Procedure Code Mod 1 Mod 2 Mod 3 Mod 4 Provider Program Medicaid Maximum Allowed Amount 10040 $60.72 10060 $44.48 10080 $52.66 10120 $50.98 10140 $53.71 10160 $46.78 11000 $52.22 11001 $24.00 11037 $21.90 11042 $60.97 11055 $15.51 11056 $22.11 Provider Type: 58 Arkansas Medicaid Nurse Practitioner Fee Schedule Run Date 3/1/19 This fee schedule does not address the various coverage limitations routinely applied by Arkansas Medicaid before final payment is determined (e.g., beneficiary and provider eligibility, benefit limits, billing instructions, frequency of services, third party liability, age restrictions, prior authorization, co-payments/coinsurance where applicable). Procedure codes and/or fee schedule amounts listed do not guarantee payment, coverage or amount allowed. Although every effort is made to ensure the accuracy of this information, discrepancies may occur. This fee schedule may be changed or updated at any time to correct such discrepancies. The reimbursement rates reflected in this fee schedule are in effect as of the date of this report. The reimbursement rate applied to a claim depends on the claim’s date of service because Arkansas Medicaid’s reimbursement rates are date-of-service effective. This fee schedule reflects only procedure codes that are currently payable. Any procedure code reflecting a Medicaid maximum of $0.00 is manually priced. Please note that Arkansas Medicaid will reimburse the lesser of the amount billed or the Medicaid maximum. For a full explanation of the procedure codes and modifiers listed here, refer to your Arkansas Medicaid provider manual and provider notices. Current Dental Terminology (including procedure codes, nomenclature, descriptors and other data contained therein) is copyright © 2015 American Dental Association. All rights reserved. Applicable FARS/DFARS apply.
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Procedure
Code Mod 1 Mod 2 Mod 3 Mod 4
Provider
Program
Medicaid
Maximum
Allowed
Amount
10040 $60.72
10060 $44.48
10080 $52.66
10120 $50.98
10140 $53.71
10160 $46.78
11000 $52.22
11001 $24.00
11037 $21.90
11042 $60.97
11055 $15.51
11056 $22.11
Provider Type: 58
Arkansas Medicaid Nurse Practitioner Fee Schedule
Run Date 3/1/19
This fee schedule does not address the various coverage limitations routinely applied by Arkansas
Medicaid before final payment is determined (e.g., beneficiary and provider eligibility, benefit limits, billing
instructions, frequency of services, third party liability, age restrictions, prior authorization,
co-payments/coinsurance where applicable). Procedure codes and/or fee schedule amounts listed do not
guarantee payment, coverage or amount allowed.
Although every effort is made to ensure the accuracy of this information, discrepancies may occur. This
fee schedule may be changed or updated at any time to correct such discrepancies. The reimbursement
rates reflected in this fee schedule are in effect as of the date of this report. The reimbursement rate
applied to a claim depends on the claim’s date of service because Arkansas Medicaid’s reimbursement
rates are date-of-service effective. This fee schedule reflects only procedure codes that are currently
payable. Any procedure code reflecting a Medicaid maximum of $0.00 is manually priced.
Please note that Arkansas Medicaid will reimburse the lesser of the amount billed or the Medicaid
maximum. For a full explanation of the procedure codes and modifiers listed here, refer to your Arkansas
Medicaid provider manual and provider notices.
Current Dental Terminology (including procedure codes, nomenclature, descriptors and other data
contained therein) is copyright © 2015 American Dental Association. All rights reserved. Applicable
FARS/DFARS apply.
11057 $24.09
11100 $42.24
11101 $24.64
11200 $44.00
11201 $13.20
11300 $46.64
11301 $53.68
11302 $75.68
11305 $44.00
11306 $50.16
11307 $69.52
11310 $63.41
11311 $80.94
11312 $93.25
11400 $51.62
11401 $62.52
11402 $75.68
11403 $84.97
11404 $98.56
11406 $214.00
11420 $50.35
11421 $66.51
11422 $75.95
11423 $92.94
11424 $105.54
11426 $212.08
11440 $64.24
11441 $80.96
11442 $93.28
11443 $151.36
11446 $3.94
11600 $87.12
11601 $95.92
11602 $124.96
11603 $151.36
11620 $84.48
11621 $102.08
11622 $154.00
11623 $168.08
11640 $104.72
11641 $156.64
11642 $205.92
11643 $252.56
11719 $10.28
11720 $22.09
11721 $37.38
11730 $39.60
11732 $21.12
11740 $30.80
11750 $143.98
11755 $66.88
11760 $62.31
11765 $69.00
11976 FP SA Family Planning $77.00
11980 $101.32
11981 $105.60
11981 FP SA Family Planning $166.19
11982 $120.46
11983 $195.38
12001 $69.23
12002 $76.16
12004 $90.85
12011 $73.64
12013 $83.50
12014 $99.03
12015 $125.26
12020 $100.70
12021 $69.86
16000 $33.98
16020 $32.52
16025 $64.24
16030 $80.14
17000 $35.20
17003 $9.58
17004 $172.94
17110 $39.60
17111 $51.82
17250 $22.03
17340 $39.60
19000 $43.12
19001 $20.35
20005 $231.20
20612 $50.50
20974 $125.89
20979 $14.19
21550 $78.68
21920 $78.89
21930 $192.39
21931 $482.21
23065 $84.34
23500 $100.08
23520 $99.66
23540 $106.58
23570 $104.27
24065 $105.74
24075 $183.16
24200 $93.37
24220 $141.41
25065 $87.12
25075 $176.24
26010 $86.02
26750 $79.10
26770 $120.43
27040 $123.37
27086 $93.58
27200 $102.08
27323 $112.25
27613 $112.46
28570 $108.47
28600 $108.47
28630 $69.02
28660 $75.53
29065 $74.70
29075 $65.46
29105 $55.81
29125 $42.80
29126 $52.24
29130 $21.61
29131 $31.05
29200 $31.90
29240 $33.15
29260 $26.22
29280 $25.38
29305 $192.60
29325 $172.26
29345 $102.08
29355 $107.21
29358 $205.92
29365 $85.39
29405 $84.48
29425 $84.48
29435 $105.11
29440 $39.66
29445 $124.58
29450 $57.49
29505 $55.81
29515 $47.63
29520 $28.33
29530 $28.74
29540 $20.14
29550 $18.46
29580 $32.31
29581 $91.06
29700 $24.55
29705 $30.84
29710 $51.19
29720 $64.20
29730 $29.38
29740 $61.47
29750 $58.12
30000 $61.06
30100 $57.20
30124 $115.82
30300 $51.41
30901 $53.71
30905 $156.64
30906 $112.46
31500 $71.34
31515 $80.96
36415 $3.00
36415 FP Family Planning $3.00
36430 $44.00
36440 $44.00
36555 $293.39
36556 $278.87
36589 $155.77
36590 $333.98
36591 $15.84
36592 $19.58
36593 $27.94
36600 $31.00
36620 $79.73
36625 $140.34
36640 $183.23
36660 $91.38
38300 $81.19
40490 $58.08
40800 $52.24
40804 $57.90
40808 $48.46
40810 $67.14
40812 $102.08
40830 $70.08
40899 $0.00
41000 $58.54
41005 $55.44
42809 $78.89
46900 $82.03
46910 $86.02
46916 $82.46
46917 $134.21
46922 $94.21
46924 $266.00
51700 $59.38
51701 $52.47
51702 $82.50
51703 $114.51
51705 $51.19
54050 $54.97
54055 $96.30
54056 $61.90
54057 $96.27
54060 $107.84
54100 $84.97
54150 $157.78
56405 $93.28
56420 $66.88
56442 $48.18
56501 $63.15
56605 $66.88
56606 $31.47
56740 $247.28
56820 $106.93
56821 $138.62
57061 $72.49
57065 $179.52
57100 $66.88
57150 $31.68
57160 $36.09
57180 $72.49
57410 $102.08
57420 $111.55
57421 $145.54
57452 $81.68
57454 $119.00
57455 $133.99
57456 $126.73
57460 $190.40
57500 $50.16
57505 $87.12
57510 $89.76
57511 $80.96
58100 $44.00
58110 $53.50
58300 FP SA Family Planning $83.93
58301 FP SA Family Planning $48.67
59020 $89.60
59025 $55.02
64550 $21.12
69000 $55.18
69100 $41.12
69110 $140.36
69200 $34.82
69209 $10.62
69210 $28.12
70030 TC $16.94
70100 TC $19.20
70110 TC $28.56
70120 TC $25.30
70130 TC $39.16
70134 TC $29.32
70140 TC $23.70
70150 TC $21.60
70160 TC $24.30
70190 TC $14.30
70200 TC $15.70
70210 TC $17.20
70220 TC $33.00
70240 TC $18.70
70250 TC $26.10
70260 TC $35.92
70300 TC $13.52
70310 TC $16.50
70320 TC $20.90
70328 TC $15.80
70330 TC $27.68
70336 TC $343.00
70350 TC $22.00
70355 TC $24.20
70360 TC $10.45
70370 TC $39.60
70371 TC $87.87
70380 TC $16.50
70450 TC $190.10
70460 TC $239.00
70470 TC $288.60
70480 TC $208.70
70481 TC $253.70
70482 TC $295.60
70486 TC $206.10
70487 TC $212.31
70488 TC $278.00
70490 TC $213.24
70491 TC $259.30
70492 TC $142.00
70496 TC $280.90
70498 TC $280.90
70540 TC $403.00
70542 TC $514.92
70543 TC $952.95
70544 TC $435.78
70545 TC $435.78
70546 TC $852.82
70547 TC $435.78
70548 TC $435.78
70549 TC $852.82
70551 TC $403.00
70552 TC $495.00
70553 TC $652.90
71045 TC $11.86
71046 TC $21.87
71046 $35.13
71046 $28.10
71047 TC $27.87
71048 TC $28.67
71048 $38.67
71100 TC $21.60
71101 TC $22.20
71110 TC $30.80
71111 TC $37.40
71120 TC $15.40
71130 TC $20.28
71250 TC $246.00
71260 TC $301.60
71270 TC $375.90
71275 TC $341.28
71550 TC $406.00
71551 TC $516.42
71552 TC $947.71
71555 TC $447.41
72020 $32.00
72020 TC $27.04
72040 $37.00
72040 TC $28.00
72050 $46.64
72050 TC $37.30
72052 TC $55.00
72070 TC $28.09
72072 TC $32.60
72074 TC $37.20
72080 TC $30.02
72081 TC $23.51
72082 TC $42.82
72083 TC $46.48
72084 TC $55.80
72100 TC $31.28
72110 TC $45.49
72114 TC $49.50
72120 TC $38.30
72125 TC $246.00
72126 TC $298.30
72127 TC $368.20
72128 TC $246.00
72129 TC $298.30
72130 TC $368.20
72131 TC $246.00
72132 TC $298.30
72133 TC $368.20
72141 TC $406.00
72142 TC $512.00
72146 TC $446.00
72147 TC $512.00
72148 TC $432.00
72149 TC $495.00
72156 TC $652.90
72157 TC $652.90
72158 TC $652.90
72159 TC $203.21
72170 TC $23.54
72190 TC $33.00
72191 TC $328.15
72192 TC $259.70
72193 TC $290.00
72194 TC $351.60
72195 TC $431.29
72196 TC $370.00
72197 TC $955.20
72198 TC $447.41
72200 TC $15.80
72202 TC $23.10
72220 TC $20.20
73000 TC $16.78
73010 TC $21.00
73020 TC $15.50
73030 TC $23.50
73050 TC $30.10
73060 TC $25.40
73070 TC $21.00
73080 TC $23.20
73090 TC $21.00
73092 TC $30.89
73100 TC $21.00
73110 TC $25.77
73120 TC $18.80
73130 TC $25.00
73140 TC $18.17
73200 TC $212.40
73201 TC $166.66
73202 TC $201.30
73206 TC $288.40
73218 TC $429.41
73219 TC $514.92
73220 TC $403.00
73221 TC $380.00
73222 TC $514.92
73223 TC $952.95
73225 TC $333.00
73501 TC $18.85
73502 TC $27.84
73503 TC $38.63
73521 TC $26.17
73522 TC $31.17
73523 TC $37.49
73551 TC $17.85
73552 TC $21.18
73560 TC $32.81
73562 TC $35.00
73564 TC $37.00
73565 TC $24.71
73590 TC $25.30
73592 TC $27.00
73600 TC $21.81
73610 TC $21.40
73615 TC $99.50
73620 TC $23.90
73630 TC $28.00
73650 TC $14.30
73660 TC $15.60
73700 TC $207.70
73701 TC $166.66
73702 TC $201.30
73706 TC $288.40
73718 TC $403.00
73719 TC $514.92
73720 TC $403.00
73721 TC $380.00
73722 TC $514.92
73723 TC $952.95
73725 TC $447.41
74018 TC $20.26
74019 TC $24.26
74021 TC $28.27
74022 TC $35.75
74150 TC $249.40
74160 TC $296.60
74170 TC $361.60
74174 TC $429.16
74175 TC $328.15
74176 TC $108.30
74177 TC $206.27
74178 TC $272.95
74181 TC $409.00
74182 TC $516.42
74183 TC $955.20
74185 TC $447.41
74210 TC $41.00
74220 TC $43.30
74230 TC $31.90
74240 TC $34.14
74241 TC $48.44
74245 TC $43.53
74246 TC $48.44
74247 TC $44.60
74249 TC $49.11
74250 TC $39.16
74251 TC $38.50
74260 TC $54.60
74261 TC $264.79
74262 TC $299.99
74263 TC $523.35
74270 TC $53.90
74280 TC $49.50
74283 TC $58.55
74290 TC $34.28
74300 TC $24.00
74301 TC $18.07
74340 TC $72.00
74400 TC $63.90
74410 TC $53.60
74415 TC $74.90
74420 TC $81.40
74710 TC $21.10
74712 TC $307.37
74713 TC $131.71
74775 TC $61.05
75557 TC $274.82
75559 TC $274.82
75561 TC $420.19
75563 TC $420.19
75565 TC $70.23
75571 TC $54.87
75572 TC $157.91
75573 TC $223.51
75574 TC $411.67
75635 TC $328.15
75885 TC $602.29
75887 TC $602.29
75889 TC $596.10
75898 TC $79.96
75984 TC $93.88
75989 TC $153.31
76010 TC $8.69
76098 TC $14.00
76100 TC $53.49
76101 TC $70.00
76102 TC $62.70
76120 TC $41.80
76125 TC $14.08
76376 TC $20.00
76377 TC $20.00
76380 TC $69.01
76496 $0.00
76497 $0.00
76498 $0.00
76499 $0.00
76506 TC $17.99
76511 TC $52.80
76512 TC $54.60
76513 TC $29.70
76514 TC $2.96
76516 TC $61.00
76519 TC $65.00
76529 TC $46.00
76536 TC $59.40
76604 TC $27.98
76641 TC $63.40
76642 TC $48.50
76700 TC $68.90
76705 TC $27.30
76706 TC $72.03
76770 TC $53.90
76775 TC $19.67
76776 TC $76.26
76800 TC $35.20
76801 TC $47.03
76802 TC $33.41
76805 TC $69.20
76810 TC $78.62
76811 TC $159.65
76812 TC $56.93
76813 TC $88.68
76814 TC $33.52
76815 TC $34.40
76816 TC $34.40
76817 TC $64.35
76818 TC $43.15
76819 TC $69.31
76825 TC $66.79
76826 TC $44.29
76827 TC $58.00
76828 TC $49.00
76830 TC $74.80
76856 TC $54.50
76857 TC $32.50
76870 TC $43.20
76872 TC $46.62
76873 TC $84.01
76881 TC $102.34
76882 TC $11.99
76885 TC $63.95
76886 TC $59.40
76936 TC $113.51
76937 TC $19.39
76940 TC $74.67
76965 TC $221.69
76977 TC $41.90
76998 TC $54.38
76999 $0.00
77001 TC $66.86
77002 TC $65.45
77003 TC $65.45
77011 TC $275.67
77013 TC $324.99
77014 TC $99.02
77022 TC $421.33
77058 TC $589.42
77059 TC $799.50
77061 TC $62.82
77062 TC $82.67
77063 TC $22.83
77065 TC $104.44
77066 TC $126.48
77067 TC $98.84
77072 TC $25.61
77073 TC $39.36
77074 TC $50.27
77075 TC $72.09
77076 TC $36.99
77077 TC $55.49
77078 TC $99.02
77080 TC $155.08
77081 TC $37.94
77084 TC $374.86
77085 TC $36.46
77086 TC $23.78
77280 TC $169.60
77285 TC $273.35
77290 TC $317.94
77295 TC $749.67
77299 $0.00
77300 TC $67.00
77306 TC $77.77
77307 TC $142.30
77316 TC $120.66
77317 TC $157.48
77318 TC $213.66
77321 TC $239.00
77331 TC $22.00
77332 TC $64.04
77333 TC $91.59
77334 TC $162.00
77336 TC $101.20
77338 TC $223.83
77370 TC $109.00
77371 TC $974.17
77372 TC $739.93
77373 TC $1,378.11
77385 $0.00
77386 TC $382.34
77387 TC $59.03
77399 $0.00
77401 TC $39.60
77402 TC $64.90
77407 TC $72.60
77412 TC $83.60
77417 TC $28.60
77423 TC $78.49
77424 $0.00
77425 $0.00
77435 TC $796.45
77470 TC $223.00
77499 $0.00
77520 $0.00
77522 $0.00
77523 $0.00
77525 $0.00
77600 TC $165.00
77605 TC $224.00
77610 TC $165.00
77615 TC $224.00
77620 TC $165.00
77761 TC $218.72
77762 TC $324.28
77763 TC $428.68
77770 TC $206.24
77771 TC $375.65
77772 TC $592.74
77778 TC $165.74
77789 TC $15.40
77790 TC $17.00
77799 $0.00
78012 TC $65.98
78013 TC $171.61
78014 TC $195.81
78015 TC $59.46
78016 TC $100.10
78018 TC $114.37
78020 TC $12.75
78070 TC $31.37
78071 TC $272.82
78072 TC $38.86
78075 TC $124.65
78099 $0.00
78102 TC $77.70
78103 TC $81.20
78104 TC $92.50
78110 TC $20.20
78111 TC $75.90
78120 TC $53.90
78121 TC $69.10
78122 TC $202.13
78130 TC $90.20
78135 TC $87.40
78140 TC $118.80
78185 TC $46.60
78191 TC $144.38
78195 TC $81.18
78199 $0.00
78201 TC $103.86
78202 TC $50.00
78205 TC $117.47
78206 TC $249.31
78215 TC $40.60
78216 TC $71.30
78226 TC $312.39
78227 TC $433.79
78230 TC $47.65
78231 TC $73.35
78232 TC $57.60
78258 TC $121.95
78261 TC $85.83
78262 TC $80.00
78264 TC $92.55
78267 TC $16.29
78270 TC $31.90
78271 TC $49.50
78272 TC $51.90
78278 TC $90.35
78282 TC $35.00
78290 TC $92.50
78291 TC $134.48
78299 $0.00
78300 TC $32.60
78305 TC $73.23
78306 TC $74.50
78315 TC $137.50
78320 TC $142.10
78350 TC $33.55
78351 TC $25.88
78399 $0.00
78414 TC $30.77
78428 TC $57.60
78445 TC $36.20
78451 TC $138.07
78452 TC $266.71
78453 TC $128.79
78454 TC $108.31
78456 TC $175.33
78457 TC $61.20
78458 TC $92.50
78459 TC $55.30
78466 TC $47.60
78468 TC $74.18
78469 TC $72.28
78472 TC $177.10
78473 TC $187.22
78481 TC $113.32
78483 TC $175.92
78494 TC $238.10
78496 TC $74.99
78499 $0.00
78579 TC $161.27
78580 TC $74.60
78582 TC $289.19
78597 TC $172.86
78598 TC $149.23
78599 $0.00
78600 TC $52.60
78601 TC $58.90
78605 TC $54.90
78606 TC $71.90
78607 TC $147.42
78608 TC $43.00
78609 TC $43.00
78610 TC $25.60
78630 TC $107.80
78635 TC $103.25
78645 TC $84.80
78647 TC $139.11
78650 TC $92.37
78660 TC $57.60
78699 $0.00
78700 TC $53.76
78701 TC $57.49
78707 TC $87.77
78708 TC $186.88
78709 TC $186.88
78710 TC $100.14
78715 TC $60.00
78725 TC $35.00
78730 TC $42.00
78740 TC $42.74
78760 TC $47.30
78761 TC $52.18
78799 $0.00
78800 TC $74.85
78801 TC $84.65
78802 TC $117.99
78803 TC $151.49
78804 TC $189.37
78805 TC $57.60
78806 TC $145.91
78807 TC $217.80
78808 TC $23.33
78810 TC $1,287.00
78999 $0.00
79403 TC $182.75
79900 TC $99.00
80047 $30.88
80047 TC $30.88
80048 $12.09
80048 TC $12.09
80048 $12.09
80050 $48.67
80050 TC $48.67
80051 $10.01
80053 $15.10
80053 TC $15.10
80053 $15.10
80055 $36.52
80055 TC $36.52
80061 $18.16
80061 TC $18.16
80061 $18.16
80069 $12.40
80069 TC $12.40
80072 $36.86
80072 TC $36.86
80074 $68.01
80074 TC $68.01
80076 $11.67
80076 TC $11.67
80081 $101.97
80091 $17.56
80091 TC $17.56
80150 $21.52
80150 TC $21.52
80156 $20.79
80156 TC $20.79
80157 $14.20
80157 TC $14.20
80158 $25.78
80158 TC $25.78
80162 $18.96
80162 TC $18.96
80163 TC $18.07
80164 $19.34
80164 TC $19.34
80164 $19.34
80165 TC $18.44
80168 $23.33
80168 TC $23.33
80170 $23.41
80170 TC $23.41
80173 $20.79
80173 TC $20.79
80176 $20.98
80176 TC $20.98
80178 $9.34
80178 TC $9.43
80184 $16.36
80184 TC $16.36
80184 $16.36
80185 $18.93
80185 TC $18.93
80185 $18.93
80186 $19.66
80186 TC $19.66
80188 $23.69
80188 TC $23.69
80190 $23.92
80190 TC $23.92
80192 $23.92
80192 TC $23.92
80194 $20.84
80194 TC $20.84
80195 $19.81
80195 TC $19.81
80195 $19.81
80197 $19.60
80197 $0.00
80197 TC $19.60
80198 $20.21
80198 TC $20.21
80200 $23.01
80200 TC $23.01
80201 $17.03
80202 $19.34
80202 TC $19.34
80202 $19.34
80299 $19.55
80299 TC $19.55
80305 TC $14.96
80306 TC $19.95
80307 TC $79.81
80320 TC $15.08
80321 TC $15.08
80322 TC $15.08
80323 TC $45.59
80324 TC $23.60
80325 TC $23.60
80326 TC $23.60
80327 TC $39.21
80328 TC $39.21
80329 TC $10.78
80330 TC $10.78
80331 TC $10.78
80332 TC $27.18
80333 TC $27.18
80334 TC $27.18
80335 TC $27.18
80336 TC $27.18
80337 TC $27.18
80338 TC $27.18
80339 TC $20.14
80340 TC $20.14
80341 $0.00
80342 TC $23.65
80343 TC $23.65
80344 TC $23.65
80345 TC $28.09
80346 TC $30.06
80347 TC $30.06
80348 TC $29.55
80349 TC $21.35
80350 TC $21.35
80351 TC $21.35
80352 TC $21.35
80353 TC $23.01
80354 TC $29.55
80355 TC $20.19
80356 TC $39.04
80357 TC $21.35
80358 TC $29.55
80359 TC $21.35
80360 TC $21.35
80361 TC $39.04
80362 TC $29.55
80363 TC $29.55
80364 TC $29.55
80365 TC $29.55
80366 TC $21.35
80367 TC $21.35
80368 TC $21.35
80369 TC $26.76
80370 TC $26.76
80371 TC $21.35
80372 TC $29.55
80373 TC $29.55
80374 TC $21.35
80375 TC $21.35
80376 TC $21.35
80377 TC $21.35
80400 $46.56
80400 TC $46.56
80402 $124.14
80402 TC $124.14
80406 $111.74
80406 TC $111.74
80408 $179.22
80408 TC $179.22
80410 $114.73
80410 TC $114.73
80412 $281.67
80412 TC $281.67
80414 $73.74
80414 TC $73.74
80415 $79.81
80415 TC $79.81
80416 $188.48
80416 $0.00
80416 TC $188.48
80417 $62.83
80417 $0.00
80417 TC $62.83
80418 $701.63
80418 TC $701.63
80420 $102.86
80420 TC $102.86
80422 $65.81
80422 TC $65.81
80424 $72.13
80424 TC $72.13
80426 $212.00
80426 TC $212.00
80428 $95.23
80428 TC $95.23
80430 $112.03
80430 TC $112.03
80432 $192.88
80432 TC $192.88
80434 $144.41
80434 TC $144.41
80435 $147.04
80435 TC $147.04
80436 $130.18
80436 TC $130.18
80438 $71.95
80438 TC $71.95
80439 $95.95
80439 TC $95.93
80500 $23.10
80500 26 $23.10
80502 $43.00
80502 26 $43.00
81000 FP Family Planning $4.52
81000 $4.52
81000 TC $4.52
81001 FP Family Planning $4.52
81001 $4.52
81001 26 $1.58
81001 TC $4.52
81002 FP Family Planning $3.66
81002 $3.66
81002 TC $3.66
81003 FP Family Planning $3.20
81003 $3.20
81003 TC $3.20
81003 $3.20
81005 $3.10
81005 TC $3.10
81007 $3.67
81007 TC $3.67
81015 $4.34
81015 TC $4.34
81025 FP Family Planning $9.03
81025 $9.03
81025 TC $9.03
81050 $4.28
81050 TC $4.28
81099 $3.26
81099 $3.26
81099 TC $3.26
81105 $150.89
81105 TC $150.89
81106 $150.89
81106 TC $150.89
81107 TC $150.89
81107 $150.89
81108 $150.89
81108 TC $150.89
81109 $150.89
81109 TC $150.89
81110 TC $150.89
81110 $150.89
81111 $150.89
81111 TC $150.89
81112 $150.89
81112 TC $150.89
81120 TC $193.25
81120 $193.25
81121 $295.79
81121 TC $295.79
81161 $0.00
81161 $0.00
81162 $2,485.86
81162 26 $2,485.86
81162 TC $2,485.86
81170 $329.51
81170 26 $329.51
81170 TC $329.51
81175 $707.02
81175 TC $707.02
81176 TC $298.64
81176 $298.64
81200 $186.14
81200 26 $13.03
81200 TC $173.10
81201 $800.00
81201 TC $744.00
81202 $380.00
81202 TC $353.40
81203 $256.00
81203 TC $238.08
81205 $174.12
81205 26 $12.19
81205 TC $161.93
81206 $86.70
81206 26 $6.07
81206 TC $80.62
81207 $72.25
81207 26 $5.06
81207 TC $67.19
81208 $120.14
81208 26 $8.41
81208 TC $111.73
81209 $67.00
81209 26 $4.69
81209 TC $62.31
81210 $75.72
81210 26 $5.30
81210 TC $70.42
81211 $2,498.54
81211 26 $174.90
81211 TC $2,323.64
81212 $428.43
81212 26 $29.99
81212 TC $398.44
81213 $524.96
81213 26 $36.74
81213 TC $488.22
81214 $1,301.32
81214 26 $91.10
81214 TC $1,210.22
81215 $352.36
81215 26 $24.66
81215 TC $327.70
81216 $1,561.69
81216 26 $109.31
81216 TC $1,452.28
81217 $352.36
81217 26 $24.66
81217 TC $327.70
81218 $329.51
81218 26 $329.51
81218 TC $329.51
81220 $400.00
81220 26 $28.00
81220 TC $372.00
81221 $99.18
81221 26 $6.94
81221 TC $92.23
81222 $116.49
81222 26 $8.15
81222 $0.00
81223 $960.00
81223 26 $67.20
81223 TC $892.80
81224 $79.02
81224 26 $5.53
81224 TC $73.49
81225 $214.24
81225 26 $15.00
81225 TC $199.24
81226 $404.44
81226 26 $28.31
81226 TC $376.13
81227 $107.59
81227 26 $7.53
81227 TC $100.06
81228 $534.32
81228 26 $37.40
81228 TC $496.92
81229 $672.58
81229 26 $47.08
81229 TC $625.50
81230 $174.81
81230 TC $174.81
81231 $174.81
81231 TC $174.81
81232 TC $174.81
81232 $174.81
81235 $319.94
81235 TC $297.54
81238 $600.00
81238 TC $600.00
81240 $33.13
81240 26 $2.32
81240 TC $30.81
81241 $62.71
81241 26 $4.39
81241 TC $58.32
81242 $94.14
81242 26 $6.59
81242 TC $87.55
81243 $9.52
81243 26 $4.86
81243 TC $64.66
81244 $47.04
81244 26 $3.30
81244 TC $43.74
81245 $89.60
81245 26 $6.27
81245 TC $83.33
81247 $174.81
81247 TC $174.81
81248 TC $375.25
81248 $375.25
81249 $600.00
81249 TC $600.00
81250 $127.28
81250 26 $8.91
81250 TC $118.37
81251 $232.98
81251 26 $16.31
81251 TC $216.66
81252 $336.00
81252 TC $312.48
81253 $135.22
81253 TC $125.76
81254 $48.26
81254 TC $44.89
81255 $138.07
81255 26 $9.66
81255 TC $128.41
81256 $83.10
81256 26 $5.82
81256 TC $77.28
81257 $198.14
81257 26 $13.87
81257 TC $184.27
81258 $375.25
81258 TC $375.25
81259 TC $600.00
81259 $600.00
81260 $94.98
81260 26 $6.65
81260 TC $88.33
81261 $118.50
81261 26 $8.30
81261 TC $110.20
81262 $40.90
81262 26 $2.86
81262 TC $38.03
81263 $207.94
81263 26 $14.56
81263 TC $193.38
81264 $89.58
81264 26 $6.27
81264 TC $83.31
81265 $331.95
81265 26 $23.24
81265 TC $308.71
81266 $127.68
81266 26 $8.94
81266 TC $118.74
81267 $119.78
81267 26 $8.38
81267 TC $111.39
81268 $119.78
81268 26 $8.38
81268 TC $111.39
81269 $202.40
81269 TC $202.40
81270 $69.52
81270 26 $4.86
81270 TC $64.66
81272 $329.51
81272 26 $329.51
81272 TC $329.51
81275 $251.70
81275 26 $17.62
81275 TC $234.09
81276 $197.19
81276 26 $197.19
81276 TC $197.19
81283 $75.44
81283 TC $75.44
81288 $0.00
81290 $94.14
81290 26 $6.59
81290 TC $87.55
81291 $89.81
81291 26 $6.29
81291 TC $83.52
81292 $825.06
81292 26 $57.75
81292 TC $767.31
81293 $352.36
81293 26 $24.66
81293 TC $327.70
81294 $216.00
81294 26 $15.12
81294 TC $200.88
81295 $664.90
81295 26 $46.54
81295 TC $618.35
81296 $352.34
81296 26 $24.66
81296 TC $327.67
81297 $216.00
81297 26 $15.12
81297 TC $200.88
81298 $801.04
81298 26 $56.07
81298 TC $744.97
81299 $352.36
81299 26 $24.66
81299 TC $327.70
81300 $216.00
81300 26 $15.12
81300 TC $200.88
81301 $316.14
81301 26 $22.13
81301 TC $294.01
81302 $483.26
81302 26 $33.83
81302 TC $449.43
81303 $0.00
81303 $0.00
81304 $80.64
81304 26 $5.65
81304 TC $74.99
81310 $47.07
81310 26 $3.30
81310 TC $43.68
81313 $0.00
81314 $329.51
81314 26 $329.51
81314 TC $329.51
81315 $94.03
81315 26 $6.58
81315 TC $87.45
81316 $94.03
81316 26 $6.58
81316 TC $87.45
81317 $848.00
81317 26 $59.36
81317 TC $788.64
81318 $352.36
81318 26 $24.66
81318 TC $327.70
81319 $216.00
81319 26 $5.12
81319 TC $200.88
81321 $483.39
81321 TC $450.02
81322 $0.00
81322 $0.00
81323 $70.61
81323 TC $65.66
81324 $1,231.28
81324 TC $1,145.09
81325 $0.00
81325 $0.00
81326 $0.00
81326 $0.00
81328 TC $174.81
81328 $174.81
81330 $158.02
81330 26 $11.06
81330 TC $146.96
81331 $57.74
81331 26 $4.04
81331 TC $53.70
81332 $83.10
81332 26 $5.82
81332 TC $77.28
81334 $329.51
81334 TC $329.51
81335 $174.81
81335 TC $174.81
81340 $118.50
81340 26 $8.30
81340 TC $110.20
81341 $36.35
81341 26 $2.54
81341 TC $33.81
81342 $118.50
81342 26 $8.30
81342 TC $110.20
81346 TC $174.81
81346 $174.81
81350 $129.32
81350 26 $9.06
81350 TC $120.26
81355 $0.00
81355 $0.00
81361 $174.81
81361 TC $174.81
81362 $375.25
81362 TC $375.25
81363 TC $202.40
81363 $202.40
81364 $324.58
81364 TC $324.58
81370 $442.20
81370 26 $30.95
81370 TC $411.25
81371 $264.67
81371 26 $18.53
81371 TC $246.14
81372 $242.91
81372 26 $17.00
81372 TC $225.91
81373 $122.46
81373 26 $8.58
81373 TC $113.89
81374 $80.00
81374 26 $5.60
81374 TC $74.40
81375 $242.74
81375 26 $16.99
81375 TC $225.75
81376 $134.40
81376 26 $9.41
81376 TC $124.99
81377 $100.96
81377 26 $7.06
81377 TC $93.90
81378 $380.00
81378 26 $26.60
81378 TC $353.40
81379 $368.80
81379 26 $25.82
81379 TC $342.98
81380 $194.91
81380 26 $13.64
81380 TC $181.27
81381 $104.00
81381 26 $7.28
81381 TC $96.72
81382 $136.00
81382 26 $9.52
81382 TC $126.48
81383 $120.00
81383 26 $8.40
81383 TC $111.60
81400 $54.98
81400 26 $3.85
81400 TC $51.14
81401 $102.02
81401 26 $7.14
81401 TC $94.88
81402 $177.02
81402 26 $12.39
81402 TC $164.63
81403 $135.22
81403 26 $9.46
81403 TC $125.76
81404 $378.79
81404 26 $26.51
81404 TC $352.28
81405 $516.86
81405 26 $36.18
81405 TC $480.68
81406 $1,013.10
81406 26 $70.92
81406 TC $942.18
81407 $1,718.42
81407 26 $120.29
81407 TC $1,598.13
81408 $1,032.52
81408 26 $72.28
81408 TC $960.24
81410 TC $360.00
81411 $0.00
81412 $0.00
81412 $0.00
81413 TC $802.33
81414 TC $802.33
81415 $0.00
81416 $0.00
81417 $0.00
81420 TC $985.80
81431 $0.00
81432 $0.00
81432 $0.00
81433 $0.00
81433 $0.00
81434 $0.00
81434 $0.00
81435 $0.00
81436 $0.00
81437 $0.00
81437 $0.00
81438 $0.00
81438 $0.00
81439 TC $802.33
81440 $0.00
81442 $0.00
81442 $0.00
81445 $0.00
81450 $0.00
81455 $0.00
81460 $0.00
81465 $0.00
81479 $0.00
81479 $0.00
81500 $0.00
81500 $0.00
81503 $0.00
81503 $0.00
81506 $0.00
81506 $0.00
81508 $0.00
81508 $0.00
81509 $0.00
81509 $0.00
81510 $0.00
81510 $0.00
81511 $0.00
81511 $0.00
81512 $0.00
81512 $0.00
81519 TC $0.00
81520 TC $3,099.02
81521 TC $3,873.00
81599 $0.00
81599 $0.00
82009 $6.46
82009 TC $6.46
82010 $10.01
82010 TC $10.01
82010 $10.01
82013 $15.95
82013 TC $15.95
82016 $19.08
82016 TC $19.08
82017 $24.09
82017 TC $24.09
82024 $23.66
82024 TC $23.66
82030 $36.84
82030 TC $36.84
82040 $7.08
82040 TC $7.08
82040 $7.08
82042 $7.39
82042 TC $7.39
82043 $8.27
82043 TC $8.27
82044 $2.71
82044 TC $2.71
82045 $49.01
82045 TC $49.01
82075 $10.77
82075 TC $10.77
82085 $13.87
82085 TC $13.87
82088 $58.20
82088 TC $58.20
82103 $19.18
82103 TC $19.18
82104 $20.65
82104 TC $20.65
82105 $23.95
82105 TC $23.95
82106 $23.95
82106 TC $23.95
82107 $92.99
82107 TC $92.99
82108 $12.47
82108 TC $12.47
82120 $5.36
82120 TC $5.36
82127 $19.08
82127 TC $19.08
82128 $19.08
82128 TC $19.08
82131 $24.09
82131 TC $24.09
82135 $23.51
82135 TC $23.51
82136 $24.09
82136 TC $24.09
82139 $24.09
82139 TC $24.09
82140 $12.49
82140 TC $12.49
82140 $12.49
82143 $9.53
82143 TC $9.53
82150 $9.26
82150 TC $9.26
82150 $9.26
82154 $41.18
82154 TC $41.18
82157 $41.81
82157 TC $41.81
82160 $35.72
82160 TC $35.72
82163 $29.32
82163 TC $29.32
82164 $20.84
82164 TC $20.84
82172 $22.12
82172 TC $22.12
82175 $27.09
82175 TC $27.09
82180 $14.12
82180 TC $14.12
82190 $21.29
82190 TC $21.29
82232 $23.11
82232 TC $23.11
82239 $24.46
82239 TC $24.46
82240 $37.95
82240 TC $37.95
82247 $7.17
82247 TC $7.17
82248 $7.17
82248 TC $7.17
82252 $3.86
82252 TC $3.86
82261 $24.09
82261 TC $24.09
82270 $4.64
82270 $4.64
82270 TC $4.64
82271 $4.69
82271 TC $4.69
82272 $4.69
82272 TC $4.69
82274 $22.22
82274 TC $22.00
82286 $9.84
82286 TC $9.84
82300 $33.05
82300 TC $33.05
82306 $42.27
82306 TC $42.27
82308 $38.24
82308 TC $38.24
82310 $7.36
82310 TC $7.36
82330 $18.87
82330 TC $18.87
82330 $18.87
82331 $7.39
82331 TC $7.39
82340 $8.62
82340 TC $8.62
82355 $16.52
82360 $18.39
82360 TC $18.39
82365 $18.41
82365 TC $18.41
82370 $17.90
82370 TC $17.90
82373 $10.28
82373 TC $10.28
82374 $6.99
82374 TC $6.99
82375 $17.60
82375 TC $17.60
82376 $8.56
82376 TC $8.56
82378 $27.09
82378 TC $27.09
82379 $24.09
82379 TC $24.09
82380 $13.18
82380 TC $13.18
82382 $24.55
82382 TC $24.55
82383 $35.78
82383 TC $35.78
82384 $36.06
82384 TC $36.06
82387 $29.71
82387 TC $29.71
82390 $15.33
82390 TC $15.33
82397 $20.18
82397 TC $20.18
82415 $18.09
82415 TC $18.09
82435 $6.56
82435 TC $6.56
82436 $7.18
82436 TC $7.18
82438 $6.99
82438 TC $6.99
82441 $7.71
82441 TC $7.71
82465 $6.22
82465 TC $6.22
82480 $11.25
82480 TC $11.25
82482 $10.97
82482 TC $10.97
82485 $7.17
82485 TC $7.17
82495 $9.98
82495 TC $9.98
82507 $39.71
82507 TC $39.71
82525 $17.72
82525 TC $17.72
82528 $32.15
82528 TC $32.15
82530 $23.87
82530 TC $23.87
82533 $23.28
82533 TC $23.28
82540 $6.61
82540 TC $6.61
82542 $25.79
82542 TC $25.79
82550 $9.31
82550 TC $9.31
82552 $19.13
82552 TC $19.13
82553 $16.48
82553 TC $16.48
82554 $16.95
82554 TC $16.95
82565 $7.31
82565 TC $7.31
82570 $7.39
82570 TC $7.39
82575 $13.50
82575 TC $13.50
82585 $12.25
82585 TC $12.25
82595 $9.25
82595 TC $9.25
82600 $27.70
82600 TC $27.70
82607 $21.52
82607 TC $21.52
82608 $20.46
82608 TC $20.46
82610 $19.63
82610 TC $19.63
82615 $11.67
82615 TC $11.67
82626 $36.09
82626 TC $36.09
82627 $31.74
82627 TC $31.74
82633 $44.24
82633 TC $44.24
82634 $41.81
82634 TC $41.81
82638 $17.48
82638 TC $17.48
82652 $54.96
82652 TC $54.96
82656 $16.56
82656 TC $16.56
82657 $25.97
82657 TC $25.79
82658 $25.79
82658 TC $25.79
82664 $49.06
82664 TC $49.06
82668 $26.84
82668 TC $26.84
82670 $39.91
82670 TC $39.91
82671 $34.28
82671 TC $34.28
82672 $30.97
82672 TC $30.97
82677 $34.54
82677 TC $34.54
82679 $35.65
82679 TC $35.65
82693 $21.28
82693 TC $21.28
82696 $33.69
82696 TC $33.69
82705 $7.27
82705 TC $7.27
82710 $16.62
82710 TC $16.62
82715 $24.58
82715 TC $24.58
82725 $19.01
82725 TC $19.01
82726 $25.79
82728 $19.46
82728 TC $18.83
82731 $91.98
82731 TC $91.98
82735 $26.48
82735 TC $26.48
82746 $21.00
82746 TC $21.00
82747 $24.73
82747 TC $24.73
82757 $24.77
82757 TC $24.77
82759 $30.68
82759 TC $30.68
82760 $11.56
82760 TC $11.56
82775 $30.08
82775 TC $30.08
82776 $9.17
82776 TC $9.17
82777 $17.80
82777 TC $17.80
82784 $8.24
82784 TC $8.24
82785 $23.13
82785 TC $23.13
82787 $11.46
82787 TC $11.46
82800 $12.10
82800 TC $12.10
82803 $27.63
82803 TC $27.63
82803 $27.63
82805 $40.52
82805 TC $40.52
82810 $12.46
82810 TC $12.46
82810 $12.46
82820 $14.28
82820 TC $14.28
82930 $5.26
82930 TC $5.26
82938 $25.28
82938 TC $25.28
82941 $25.19
82941 TC $25.19
82943 $20.41
82943 TC $20.41
82945 $5.60
82945 TC $5.60
82945 $5.60
82946 $21.52
82946 TC $21.52
82947 $5.60
82947 TC $5.60
82947 $5.60
82948 $4.52
82948 TC $4.52
82950 $6.78
82950 TC $6.78
82951 $18.39
82951 TC $18.39
82952 $5.60
82952 TC $5.60
82955 $13.85
82955 TC $13.85
82960 $8.66
82960 TC $8.66
82962 $4.37
82962 TC $4.37
82963 $30.68
82963 TC $30.68
82965 $9.98
82965 TC $9.98
82977 $10.28
82977 TC $10.28
82978 $20.36
82978 TC $20.36
82979 $8.24
82979 TC $8.24
82985 $21.52
82985 TC $21.52
83001 $26.55
83001 TC $26.55
83002 $26.45
83002 TC $26.45
83003 $23.81
83003 TC $23.81
83006 TC $29.93
83009 $41.79
83009 TC $41.79
83010 $17.96
83010 TC $17.96
83012 $24.55
83012 TC $24.55
83013 $41.33
83013 TC $41.33
83014 $11.22
83014 TC $11.22
83015 $26.90
83015 TC $26.90
83018 $31.28
83018 TC $30.27
83020 FP Family Planning $18.39
83020 $18.39
83020 TC $18.39
83021 $25.79
83021 TC $25.79
83026 $3.37
83026 TC $3.37
83030 $11.81
83030 TC $11.81
83033 $8.11
83033 TC $8.11
83036 $13.87
83036 TC $13.87
83045 $7.08
83045 TC $7.08
83050 $8.26
83050 TC $8.26
83051 $10.44
83051 TC $10.44
83060 $11.81
83060 TC $11.81
83065 $9.84
83065 TC $9.84
83068 $12.10
83068 TC $12.10
83069 $5.63
83069 TC $5.63
83070 $4.77
83070 TC $4.77
83080 $24.09
83080 TC $24.09
83088 $39.86
83088 TC $39.86
83090 $24.09
83090 TC $24.09
83150 $12.89
83150 TC $12.89
83491 $25.02
83491 TC $25.02
83497 $18.41
83497 TC $18.41
83498 $38.79
83498 TC $38.79
83500 $32.34
83500 TC $32.34
83505 $34.71
83505 TC $34.71
83516 $16.48
83516 TC $16.48
83518 $6.55
83518 TC $6.55
83519 $12.87
83519 TC $12.87
83520 FP Family Planning $18.49
83520 $18.49
83520 TC $18.49
83525 $16.34
83525 TC $16.34
83527 $18.50
83527 TC $18.50
83528 $22.71
83528 TC $22.71
83540 $9.25
83540 TC $9.25
83550 $12.48
83550 TC $12.48
83570 $12.63
83570 TC $12.63
83582 $20.24
83582 TC $20.24
83586 $18.28
83586 TC $18.28
83593 $37.56
83593 TC $37.56
83605 $15.25
83605 TC $15.25
83605 $15.25
83615 $8.63
83615 TC $8.63
83625 $18.28
83625 TC $18.28
83630 $16.66
83630 TC $16.66
83631 $28.33
83631 TC $28.33
83632 $28.86
83632 TC $28.86
83633 $7.86
83633 TC $7.86
83655 $17.28
83655 TC $17.28
83661 $18.28
83661 TC $31.39
83662 $27.01
83662 TC $27.01
83663 $13.51
83663 TC $13.51
83664 $6.75
83664 TC $6.75
83670 $13.08
83670 TC $13.08
83690 $9.84
83690 TC $9.84
83690 $9.84
83695 $18.69
83695 TC $18.69
83698 $49.01
83698 TC $49.01
83700 $16.25
83700 TC $16.25
83701 $35.19
83701 TC $35.19
83704 $45.55
83704 TC $45.55
83718 $11.69
83718 TC $11.69
83719 $16.62
83719 TC $16.62
83721 $13.62
83721 TC $13.62
83727 $24.55
83727 TC $24.55
83735 $9.57
83735 TC $9.57
83735 $9.57
83775 $10.53
83775 TC $10.53
83785 $35.11
83785 TC $35.11
83789 $25.79
83789 TC $25.79
83825 $23.22
83825 TC $23.22
83835 $21.51
83835 TC $21.51
83857 $15.33
83857 TC $15.33
83861 $23.58
83861 TC $23.58
83864 $28.43
83864 TC $28.43
83872 $7.44
83872 TC $7.44
83873 $24.57
83873 TC $24.57
83874 $18.43
83874 TC $18.43
83876 $18.91
83876 TC $18.91
83880 $47.43
83880 TC $47.43
83883 $19.42
83883 TC $19.42
83885 $34.99
83885 TC $34.99
83915 $15.92
83915 TC $15.92
83916 $28.72
83916 TC $28.72
83918 $23.51
83918 TC $23.51
83919 $23.51
83919 TC $23.51
83921 $23.51
83921 TC $23.51
83930 $9.43
83930 TC $9.43
83935 $9.73
83935 TC $9.73
83937 $42.64
83937 TC $42.64
83945 $18.39
83945 TC $18.39
83950 $89.01
83950 TC $89.01
83951 $94.04
83951 TC $94.04
83970 $58.94
83970 TC $58.94
83986 $5.12
83986 TC $5.12
83992 $19.92
83992 TC $19.92
83993 $28.33
83993 TC $28.33
84030 $7.83
84030 TC $7.83
84035 $3.44
84035 TC $3.44
84060 $10.54
84060 TC $10.54
84066 $13.80
84066 TC $13.80
84075 $7.39
84075 TC $7.39
84078 $6.78
84078 TC $6.78
84080 $21.12
84080 TC $21.12
84081 $23.60
84081 TC $23.60
84085 $9.17
84085 TC $9.17
84087 $14.75
84087 TC $14.75
84100 $6.78
84100 TC $6.78
84100 $6.78
84105 $7.39
84105 TC $7.39
84106 $6.12
84106 TC $6.12
84110 $9.17
84110 TC $9.17
84112 $90.64
84112 TC $90.64
84119 $12.30
84119 TC $12.30
84120 $19.11
84120 TC $19.11
84126 $36.37
84126 TC $36.37
84132 $6.56
84132 TC $6.56
84132 $6.56
84133 $6.14
84133 TC $6.14
84134 $20.83
84134 TC $20.83
84134 $20.83
84135 $27.32
84135 TC $27.32
84138 $27.03
84138 TC $27.03
84140 $29.53
84140 TC $29.53
84143 $32.59
84143 TC $32.59
84144 $29.79
84144 TC $29.79
84145 $28.69
84145 TC $28.69
84145 $28.69
84146 $27.67
84146 TC $27.67
84150 $35.67
84150 TC $35.65
84152 $26.27
84152 TC $26.27
84153 $26.27
84153 TC $26.27
84154 $26.27
84154 TC $26.27
84155 $5.23
84155 TC $5.23
84156 $5.25
84156 TC $5.25
84157 $5.25
84157 TC $5.25
84157 $5.25
84160 $7.39
84160 TC $7.39
84163 $11.67
84163 TC $11.67
84165 $15.33
84165 TC $15.33
84165 26 $24.37
84166 $27.75
84166 TC $27.75
84181 $24.32
84181 TC $24.32
84182 $25.70
84182 TC $25.70
84202 $20.49
84202 TC $20.49
84203 $9.17
84203 TC $9.17
84206 $25.44
84206 TC $25.44
84207 $40.11
84207 TC $40.11
84210 $15.51
84210 TC $15.51
84220 $6.13
84220 TC $6.13
84228 $16.62
84228 TC $16.62
84233 $91.98
84233 TC $91.98
84234 $92.63
84234 TC $92.63
84235 $74.72
84238 $52.21
84238 TC $52.21
84244 $31.41
84244 TC $31.41
84252 $28.89
84252 TC $28.89
84255 $36.46
84255 TC $36.46
84260 $44.24
84260 TC $44.24
84270 $31.03
84270 TC $31.03
84275 $19.18
84275 TC $19.18
84285 $33.64
84285 TC $33.64
84295 $6.87
84295 TC $6.87
84295 $6.87
84300 $6.94
84300 TC $6.94
84302 $6.79
84302 TC $6.79
84305 $30.36
84305 TC $30.36
84307 $26.11
84307 TC $26.11
84311 $9.43
84311 TC $9.43
84315 $1.86
84315 TC $1.86
84375 $27.09
84375 TC $27.09
84376 $7.86
84376 TC $7.86
84377 $7.86
84377 TC $7.86
84378 $16.45
84378 TC $16.45
84379 $16.45
84379 TC $16.45
84392 $6.78
84392 TC $6.78
84402 $36.36
84402 TC $36.36
84403 $36.87
84403 TC $36.87
84410 $72.55
84410 TC $72.55
84425 $30.33
84425 TC $30.33
84430 $16.62
84430 TC $16.62
84431 $19.16
84431 TC $19.16
84432 $22.94
84432 TC $22.94
84436 $8.90
84436 TC $8.90
84437 $9.25
84437 TC $9.25
84439 $12.88
84439 TC $12.88
84442 $21.12
84442 TC $21.12
84443 $23.98
84443 TC $23.98
84445 $72.62
84445 TC $72.62
84446 $20.25
84446 TC $20.25
84449 $25.70
84449 TC $25.70
84450 $7.38
84450 TC $7.38
84450 $7.38
84460 $7.56
84460 TC $7.56
84466 $18.24
84466 TC $18.24
84478 $8.22
84478 TC $8.22
84478 $8.22
84479 $9.25
84479 TC $9.25
84480 $20.25
84480 TC $20.25
84481 $24.19
84481 TC $24.19
84482 $22.51
84482 TC $22.51
84484 $14.05
84484 TC $14.05
84485 $7.56
84485 TC $7.56
84488 $7.84
84488 TC $7.84
84490 $9.43
84490 TC $9.43
84510 $9.17
84510 TC $9.17
84512 $10.99
84520 $5.63
84520 TC $5.63
84525 $5.36
84525 TC $5.36
84540 $6.78
84540 TC $6.78
84545 $8.77
84545 TC $8.77
84550 $6.46
84550 TC $6.46
84560 $6.78
84560 TC $6.78
84577 $17.81
84577 TC $17.81
84578 $4.11
84578 TC $4.11
84580 $10.14
84580 TC $10.14
84583 $7.18
84583 TC $7.18
84585 $22.13
84585 TC $22.13
84586 $50.46
84586 TC $50.46
84588 $48.47
84588 TC $48.47
84590 $15.26
84590 TC $15.26
84591 $15.26
84591 TC $15.26
84597 $19.57
84597 TC $19.57
84600 $22.06
84600 TC $22.06
84620 $16.92
84620 TC $16.92
84630 $16.26
84630 TC $16.26
84681 $29.71
84681 TC $29.71
84703 FP Family Planning $10.73
84703 $10.73
84703 TC $10.73
84704 $11.67
84704 TC $11.67
84830 $14.33
84830 TC $14.33
84999 $0.00
84999 $0.00
84999 $0.00
85002 $6.43
85002 TC $6.43
85004 $9.04
85004 TC $9.04
85007 $4.92
85007 TC $4.92
85008 $4.92
85008 TC $4.92
85009 $5.31
85009 TC $5.31
85013 $3.38
85013 TC $3.38
85014 FP Family Planning $3.38
85014 $3.38
85014 TC $3.38
85014 $3.38
85018 FP Family Planning $3.38
85018 $3.38
85018 TC $3.38
85025 $11.10
85025 TC $11.10
85025 $11.10
85027 $9.25
85027 TC $9.25
85032 $6.01
85032 TC $6.01
85041 $4.30
85041 TC $4.30
85044 $6.14
85044 TC $6.14
85045 $5.72
85045 TC $5.72
85046 $7.98
85046 TC $7.98
85048 $3.64
85048 TC $3.64
85049 $6.25
85049 TC $6.25
85049 $6.25
85055 $28.00
85055 26 $2.00
85060 $17.83
85060 26 $7.13
85060 TC $10.70
85097 $41.80
85097 26 $41.80
85130 $8.90
85130 TC $8.90
85170 $5.17
85170 TC $5.17
85175 $6.49
85175 TC $6.49
85210 $9.17
85210 TC $9.17
85220 $25.20
85220 TC $25.20
85230 $25.58
85230 TC $25.58
85240 $25.58
85240 TC $25.58
85244 $29.16
85244 TC $29.16
85245 $32.78
85245 TC $32.78
85246 $32.78
85246 TC $32.78
85247 $32.78
85247 TC $32.78
85250 $27.19
85250 TC $27.19
85260 $25.58
85260 TC $25.58
85270 $25.58
85270 TC $25.58
85280 $27.63
85280 TC $27.63
85290 $23.33
85290 TC $23.33
85291 $12.69
85291 TC $12.69
85292 $27.04
85292 TC $27.04
85293 $27.04
85293 TC $27.04
85300 $16.93
85300 TC $16.93
85301 $15.45
85301 TC $15.45
85302 $17.16
85302 TC $17.16
85303 $19.75
85303 TC $19.75
85305 $16.55
85305 TC $16.55
85306 $21.89
85306 TC $21.89
85307 $21.89
85307 TC $21.89
85335 $18.39
85335 TC $18.39
85337 $14.89
85337 TC $14.89
85345 $6.14
85345 TC $6.14
85347 $5.71
85347 TC $5.71
85348 $5.31
85348 TC $5.31
85360 $12.00
85360 TC $12.00
85362 $9.84
85362 TC $9.84
85366 $12.30
85366 TC $12.30
85370 $16.22
85370 TC $16.22
85378 $10.19
85378 TC $10.19
85379 $14.53
85379 TC $14.53
85380 $14.22
85380 TC $14.22
85384 $12.13
85384 TC $12.13
85384 $12.13
85385 $12.13
85385 TC $12.13
85390 $7.37
85390 TC $7.37
85396 $0.00
85396 $0.00
85397 $33.51
85397 TC $33.51
85400 $12.63
85400 TC $12.63
85410 $11.02
85410 TC $11.02
85415 $24.55
85415 TC $24.55
85420 $9.17
85420 TC $9.17
85421 $14.54
85421 TC $14.54
85441 $6.00
85441 TC $6.00
85445 $9.73
85445 TC $9.73
85460 $11.05
85460 TC $11.05
85461 $8.72
85461 TC $8.72
85475 $12.67
85475 TC $12.67
85520 $11.15
85520 TC $11.15
85525 $16.37
85525 TC $16.37
85530 $20.25
85530 TC $20.25
85536 $9.25
85536 TC $9.25
85540 $12.28
85540 TC $12.28
85547 $9.57
85547 TC $9.57
85549 $26.78
85549 TC $26.78
85555 $9.55
85555 TC $9.55
85557 $19.08
85557 TC $19.08
85576 $30.68
85576 TC $30.68
85597 $25.67
85597 TC $25.67
85598 $25.30
85598 TC $25.30
85610 $5.61
85610 TC $5.61
85610 $5.61
85611 $5.63
85611 TC $5.63
85612 $8.24
85612 TC $8.24
85613 $8.24
85613 TC $8.24
85635 $14.06
85635 TC $14.06
85651 $5.07
85651 TC $5.07
85652 $3.85
85652 $0.00
85652 TC $3.85
85660 FP Family Planning $7.88
85660 $7.88
85660 TC $7.88
85670 $8.25
85670 TC $8.25
85675 $9.79
85675 TC $9.79
85705 $13.75
85705 TC $13.75
85730 $8.58
85730 TC $8.58
85730 $8.58
85732 $9.25
85732 TC $9.25
85810 $16.68
85810 TC $16.68
85999 $0.00
85999 $0.00
85999 $0.00
86000 $2.26
86000 TC $2.26
86001 $7.46
86001 TC $7.46
86003 $7.46
86003 TC $7.46
86005 $11.39
86005 TC $11.39
86008 $22.14
86008 TC $22.14
86021 $21.49
86021 TC $21.49
86022 $26.23
86022 TC $26.23
86023 $17.78
86023 TC $17.78
86038 $17.26
86038 TC $17.26
86038 $17.26
86039 $15.94
86039 TC $15.94
86060 $10.43
86060 TC $10.43
86063 $8.25
86063 TC $8.25
86077 $38.50
86077 26 $28.60
86078 $38.50
86078 26 $38.50
86079 $38.50
86079 26 $38.50
86140 $7.39
86140 TC $7.39
86141 $17.89
86141 TC $17.89
86146 $36.33
86146 TC $36.33
86147 $36.33
86147 TC $36.33
86148 $16.60
86152 $0.00
86152 $0.00
86153 $41.80
86153 26 $41.80
86155 $22.82
86155 TC $22.82
86156 $9.57
86156 TC $9.57
86157 $11.51
86157 TC $11.51
86160 $17.14
86160 TC $17.14
86161 $17.14
86161 TC $17.14
86162 $29.02
86162 TC $29.02
86171 $14.31
86171 TC $14.31
86200 $18.69
86200 TC $18.69
86215 $17.40
86215 TC $17.40
86225 $19.62
86225 TC $19.62
86226 $17.29
86226 TC $17.29
86235 $25.61
86235 TC $25.61
86255 $17.22
86255 TC $17.22
86256 $17.22
86256 TC $17.22
86277 $22.48
86277 TC $22.48
86280 $11.69
86280 TC $11.69
86294 $15.40
86294 TC $15.40
86300 $29.72
86301 $29.72
86301 TC $29.72
86304 $29.72
86304 TC $29.72
86308 $7.39
86308 TC $7.39
86309 $9.25
86309 TC $9.25
86310 $10.53
86310 TC $10.53
86316 $29.72
86316 TC $29.72
86317 $21.41
86317 TC $21.41
86318 $18.49
86318 TC $18.49
86320 $32.01
86320 TC $32.01
86325 $31.93
86325 TC $31.93
86327 $32.40
86327 TC $32.40
86329 $20.05
86329 TC $20.05
86331 $16.21
86331 TC $16.21
86332 $34.80
86332 TC $34.80
86334 $31.90
86334 TC $31.90
86335 $42.37
86335 TC $42.37
86336 $21.77
86336 TC $21.77
86337 $30.58
86337 TC $30.58
86340 $21.52
86340 TC $21.52
86341 $28.25
86341 TC $28.25
86343 $17.79
86343 TC $17.79
86344 $11.41
86344 TC $11.41
86352 TC $0.54
86353 $65.11
86353 TC $65.11
86355 $54.46
86355 TC $54.46
86356 $29.07
86356 TC $29.07
86357 $54.46
86357 TC $54.46
86359 $53.87
86359 TC $53.87
86360 $57.49
86360 TC $57.49
86361 $28.75
86367 $54.46
86367 TC $54.46
86376 $20.78
86376 TC $20.78
86376 $20.78
86382 $24.14
86382 TC $24.14
86384 $14.08
86384 TC $14.08
86386 $22.61
86386 26 $22.61
86403 $14.55
86403 TC $14.55
86403 $14.55
86406 $15.19
86406 TC $15.19
86430 $8.11
86430 TC $8.11
86431 $8.11
86431 TC $8.11
86480 $89.48
86481 $87.22
86481 TC $87.22
86485 $0.95
86485 26 $0.29
86485 TC $0.66
86486 $7.11
86486 26 $2.20
86486 TC $4.91
86490 $9.00
86490 26 $9.00
86490 TC $9.00
86510 $11.00
86510 26 $10.00
86510 TC $10.00
86580 $8.80
86580 TC $8.80
86588 TC $9.82
86590 $14.08
86590 TC $14.08
86592 FP Family Planning $6.10
86592 $6.10
86592 TC $6.10
86592 $6.10
86593 FP Family Planning $6.29
86593 $6.29
86593 TC $6.29
86602 $14.53
86602 TC $14.53
86603 $18.38
86603 TC $18.38
86606 $21.49
86606 TC $21.49
86609 $18.40
86609 TC $18.40
86611 $14.53
86611 TC $14.53
86612 $18.42
86612 TC $18.42
86615 $18.84
86615 TC $18.84
86617 $22.11
86617 TC $22.11
86618 $24.32
86618 TC $24.32
86619 $19.11
86619 TC $19.11
86622 $12.76
86622 TC $12.76
86625 $18.73
86625 TC $18.73
86628 $17.15
86628 TC $17.15
86631 $16.90
86631 TC $16.90
86632 $18.14
86632 TC $18.14
86635 $16.38
86635 TC $16.38
86638 $17.31
86638 TC $17.31
86641 $20.58
86641 TC $20.58
86644 $20.55
86644 TC $20.55
86644 $20.55
86645 $24.06
86645 TC $24.06
86648 $21.72
86648 TC $21.72
86651 $18.84
86651 TC $18.84
86652 $18.84
86652 TC $18.84
86653 $18.84
86653 TC $18.84
86654 $18.84
86654 TC $18.84
86658 $18.61
86658 TC $18.61
86663 $18.73
86663 TC $18.73
86664 $21.84
86664 TC $21.84
86665 $25.91
86665 TC $25.91
86666 $14.53
86666 TC $14.53
86668 $14.86
86668 TC $14.86
86671 $17.52
86671 TC $17.52
86674 $21.02
86674 TC $21.02
86677 $20.72
86677 TC $20.72
86682 $18.57
86682 TC $18.57
86683 $3.62
86683 TC $3.62
86684 $20.97
86684 TC $20.97
86687 FP Family Planning $11.99
86687 $11.99
86687 TC $11.99
86688 $20.02
86688 TC $20.02
86689 $27.64
86689 TC $27.64
86692 $24.51
86692 TC $24.51
86694 $20.55
86694 TC $20.55
86695 $13.55
86695 TC $13.55
86696 $27.64
86696 TC $27.64
86698 $17.86
86698 TC $17.86
86701 FP Family Planning $12.69
86701 $12.69
86701 TC $12.69
86702 $19.31
86702 TC $19.31
86703 $19.59
86703 TC $19.59
86704 $17.22
86705 $16.81
86706 $15.33
86707 $16.51
86708 $17.69
86709 $16.07
86710 $19.36
86710 TC $19.36
86711 $16.00
86711 TC $16.00
86713 $21.86
86713 TC $21.86
86717 $17.49
86717 TC $17.49
86720 $18.84
86720 TC $18.84
86723 $18.84
86723 TC $18.84
86727 $18.38
86727 TC $18.38
86732 $18.84
86732 TC $18.84
86735 $18.63
86735 TC $18.63
86738 $18.92
86738 TC $18.92
86738 $18.92
86741 $18.84
86741 TC $18.84
86744 $18.84
86744 TC $18.84
86747 $21.46
86747 TC $21.46
86750 $18.84
86750 TC $18.84
86753 $17.69
86753 TC $17.69
86756 $18.40
86756 TC $18.40
86757 $27.64
86757 TC $27.64
86759 $18.84
86759 TC $18.84
86762 $20.55
86762 TC $20.55
86765 $18.40
86765 TC $18.40
86768 $18.84
86768 TC $18.84
86771 $18.84
86771 TC $18.84
86774 $21.13
86774 TC $21.13
86777 $20.55
86777 TC $20.55
86778 $20.56
86778 TC $20.56
86780 $19.55
86780 TC $19.55
86784 $17.94
86784 TC $17.94
86787 $18.40
86787 TC $18.40
86788 $24.32
86788 TC $24.32
86789 $20.78
86789 TC $20.78
86790 $18.40
86790 TC $18.40
86793 $18.84
86793 TC $18.84
86794 $20.80
86794 TC $20.80
86800 $22.71
86800 TC $22.71
86803 $20.39
86804 $22.11
86805 $74.67
86805 TC $74.67
86806 $67.95
86806 TC $67.95
86807 $33.22
86807 TC $33.22
86808 $33.22
86808 TC $33.22
86812 $36.85
86812 TC $36.85
86813 $82.80
86813 TC $82.80
86816 $39.77
86816 TC $39.77
86817 $91.95
86817 TC $91.95
86821 $80.63
86821 TC $80.63
86825 $89.40
86825 TC $89.40
86826 $29.80
86826 TC $29.80
86828 $54.40
86828 TC $54.40
86829 $40.80
86829 TC $40.80
86830 $102.83
86830 TC $102.83
86831 $88.14
86831 TC $88.14
86832 $161.59
86832 TC $161.59
86833 $146.90
86833 TC $146.90
86834 $455.39
86834 TC $455.39
86835 $411.32
86835 TC $411.32
86849 $0.00
86849 $0.00
86850 $8.80
86850 26 $2.51
86850 TC $6.29
86860 $22.00
86860 26 $7.00
86860 TC $16.00
86870 $16.50
86870 26 $4.40
86870 TC $12.10
86880 $7.67
86880 TC $7.67
86885 $8.16
86885 TC $8.16
86886 $7.39
86886 TC $7.39
86890 $69.00
86890 26 $20.00
86890 TC $49.00
86891 $86.00
86891 26 $26.00
86891 TC $60.00
86900 $4.26
86900 TC $4.26
86900 $4.26
86901 $20.00
86901 26 $6.50
86901 TC $13.50
86902 $5.38
86902 TC $5.38
86904 $13.58
86904 TC $13.58
86905 $5.46
86905 TC $5.46
86906 $11.07
86906 TC $11.07
86910 $25.45
86910 TC $25.45
86911 $7.23
86911 TC $7.23
86920 $55.00
86920 26 $16.84
86920 TC $38.16
86921 $32.26
86921 26 $10.00
86921 TC $22.26
86922 $68.84
86922 26 $21.34
86922 TC $47.50
86923 $7.32
86923 26 $0.52
86927 $7.00
86927 26 $2.00
86927 TC $5.00
86930 $47.00
86930 26 $15.00
86930 TC $32.00
86931 $47.00
86931 26 $15.00
86931 TC $32.00
86932 $65.00
86932 26 $20.00
86932 TC $45.00
86940 $11.71
86940 TC $11.71
86941 $16.08
86941 TC $16.08
86945 $24.00
86945 26 $7.00
86945 TC $17.00
86950 $0.00
86950 $0.00
86950 $0.00
86960 $0.00
86960 $0.00
86965 $7.70
86965 26 $2.20
86965 TC $5.50
86970 $34.00
86970 26 $10.00
86970 TC $24.00
86971 $34.00
86971 26 $10.00
86971 TC $24.00
86972 $34.00
86972 26 $10.00
86972 TC $24.00
86975 $0.00
86975 $0.00
86975 $0.00
86976 $12.00
86976 26 $3.00
86976 TC $8.00
86977 $12.00
86977 26 $3.00
86977 TC $8.00
86978 $27.00
86978 26 $8.00
86978 TC $19.00
86985 $7.00
86985 26 $2.00
86985 TC $5.00
86999 $0.00
86999 $0.00
86999 $0.00
87015 $9.54
87015 TC $9.54
87015 $9.54
87040 $14.75
87040 TC $14.75
87040 $14.75
87045 $13.47
87045 TC $13.47
87046 $3.37
87046 TC $3.37
87070 $12.30
87070 TC $12.30
87070 $12.30
87071 $6.74
87071 TC $6.74
87073 $6.74
87073 TC $6.74
87075 FP Family Planning $12.49
87075 $12.49
87076 $11.53
87076 TC $11.53
87077 $11.53
87077 TC $11.53
87077 $11.53
87081 FP Family Planning $9.47
87081 $9.47
87081 TC $9.47
87084 $12.30
87084 TC $12.30
87086 $11.53
87086 TC $11.53
87086 $11.53
87088 FP Family Planning $11.55
87088 $11.55
87088 TC $11.55
87101 $8.24
87101 TC $8.24
87102 $12.00
87102 TC $12.00
87102 $12.00
87103 $12.88
87103 TC $12.88
87106 $11.70
87106 TC $11.70
87107 $11.70
87107 TC $11.70
87109 $21.97
87109 TC $21.97
87110 $27.98
87110 TC $27.98
87116 $15.43
87116 TC $15.43
87116 $15.43
87118 $15.63
87118 TC $15.63
87140 $7.97
87140 TC $7.97
87143 $17.90
87143 TC $17.90
87147 $7.39
87147 TC $7.39
87147 $7.39
87149 $28.63
87149 TC $28.63
87150 $51.95
87150 TC $51.95
87152 $7.47
87152 TC $7.47
87153 $70.73
87153 TC $70.73
87158 $7.47
87158 TC $7.47
87164 $15.33
87164 TC $15.33
87166 $16.13
87166 TC $16.13
87168 $6.10
87168 TC $6.10
87169 $6.10
87169 TC $6.10
87172 $6.10
87172 TC $6.10
87176 $7.84
87176 TC $7.84
87177 $12.71
87177 TC $12.71
87181 $6.78
87181 TC $6.78
87184 $9.85
87184 TC $9.85
87185 $6.78
87185 TC $6.78
87186 $8.24
87186 TC $8.24
87186 $8.24
87187 $8.24
87187 TC $8.24
87188 $6.64
87188 TC $6.64
87190 $8.07
87190 TC $8.07
87197 $15.80
87197 TC $15.80
87198 $12.45
87198 TC $12.45
87199 $12.45
87199 TC $12.45
87205 $6.10
87205 TC $6.10
87205 $6.10
87206 $7.67
87206 TC $7.67
87206 $7.67
87207 $8.56
87207 TC $8.56
87209 $25.95
87209 TC $25.95
87210 FP Family Planning $6.10
87210 $6.10
87210 TC $6.10
87220 $4.94
87220 TC $4.94
87230 $28.19
87230 TC $28.19
87250 $27.92
87250 TC $27.92
87252 $37.22
87252 TC $37.22
87252 $37.22
87253 $28.84
87253 TC $28.84
87254 $6.99
87254 TC $6.99
87255 $47.31
87255 TC $47.31
87260 $12.87
87265 $12.87
87267 $12.59
87267 TC $12.59
87269 $12.92
87269 TC $12.92
87270 $12.87
87271 $12.59
87271 TC $12.59
87272 $12.87
87273 $12.45
87273 TC $12.87
87274 $12.87
87275 $12.87
87275 TC $12.87
87276 $12.87
87278 $12.87
87279 $12.87
87279 TC $12.87
87280 $12.87
87281 $12.87
87281 TC $12.87
87283 $12.87
87283 TC $12.87
87285 $12.87
87290 $12.87
87299 $12.87
87300 $6.43
87301 $12.87
87305 $13.01
87305 TC $13.01
87320 $12.87
87324 $12.87
87327 $12.87
87327 TC $12.87
87328 $12.87
87329 $12.92
87329 TC $12.92
87332 $12.87
87335 $12.87
87336 $12.87
87336 TC $12.87
87337 $12.87
87337 TC $12.87
87338 $6.12
87338 TC $6.12
87339 $12.87
87339 TC $12.87
87340 $14.75
87341 $14.75
87341 TC $14.75
87350 $16.45
87380 $23.45
87385 $12.87
87389 FP Family Planning $34.12
87389 $34.12
87389 TC $34.12
87390 FP Family Planning $25.19
87390 $25.19
87391 $25.19
87400 $6.43
87400 TC $6.43
87420 $12.87
87425 $12.87
87427 $12.87
87427 TC $12.87
87430 $12.87
87449 $12.87
87450 $6.55
87451 $6.55
87451 TC $6.55
87471 $50.12
87475 $28.63
87476 $50.12
87480 $28.63
87481 $50.12
87482 $23.52
87483 $571.72
87483 TC $571.72
87485 $28.63
87486 $50.12
87487 $61.17
87490 FP Family Planning $28.63
87490 $28.63
87491 FP Family Planning $50.12
87491 $50.12
87492 $23.52
87493 $51.95
87493 TC $51.95
87495 $28.63
87496 $50.12
87497 $61.17
87498 $50.67
87498 TC $50.67
87500 $50.67
87500 TC $50.67
87501 $72.22
87501 TC $72.22
87502 $119.75
87502 TC $119.75
87503 $29.22
87503 TC $29.22
87505 TC $174.58
87506 TC $290.45
87507 TC $567.18
87510 $28.63
87511 $50.12
87512 $23.52
87516 $50.12
87517 $61.17
87520 $28.63
87521 $50.12
87522 $61.17
87525 $28.63
87526 $50.12
87527 $23.52
87528 $28.63
87529 $50.12
87530 $61.17
87531 FP Family Planning $50.12
87531 $28.63
87532 $50.12
87533 $23.52
87534 $28.63
87535 $50.12
87536 $121.51
87537 $28.63
87538 $50.12
87539 $23.52
87540 $28.63
87541 $50.12
87542 $23.52
87550 $28.63
87551 $50.12
87551 TC $50.12
87552 $61.17
87555 $28.63
87556 $50.12
87557 $61.17
87560 $28.63
87561 $50.12
87562 $61.17
87580 $28.63
87581 $50.12
87582 $23.52
87590 FP Family Planning $28.63
87590 $28.63
87591 FP Family Planning $50.12
87591 $50.12
87592 $23.52
87621 FP Family Planning $50.12
87623 TC $47.76
87624 TC $47.76
87625 TC $47.76
87631 $92.72
87631 TC $92.72
87632 $135.48
87632 TC $135.48
87633 $242.38
87633 TC $242.38
87634 TC $86.66
87634 $86.66
87640 $50.67
87640 TC $50.67
87641 $50.67
87641 TC $50.67
87650 $28.63
87651 $50.12
87652 $23.52
87653 $50.67
87653 TC $50.67
87660 $28.74
87660 TC $28.74
87662 $63.35
87662 TC $63.35
87797 $28.63
87798 $50.12
87799 $61.17
87800 $28.63
87800 TC $28.63
87801 $50.12
87801 TC $50.12
87802 $12.45
87802 TC $12.45
87803 $12.45
87803 TC $12.45
87804 $12.45
87804 TC $12.45
87806 TC $32.77
87807 $13.01
87807 TC $13.01
87808 $13.01
87808 TC $13.01
87809 $13.01
87809 TC $13.01
87810 $12.87
87850 $12.87
87880 $12.87
87899 $12.87
87899 $12.87
87900 $188.18
87900 TC $188.18
87901 $367.64
87901 TC $367.64
87902 $364.64
87902 TC $364.64
87903 $697.80
87903 TC $697.80
87904 $37.22
87904 TC $37.22
87905 $17.84
87905 TC $17.84
87906 $181.14
87906 TC $181.14
87910 $119.88
87910 TC $119.88
87912 $119.88
87912 TC $119.88
87999 $0.00
87999 $0.00
88104 $33.31
88104 26 $14.04
88104 TC $19.27
88106 $29.90
88106 26 $12.90
88106 TC $17.00
88108 $35.67
88108 26 $11.89
88108 TC $23.78
88112 $121.51
88112 26 $65.63
88112 TC $55.88
88120 $549.36
88120 26 $70.41
88120 TC $478.95
88121 $463.68
88121 26 $61.78
88121 TC $401.90
88125 $43.00
88125 26 $13.00
88125 TC $30.00
88130 $21.48
88130 TC $21.48
88140 $11.42
88140 TC $11.42
88142 FP Family Planning $19.00
88142 $19.00
88143 FP Family Planning $19.00
88143 $19.00
88143 TC $19.00
88147 FP Family Planning $7.15
88147 TC $7.15
88148 FP Family Planning $7.15
88148 TC $7.15
88150 FP Family Planning $7.39
88150 TC $7.39
88152 FP Family Planning $7.39
88152 $7.39
88153 $7.39
88153 TC $7.39
88155 FP Family Planning $8.56
88155 $8.56
88155 TC $8.56
88160 $35.93
88160 26 $22.46
88160 TC $13.47
88161 $27.27
88161 26 $26.19
88162 $72.19
88162 26 $48.27
88162 TC $23.92
88164 $7.39
88164 TC $7.39
88165 FP Family Planning $7.39
88165 $7.39
88165 TC $7.39
88166 FP Family Planning $7.39
88166 $7.39
88166 TC $7.39
88167 FP Family Planning $7.39
88167 $7.39
88167 TC $7.39
88172 $78.33
88172 26 $25.44
88172 TC $52.89
88173 $71.60
88173 26 $61.00
88174 $20.39
88174 TC $20.39
88175 $20.75
88175 TC $20.75
88177 $35.87
88177 26 $28.30
88177 TC $7.58
88182 $91.30
88182 26 $54.93
88182 TC $36.37
88184 $43.18
88184 TC $43.18
88185 $21.42
88185 TC $21.42
88187 $84.86
88187 26 $84.86
88188 $106.96
88188 26 $106.96
88189 $133.20
88189 26 $133.20
88199 $0.00
88199 $0.00
88199 $0.00
88230 $91.26
88230 TC $91.26
88233 $91.26
88233 TC $91.26
88235 $91.26
88235 TC $91.26
88237 $91.26
88237 TC $91.26
88239 $91.26
88239 TC $91.26
88240 $14.43
88240 TC $14.43
88241 $14.43
88241 TC $14.43
88245 $91.26
88245 TC $91.26
88248 $247.30
88248 TC $247.30
88249 $247.30
88249 TC $247.30
88261 $252.38
88261 TC $252.38
88262 $177.99
88262 TC $177.99
88263 $91.26
88263 TC $91.26
88264 $177.99
88264 TC $177.99
88267 $256.72
88267 TC $256.72
88269 $237.51
88269 TC $237.51
88271 $30.59
88271 TC $30.59
88272 $38.23
88272 TC $38.23
88273 $45.88
88273 TC $45.88
88274 $49.70
88274 TC $49.70
88275 $57.35
88275 TC $57.35
88280 $35.84
88280 TC $35.84
88283 $39.86
88283 TC $39.86
88285 $27.14
88285 TC $27.14
88289 $49.17
88289 TC $49.17
88291 $5.72
88291 TC $5.72
88299 $0.00
88299 $0.00
88300 $18.70
88300 26 $9.00
88300 TC $9.70
88302 FP Family Planning $33.00
88302 FP U1 Family Planning $12.00
88302 FP U3 Family Planning $20.88
88302 $33.00
88304 $41.80
88304 26 $16.94
88304 TC $24.86
88305 $54.55
88305 26 $22.06
88305 TC $32.49
88307 $110.41
88307 26 $44.67
88307 TC $65.74
88309 $276.48
88309 26 $158.06
88309 TC $118.42
88311 $19.80
88311 26 $6.80
88311 TC $13.00
88312 $35.93
88312 26 $12.58
88312 TC $23.35
88313 $37.22
88313 26 $13.54
88313 TC $23.68
88314 $72.91
88314 26 $22.63
88314 TC $50.28
88319 $71.33
88319 26 $37.30
88319 TC $34.03
88321 $55.00
88321 26 $55.00
88323 $77.37
88323 26 $41.80
88325 $58.00
88325 26 $58.00
88329 $44.00
88329 26 $44.00
88331 $62.15
88331 26 $53.00
88332 $44.00
88332 26 $40.00
88332 TC $14.40
88333 $103.44
88333 26 $83.94
88334 $53.09
88334 26 $41.26
88341 TC $40.26
88342 $64.90
88342 26 $25.30
88342 TC $39.60
88344 TC $68.15
88346 $63.71
88346 26 $50.96
88346 TC $12.75
88348 $268.40
88348 26 $83.60
88348 TC $184.80
88350 $69.98
88350 26 $29.37
88350 TC $40.62
88355 $157.52
88355 26 $105.76
88355 TC $51.76
88356 $241.15
88356 26 $168.76
88356 TC $72.38
88358 $229.78
88358 26 $171.61
88358 TC $58.17
88360 $135.67
88360 26 $76.00
88361 $139.51
88361 26 $55.13
88361 TC $84.38
88362 $198.02
88362 26 $122.26
88362 TC $75.76
88363 $47.50
88363 26 $14.73
88363 TC $32.78
88364 TC $62.13
88365 $114.69
88365 26 $56.10
88365 TC $58.59
88366 TC $76.39
88367 $257.83
88367 26 $88.58
88367 TC $169.25
88368 $234.06
88368 26 $96.05
88368 TC $138.01
88369 TC $43.12
88371 $31.73
88371 TC $31.73
88372 $32.49
88372 TC $32.49
88373 TC $34.56
88374 TC $141.67
88375 $0.00
88375 $0.00
88375 $0.00
88377 TC $131.85
88380 $0.00
88380 $0.00
88381 $207.42
88381 26 $73.98
88381 TC $133.44
88387 $51.69
88387 26 $41.26
88388 $30.83
88388 26 $25.61
88399 $0.00
88399 $0.00
88399 $0.00
88720 $7.33
88720 TC $7.33
88738 $7.43
88738 TC $7.43
88740 $7.33
88740 TC $7.33
88741 $7.33
88741 TC $7.33
88749 $0.00
88749 $0.00
88749 $0.00
89049 $183.16
89049 26 $109.90
89050 $6.75
89050 TC $6.75
89050 $6.75
89051 $7.86
89051 TC $7.86
89051 $7.86
89055 $5.96
89055 TC $5.96
89060 $10.21
89060 TC $10.21
89125 $6.16
89125 TC $6.16
89160 $5.26
89160 TC $5.26
89190 $6.78
89190 TC $6.78
89220 $14.00
89220 26 $4.34
89220 TC $9.66
89230 $14.21
89230 26 $14.21
89230 TC $14.21
89240 $0.00
89240 $0.00
89240 $0.00
89300 FP Family Planning $12.73
89300 $12.73
89300 TC $12.73
89310 Family Planning $12.29
89310 FP Family Planning $12.29
89310 $12.29
89310 U1 $8.99
89310 26 U1 $8.99
89310 26 U2 $8.99
89310 TC $12.29
89320 FP Family Planning $17.22
89320 $17.22
89320 TC $17.22
89321 $17.22
89321 TC $17.22
89322 $22.37
89322 TC $22.37
89325 $15.24
89325 TC $15.24
89329 $29.95
89329 TC $29.95
89330 $14.14
89330 TC $14.14
89331 $28.28
89331 TC $28.28
90281 $0.00
90283 $0.00
90284 $0.00
90287 $0.00
90288 $0.00
90291 $0.00
90296 $0.00
90371 $34.02
90371 U1 $69.96
90375 $281.91
90376 $296.24
90385 $49.61
90385 U1 $49.61
90386 $0.00
90389 $101.60
90393 $0.00
90396 $126.60
90399 $0.00
90581 $0.00
90585 $147.50
90586 $12.75
90620 SL $9.56
90620 EP TJ $9.56
90620 $183.11
90621 SL $9.56
90621 EP TJ $9.56
90621 $131.81
90630 EP TJ $9.56
90630 $25.07
90630 SL $9.56
90632 $61.05
90633 SL $9.56
90633 EP TJ $9.56
90633 $31.35
90634 SL $9.56
90634 EP TJ $9.56
90634 $31.35
90636 SL $9.56
90636 EP TJ $9.56
90636 $91.28
90646 SL $9.56
90646 $25.09
90647 SL $9.56
90647 EP TJ $9.56
90647 $25.09
90648 SL $9.56
90648 EP TJ $9.56
90649 SL $9.56
90649 EP TJ $9.56
90650 SL $9.56
90650 EP TJ $9.56
90651 SL $9.56
90651 EP TJ $9.56
90654 SL $9.56
90654 EP TJ $9.56
90654 $10.31
90655 SL $9.56
90655 EP TJ $9.56
90656 SL $9.56
90656 EP TJ $9.56
90656 $13.12
90657 SL $9.56
90657 EP TJ $9.56
90658 SL $9.56
90658 EP TJ $9.56
90658 $12.06
90660 SL $9.56
90660 EP TJ $9.56
90660 $18.40
90662 $13.80
90670 SL $9.56
90670 EP TJ $9.56
90672 SL $9.56
90672 EP TJ $9.56
90672 $24.60
90673 SL $9.56
90673 EP TJ $9.56
90673 $37.19
90674 SL $9.56
90674 $22.94
90675 $262.98
90676 $0.00
90680 SL $9.56
90680 EP TJ $9.56
90681 SL $9.56
90681 EP TJ $9.56
90682 SL $9.56
90682 EP TJ $9.56
90682 $46.31
90685 SL $9.56
90685 EP TJ $9.56
90686 SL $9.56
90686 EP TJ $9.56
90686 $16.14
90688 SL $9.56
90688 EP TJ $9.56
90688 $16.15
90690 $9.71
90691 $42.10
90696 SL $9.56
90696 EP TJ $9.56
90698 SL $9.56
90698 EP TJ $9.56
90700 SL $9.56
90700 EP TJ $9.56
90702 SL $9.56
90702 EP TJ $9.56
90707 SL $9.56
90707 EP TJ $9.56
90707 $38.10
90710 SL $9.56
90710 EP TJ $9.56
90710 $26.96
90713 SL $9.56
90713 EP TJ $9.56
90713 $20.84
90714 SL $9.56
90714 EP TJ $9.56
90714 $14.00
90715 SL $9.56
90715 EP TJ $9.56
90715 $28.80
90716 SL $9.56
90716 EP TJ $9.56
90716 $51.53
90717 $0.00
90723 SL $9.56
90723 EP TJ $9.56
90732 SL $9.56
90732 EP TJ $9.56
90732 $12.34
90733 $69.85
90734 SL $9.56
90734 EP TJ $9.56
90734 $65.60
90736 $129.20
90740 $153.14
90743 SL $9.56
90743 EP TJ $9.56
90743 $55.09
90744 SL $9.56
90744 EP TJ $9.56
90744 $25.80
90746 $57.58
90747 SL $9.56
90747 EP TJ $9.56
90747 $110.20
90748 SL $9.56
90748 EP TJ $9.56
90748 $33.98
90749 $0.00
90750 $112.00
90756 SL $9.56
90756 $22.79
90791 U4 $114.43
90791 U4 UC UK $125.87
90792 U4 $121.74
90832 U4 $46.38
90832 U4 UC UK $51.02
90832 U4 U5 $46.38
90832 $61.78
90833 $43.05
90834 U4 $69.57
90834 U4 UC UK $76.53
90834 U4 U5 $69.57
90834 $83.42
90836 $69.99
90837 U4 $92.76
90837 U4 UC UK $102.04
90837 U4 U5 $92.76
90837 $123.02
90838 $112.52
90846 U4 $77.27
90846 U4 U5 $77.27
90847 U4 $77.28
90847 U4 UC UK $85.01
90847 U4 U5 $77.28
90847 $78.32
90849 U4 $89.57
90849 U4 U5 $89.57
90849 $40.00
90853 U4 $47.76
90853 U4 U5 $47.46
90853 $40.00
90882 $17.60
90887 U4 $53.65
90887 U4 UC UK $59.02
92551 $7.92
92552 $15.84
92567 $12.00
92567 $13.20
92950 $151.36
93000 $22.88
93005 $15.84
93041 $5.28
94010 $30.22
94060 $51.04
94070 $66.88
94150 $8.80
94200 $16.72
94760 $11.44
94761 $24.64
95060 $8.80
95065 $4.62
95115 $8.82
95117 $11.33
95120 $5.00
95125 $6.00
95130 $11.44
95131 $22.88
95132 $35.20
95133 $40.48
95134 $0.00
95144 $5.46
96365 $72.46
96366 $23.14
96367 $36.42
96368 $21.62
96369 $157.45
96370 $16.70
96371 $76.26
96374 $57.29
96375 $25.04
96377 $0.00
96379 $0.00
96401 $66.39
96402 $35.66
96405 $33.57
96406 $46.16
96409 $122.54
96411 $70.94
96413 $173.00
96415 $39.08
96416 $185.90
96417 $84.60
96420 $58.40
96422 $61.54
96423 $24.25
96425 $71.34
96521 $153.27
96522 $110.78
96523 $28.08
96549 $0.00
97110 $21.76
97110 UB $17.40
97110 $21.76
97110 UB $17.40
97150 $5.94
97150 UB $4.75
97150 $5.94
97150 UB $4.75
97597 $48.12
97598 $61.17
97602 $67.65
99082 $0.00
99082 UB $0.70
99172 $17.68
99173 EP $14.08
99175 $31.47
99188 $15.96
99195 $13.20
99201 $23.76
99202 $36.08
99203 $51.92
99204 $70.40
99205 $110.00
99211 $11.44
99212 $22.00
99213 $29.04
99214 $56.04
99215 $84.80
99221 $51.92
99222 $73.92
99223 $113.52
99231 $27.60
99232 $40.48
99233 $54.56
99238 $42.24
99241 $42.80
99242 $58.08
99243 $80.96
99244 $95.92
99245 $98.56
99251 $42.40
99252 $58.08
99253 $78.85
99254 $95.92
99255 $98.56
99281 $17.60
99282 $28.00
99283 $43.12
99284 $57.20
99285 $67.00
99291 $133.76
99292 $66.88
99304 $50.11
99305 $66.53
99306 $82.08
99307 $25.92
99308 $42.91
99309 $60.48
99310 $75.74
99318 $50.11
99341 $45.06
99342 $57.20
99343 $74.80
99347 $31.14
99348 $45.59
99349 $66.78
99360 $38.40
99381 $56.41
99381 EP H9 $56.41
99381 EP U1 $56.41
99382 $56.41
99382 EP H9 $56.41
99382 EP U1 $56.41
99383 $56.41
99383 EP H9 $56.41
99383 EP U1 $56.41
99384 $56.41
99384 EP H9 $56.41
99384 EP U1 $56.41
99385 $56.41
99385 EP H9 $56.41
99385 EP U1 $56.41
99391 $56.41
99391 EP H9 $56.41
99391 EP U2 $56.41
99392 $56.41
99392 EP H9 $56.41
99392 EP U2 $56.41
99393 $56.41
99393 EP H9 $56.41
99393 EP U2 $56.41
99394 $56.41
99394 EP H9 $56.41
99394 EP U2 $56.41
99395 $56.41
99395 EP H9 $56.41
99395 EP U2 $56.41
99401 EP $11.29
99401 FP SA UA Family Planning $29.04
99401 FP SA UB Family Planning $29.04
99402 SA U1 UA $11.52
99402 SA U2 UA $13.31
99402 SA U3 $17.11
99402 SA U3 UA $17.11
99402 SA U4 UA $15.36
99402 SA U5 UA $30.72
99402 SA UA $8.68
99402 FP SA Family Planning $56.32
99406 SE $20.00
99407 SE $25.00
99460 UA $108.16
99461 UA $108.16
99463 UA $108.16
99466 $185.18
99467 $92.45
C9460 $17.08
C9492 $55.66
C9744 $0.00
D1206 $15.96
D5008 EP $12.02
G0328 $22.96
G6015 $0.00
H0001 U4 $107.75
H0014 U4 $250.00
H0015 U4 $115.74
H0018 U4 $350.00
H0035 U4 $214.05
H0038 U4 UC $16.77
H0038 U4 $8.39
H0043 U4 $25.59
H0045 U4 $165.00
H2011 U4 U6 $23.19
H2011 U4 U5 $18.00
H2014 U4 UC $16.77
H2014 U4 $8.39
H2015 U4 UC $90.08
H2015 U4 U1 $67.08
H2017 U4 UB $9.60
H2017 U4 UA $7.68
H2017 U4 UC $11.15
H2017 U4 U6 $11.15
H2017 U4 U3 $11.15
H2017 U4 U5 $11.15
H2017 HQ U4 U6 $5.58
H2019 U4 UC $22.52
H2019 U4 $16.77
H2020 U4 $245.00
H2023 U4 $25.59
H2027 U4 $25.76
H2027 U4 UK $28.34
J0120 $13.77
J0171 $1.64
J0202 $1,743.82
J0207 $306.77
J0210 $12.88
J0256 $2.09
J0280 $14.64
J0285 $173.33
J0290 $5.76
J0295 $8.70
J0300 $3.49
J0330 $2.39
J0360 $7.01
J0380 $14.24
J0461 $0.03
J0470 $21.60
J0475 $205.85
J0500 $12.12
J0515 $7.81
J0558 $4.82
J0561 $5.66
J0565 $30.40
J0570 $1,260.23
J0585 $6.12
J0586 $8.08
J0595 $3.94
J0596 $30.99
J0600 $21.00
J0610 $2.48
J0620 $28.65
J0630 $40.46
J0636 $1.38
J0640 $66.01
J0670 $8.25
J0690 $4.55
J0694 $10.88
J0695 $4.96
J0696 $11.84
J0697 $8.84
J0698 $13.05
J0702 $3.46
J0713 $6.07
J0714 $81.23
J0720 $5.75
J0725 $3.33
J0735 $6.45
J0740 $692.34
J0743 $15.22
J0745 $2.20
J0770 $23.37
J0780 $3.28
J0800 $21.10
J0833 $65.42
J0834 $91.20
J0850 $464.34
J0875 $14.58
J0881 $4.59
J0882 $4.59
J0883 $5.18
J0884 $5.18
J0885 $11.70
J0887 $2.05
J0888 $2.05
J0895 $10.28
J0945 $7.60
J1000 $4.56
J1020 $3.66
J1030 $5.36
J1040 $8.44
J1050 $0.47
J1050 FP Family Planning $0.47
J1100 $7.40
J1110 $9.97
J1120 $28.82
J1130 $0.24
J1160 $3.47
J1165 $2.44
J1170 $2.67
J1190 $146.37
J1200 $3.12
J1205 $10.66
J1212 $2.14
J1230 $3.57
J1240 $2.10
J1245 $24.82
J1250 $21.55
J1260 $14.81
J1325 $17.03
J1330 $3.71
J1335 $21.24
J1364 $7.54
J1380 $2.08
J1410 $3.68
J1435 $2.23
J1442 $0.99
J1443 $0.03
J1447 $0.77
J1455 $13.20
J1460 $3.28
J1555 $13.79
J1559 $8.88
J1560 $23.98
J1561 $32.88
J1566 $22.22
J1570 $34.66
J1575 $10.83
J1580 $5.05
J1600 $11.65
J1610 $38.55
J1626 $18.45
J1627 $4.60
J1630 $6.78
J1631 $29.55
J1642 $1.01
J1644 $2.32
J1645 $67.86
J1650 $17.66
J1670 $11.42
J1720 $4.94
J1742 $18.77
J1750 $12.25
J1786 $43.59
J1790 $7.60
J1800 $5.77
J1815 $3.23
J1830 $68.40
J1833 $0.73
J1840 $12.64
J1850 $6.90
J1885 $9.74
J1940 $3.67
J1942 $2.80
J1950 $397.04
J1955 $35.80
J1980 $24.90
J2001 $0.88
J2010 $4.16
J2060 $4.64
J2150 $6.09
J2175 $2.19
J2182 $30.53
J2185 $4.40
J2210 $3.76
J2250 $3.89
J2260 $31.26
J2270 $2.12
J2278 $6.17
J2280 $9.30
J2300 $2.85
J2310 $4.84
J2315 $3.25
J2320 $3.58
J2354 $3.81
J2360 $6.48
J2370 $4.85
J2400 $15.70
J2405 $6.79
J2407 $25.62
J2410 $4.91
J2430 $254.81
J2440 $5.01
J2502 $319.20
J2505 $2,507.50
J2510 $4.04
J2515 $3.39
J2540 $2.40
J2547 $1.81
J2550 $5.44
J2560 $4.20
J2590 $2.55
J2597 $22.51
J2675 $8.45
J2680 $20.51
J2690 $32.26
J2700 $4.77
J2710 $3.22
J2720 $5.66
J2730 $28.07
J2760 $27.37
J2765 $3.95
J2783 $105.54
J2788 $45.10
J2790 $120.60
J2800 $6.33
J2820 $23.98
J2820 U1 $201.60
J2840 $570.00
J2860 $97.81
J2916 $8.17
J2920 $5.05
J2930 $10.85
J3000 $1.99
J3010 $3.66
J3030 $30.02
J3070 $4.64
J3090 $1.21
J3105 $3.60
J3121 $0.06
J3145 $1.25
J3230 $10.33
J3240 $495.60
J3250 $3.76
J3260 $8.42
J3301 $2.02
J3303 $11.87
J3360 $6.15
J3370 $9.40
J3380 $17.03
J3410 $2.19
J3420 $2.23
J3430 $4.18
J3465 $4.51
J3470 $7.05
J3475 $1.91
J3480 $1.62
J3485 $0.96
J3490 $0.00
J3490 Family Planning $0.00
J7121 $1.12
J7175 $9.27
J7179 $2.26
J7188 $5.88
J7190 $0.86
J7192 $1.12
J7193 $1.12
J7194 $1.96
J7195 $0.95
J7197 $2.42
J7199 $0.00
J7202 $4.85
J7205 $1.89
J7207 $2.26
J7209 $1.93
J7210 $1.88
J7297 FP Family Planning $625.00
J7298 $772.65
J7298 FP Family Planning $772.65
J7300 FP Family Planning $598.00
J7301 FP Family Planning $650.32
J7303 FP Family Planning $37.70
J7307 FP Family Planning $771.32
J7320 $8.00
J7322 $19.00
J7328 $0.00
J7501 $77.52
J7504 $262.24
J7505 $661.20
J7507 $2.66
J7509 $0.49
J7510 $0.04
J7513 $380.36
J7518 $2.42
J7599 $0.00
J8530 $1.82
J9000 $42.18
J9015 $448.81
J9017 $32.94
J9022 $75.79
J9023 $79.37
J9031 $147.50
J9032 $32.50
J9034 $23.69
J9035 $69.61
J9039 $108.60
J9040 $256.19
J9041 $28.38
J9045 $114.45
J9050 $40.00
J9055 $53.57
J9060 $28.06
J9065 $48.80
J9070 $50.13
J9098 $332.05
J9100 $6.25
J9120 $10.54
J9130 $7.88
J9145 $46.92
J9150 $125.65
J9171 $17.62
J9176 $6.23
J9178 $24.73
J9181 $13.15
J9185 $285.41
J9190 $1.62
J9200 $87.50
J9201 $106.72
J9202 $318.75
J9203 $193.16
J9205 $39.51
J9206 $134.25
J9208 $127.45
J9209 $36.48
J9211 $258.84
J9213 $32.24
J9214 $11.59
J9216 $133.00
J9217 $525.18
J9218 $11.60
J9219 $5,399.80
J9230 $10.36
J9245 $308.78
J9250 $5.52
J9260 $13.63
J9263 $8.45
J9266 $254.16
J9267 $0.16
J9268 $1,562.75
J9271 $45.70
J9280 $110.36
J9285 $49.95
J9293 $193.02
J9295 $5.25
J9299 $25.37
J9305 $40.54
J9308 $54.02
J9320 $54.25
J9325 $46.13
J9340 $54.71
J9352 $283.34
J9355 $89.51
J9360 $3.52
J9370 $34.62
J9390 $90.72
J9600 $2,444.76
J9999 $0.00
P9612 $3.00
P9615 $3.00
Q0111 FP Family Planning $5.90
Q2040 $541,500.00
Q3014 $2.54
Q3014 $2.54
Q3014 Family Planning $2.54
Q3014 $2.54
Q5101 $0.97
Q5102 $100.31
Q9991 $1,674.80
Q9992 $1,674.80
S0108 $2.06
S0164 $3.79
S0177 $5.40
S0179 $0.65
S0187 $1.39
S0220 U4 $57.60
S0610 $70.40
S0612 $29.04
T1015 $25.30
T1502 $1.60
V5008 EP $12.02
Related Documents
