13$

V2755 00 16.87$

V2760 00 15.21$

V2761 00 By Report

V2762 00 55.56$

V2770 00 18.70$

V2780 00 11.90$

V2782 00 60.02$

V2783 00 67.67$

V2784 00 44.00$

V2786 00 -$



Page | 60

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