| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
|
284,431 |
246,395 |
$13.44M |
| 99214 |
|
151,927 |
135,923 |
$9.84M |
| 99232 |
|
94,750 |
30,731 |
$3.97M |
| 99204 |
|
21,125 |
19,697 |
$2.05M |
| 99203 |
|
24,650 |
23,001 |
$1.58M |
| 99223 |
Prolong inpt eval add15 m |
14,000 |
11,790 |
$1.43M |
| 99233 |
Prolong inpt eval add15 m |
17,678 |
6,408 |
$1.11M |
| 88305 |
|
27,846 |
26,080 |
$1.06M |
| 99392 |
|
14,300 |
13,707 |
$1.02M |
| 99222 |
|
12,680 |
10,751 |
$970K |
| 99469 |
|
3,779 |
598 |
$931K |
| D7210 |
|
8,446 |
1,694 |
$825K |
| 99391 |
|
12,749 |
11,871 |
$814K |
| 87637 |
|
5,759 |
5,270 |
$668K |
| 90471 |
|
41,663 |
39,461 |
$595K |
| 99212 |
|
20,791 |
18,481 |
$594K |
| 99393 |
|
8,040 |
7,729 |
$589K |
| 88307 |
|
9,641 |
9,225 |
$589K |
| 90834 |
|
9,121 |
6,207 |
$569K |
| 99215 |
Prolong outpt/office vis |
5,119 |
4,732 |
$527K |
| D2392 |
|
7,375 |
2,055 |
$515K |
| 99479 |
|
5,155 |
927 |
$479K |
| D7140 |
|
8,450 |
1,750 |
$459K |
| 90472 |
|
20,390 |
19,258 |
$431K |
| 59409 |
|
593 |
549 |
$412K |
| D2930 |
|
7,085 |
1,165 |
$412K |
| 99231 |
|
15,858 |
7,123 |
$387K |
| 99238 |
|
8,089 |
7,332 |
$381K |
| 90792 |
|
3,325 |
3,086 |
$356K |
| 99309 |
|
28,826 |
21,700 |
$351K |
| 76816 |
|
9,962 |
8,954 |
$336K |
| 93306 |
|
8,949 |
8,396 |
$324K |
| 99291 |
|
2,302 |
812 |
$320K |
| 99468 |
|
503 |
472 |
$307K |
| 99394 |
|
3,737 |
3,590 |
$299K |
| D3220 |
|
5,019 |
1,111 |
$285K |
| D2391 |
|
5,775 |
1,706 |
$281K |
| 99205 |
Prolong outpt/office vis |
2,157 |
1,985 |
$266K |
| D0140 |
|
8,860 |
6,862 |
$260K |
| 43239 |
|
3,383 |
3,018 |
$252K |
| 99480 |
|
2,422 |
586 |
$232K |
| 20610 |
|
5,781 |
4,381 |
$221K |
| 99202 |
|
4,368 |
4,093 |
$182K |
| 64615 |
|
2,430 |
2,167 |
$173K |
| 99395 |
|
2,245 |
2,146 |
$172K |
| 95886 |
|
3,004 |
2,800 |
$152K |
| 99472 |
|
582 |
118 |
$150K |
| 93458 |
|
757 |
678 |
$139K |
| D1120 |
|
5,382 |
3,552 |
$118K |
| D0330 |
|
2,342 |
1,981 |
$118K |
| 59514 |
|
140 |
126 |
$115K |
| 59430 |
|
485 |
457 |
$115K |
| 87651 |
|
3,823 |
3,331 |
$107K |
| 90686 |
|
16,195 |
15,437 |
$106K |
| 90832 |
|
2,113 |
1,618 |
$105K |
| D2331 |
|
2,229 |
580 |
$102K |
| 45380 |
|
869 |
821 |
$101K |
| 99219 |
|
1,313 |
1,192 |
$101K |
| 45385 |
|
591 |
567 |
$101K |
| 90833 |
|
2,095 |
1,943 |
$95K |
| 78452 |
|
1,926 |
1,843 |
$91K |
| D1208 |
|
5,418 |
3,770 |
$91K |
| 45378 |
|
783 |
746 |
$90K |
| D1351 |
|
3,781 |
808 |
$89K |
| 99396 |
|
1,033 |
1,000 |
$87K |
| 59025 |
|
4,108 |
1,494 |
$85K |
| D9420 |
|
3,350 |
2,117 |
$83K |
| 76819 |
|
2,818 |
1,574 |
$83K |
| D2330 |
|
1,981 |
592 |
$80K |
| 87804 |
|
5,332 |
2,542 |
$78K |
| 76811 |
|
1,220 |
1,110 |
$78K |
| 88342 |
|
2,868 |
2,722 |
$77K |
| 76815 |
|
2,938 |
1,346 |
$77K |
| 17110 |
|
1,039 |
896 |
$74K |
| 99460 |
|
1,166 |
1,088 |
$72K |
| 93000 |
|
5,915 |
5,376 |
$72K |
| 76817 |
|
2,330 |
1,813 |
$71K |
| 76830 |
|
1,753 |
1,661 |
$67K |
| 96110 |
|
6,249 |
5,903 |
$67K |
| D1110 |
|
1,467 |
1,205 |
$65K |
| 95951 |
|
339 |
160 |
$64K |
| 36415 |
|
14,759 |
12,744 |
$64K |
| D0220 |
|
4,538 |
3,194 |
$63K |
| 88341 |
|
1,017 |
943 |
$62K |
| 95720 |
|
468 |
257 |
$60K |
| 99152 |
|
1,241 |
1,117 |
$59K |
| D0272 |
|
3,718 |
2,349 |
$57K |
| 99235 |
|
499 |
472 |
$54K |
| 99239 |
|
725 |
682 |
$54K |
| 83036 |
|
5,450 |
5,096 |
$52K |
| 92567 |
|
3,833 |
3,638 |
$52K |
| 99443 |
|
1,235 |
1,163 |
$51K |
| 88112 |
|
2,271 |
2,031 |
$51K |
| 66984 |
|
492 |
291 |
$50K |
| 99220 |
|
453 |
407 |
$48K |
| D0274 |
|
1,347 |
1,167 |
$48K |
| 99385 |
|
558 |
540 |
$47K |
| 95810 |
|
647 |
623 |
$46K |
| 99225 |
|
1,013 |
568 |
$45K |
| 87428 |
|
1,563 |
1,415 |
$44K |
| 90960 |
|
864 |
821 |
$44K |
| D9222 |
|
410 |
331 |
$43K |
| 76805 |
|
983 |
906 |
$43K |
| D0230 |
|
4,245 |
2,275 |
$42K |
| 90670 |
|
6,987 |
6,636 |
$42K |
| 88304 |
|
4,876 |
4,718 |
$42K |
| 93303 |
|
1,058 |
932 |
$41K |
| 95913 |
|
331 |
294 |
$41K |
| 90853 |
|
2,402 |
1,329 |
$40K |
| D0350 |
|
2,993 |
1,819 |
$39K |
| 11042 |
|
1,165 |
615 |
$39K |
| 73564 |
|
2,845 |
2,370 |
$39K |
| 87880 |
|
2,520 |
2,312 |
$39K |
| 99496 |
|
222 |
213 |
$39K |
| 90935 |
|
1,255 |
556 |
$38K |
| 84443 |
|
2,920 |
2,694 |
$38K |
| D0120 |
|
1,771 |
1,423 |
$38K |
| 69436 |
|
292 |
248 |
$38K |
| 99217 |
|
892 |
814 |
$37K |
| 47562 |
|
82 |
77 |
$37K |
| D0150 |
|
1,197 |
998 |
$37K |
| 81003 |
|
12,864 |
10,561 |
$35K |
| 95811 |
|
448 |
437 |
$34K |
| 93016 |
|
2,064 |
1,978 |
$34K |
| 64493 |
|
608 |
541 |
$33K |
| 99495 |
|
256 |
241 |
$32K |
| 93010 |
|
4,259 |
3,703 |
$32K |
| 11721 |
|
2,168 |
1,975 |
$31K |
| 99284 |
|
406 |
382 |
$31K |
| 93018 |
|
2,201 |
2,107 |
$31K |
| D2393 |
|
254 |
141 |
$30K |
| 92552 |
|
1,348 |
1,295 |
$28K |
| 81025 |
|
4,070 |
3,718 |
$28K |
| 99349 |
|
2,146 |
1,724 |
$28K |
| 01992 |
|
241 |
230 |
$28K |
| 43235 |
|
366 |
340 |
$27K |
| 92133 |
|
848 |
784 |
$26K |
| 76818 |
|
780 |
316 |
$26K |
| 20553 |
|
1,007 |
933 |
$24K |
| 80053 |
|
3,481 |
3,174 |
$23K |
| 99383 |
|
294 |
276 |
$22K |
| 88141 |
|
1,202 |
1,150 |
$22K |
| 90791 |
|
206 |
194 |
$21K |
| 73630 |
|
2,764 |
2,298 |
$21K |
| 93701 |
|
2,847 |
2,555 |
$21K |
| D2332 |
|
261 |
112 |
$21K |
| 90474 |
|
2,547 |
2,441 |
$21K |
| 85060 |
|
1,592 |
1,403 |
$20K |
| 96127 |
|
7,474 |
7,045 |
$20K |
| 80061 |
|
1,722 |
1,612 |
$19K |
| 64494 |
|
580 |
528 |
$19K |
| 99283 |
|
403 |
380 |
$19K |
| D9223 |
|
689 |
330 |
$19K |
| 99221 |
|
314 |
280 |
$19K |
| 64635 |
|
130 |
112 |
$18K |
| 73610 |
|
2,488 |
2,054 |
$17K |
| 94726 |
|
2,080 |
2,020 |
$17K |
| 72082 |
|
774 |
722 |
$17K |
| J0702 |
Betamethasone acet&sod phosp |
940 |
819 |
$17K |
| 85025 |
|
2,651 |
2,349 |
$16K |
| 95911 |
|
201 |
187 |
$16K |
| 73110 |
|
2,331 |
1,790 |
$16K |
| 64495 |
|
489 |
442 |
$16K |
| 58300 |
|
265 |
243 |
$15K |
| 96372 |
|
1,688 |
1,325 |
$15K |
| 90837 |
|
177 |
137 |
$15K |
| 92136 |
|
570 |
303 |
$14K |
| 93298 |
|
1,030 |
919 |
$14K |
| 87635 |
|
338 |
318 |
$14K |
| 90785 |
|
1,756 |
1,678 |
$14K |
| 92557 |
|
467 |
455 |
$14K |
| 11981 |
|
267 |
230 |
$14K |
| D2150 |
|
244 |
104 |
$14K |
| 93320 |
|
1,056 |
933 |
$13K |
| T1016 |
Case management |
180 |
150 |
$13K |
| 20550 |
|
368 |
299 |
$13K |
| D9310 |
|
273 |
244 |
$13K |
| 11102 |
|
229 |
180 |
$12K |
| 11104 |
|
146 |
135 |
$12K |
| 92555 |
|
716 |
686 |
$12K |
| 83655 |
|
1,155 |
1,105 |
$12K |
| 90723 |
|
5,927 |
5,667 |
$12K |
| D2335 |
|
116 |
36 |
$12K |
| 92083 |
|
353 |
312 |
$12K |
| 88311 |
|
1,188 |
1,098 |
$12K |
| 94010 |
|
1,342 |
1,246 |
$12K |
| 82306 |
|
801 |
722 |
$12K |
| 99442 |
|
408 |
371 |
$11K |
| 73030 |
|
1,130 |
978 |
$11K |
| 85610 |
|
2,494 |
1,439 |
$11K |
| 76813 |
|
248 |
222 |
$11K |
| 94729 |
|
1,458 |
1,403 |
$11K |
| 54150 |
|
156 |
145 |
$11K |
| 73130 |
|
1,623 |
1,324 |
$11K |
| 90715 |
|
1,475 |
1,377 |
$11K |
| 95806 |
|
446 |
383 |
$10K |
| 90677 |
|
1,627 |
1,564 |
$10K |
| 84439 |
|
1,665 |
1,526 |
$10K |
| 90651 |
|
1,669 |
1,568 |
$10K |
| 95816 |
|
254 |
241 |
$10K |
| J0585 |
Injection,onabotulinumtoxina |
988 |
524 |
$9K |
| 95812 |
|
258 |
246 |
$9K |
| 81002 |
|
3,762 |
2,820 |
$9K |
| 95910 |
|
121 |
116 |
$9K |
| 99386 |
|
89 |
88 |
$9K |
| 97597 |
|
321 |
188 |
$9K |
| 93308 |
|
616 |
557 |
$8K |
| 95912 |
|
90 |
84 |
$8K |
| D7240 |
|
33 |
12 |
$8K |
| 93248 |
|
619 |
562 |
$8K |
| 91200 |
|
659 |
635 |
$8K |
| 94060 |
|
859 |
830 |
$8K |
| 99211 |
|
564 |
521 |
$8K |
| 64636 |
|
96 |
84 |
$7K |
| 92507 |
|
167 |
79 |
$7K |
| 73562 |
|
705 |
607 |
$7K |
| 88302 |
|
1,096 |
1,062 |
$7K |
| D2140 |
|
127 |
54 |
$7K |
| 99306 |
Prolong nursin fac eval 15m |
301 |
270 |
$7K |
| D9992 |
|
517 |
390 |
$7K |
| 73080 |
|
961 |
737 |
$7K |
| 99305 |
|
291 |
260 |
$6K |
| 99441 |
|
332 |
304 |
$6K |
| 42820 |
|
30 |
25 |
$6K |
| 96900 |
|
619 |
137 |
$6K |
| 72170 |
|
629 |
583 |
$6K |
| 99381 |
|
97 |
85 |
$6K |
| 20552 |
|
222 |
189 |
$6K |
| 88312 |
|
195 |
181 |
$6K |
| 99382 |
|
75 |
72 |
$6K |
| 93297 |
|
305 |
283 |
$5K |
| 29075 |
|
97 |
89 |
$5K |
| 99462 |
|
179 |
135 |
$5K |
| 90647 |
|
5,283 |
5,035 |
$5K |
| 93325 |
|
1,455 |
1,281 |
$5K |
| 20526 |
|
99 |
88 |
$5K |
| 11100 |
|
87 |
83 |
$5K |
| 88173 |
|
65 |
64 |
$5K |
| 95004 |
|
74 |
72 |
$5K |
| 99188 |
|
236 |
228 |
$4K |
| 97803 |
|
340 |
215 |
$4K |
| 99201 |
|
157 |
152 |
$4K |
| 99224 |
|
183 |
109 |
$4K |
| S0281 |
Medical home, maintenance |
117 |
104 |
$4K |
| 96161 |
|
1,822 |
1,704 |
$4K |
| 93296 |
|
467 |
409 |
$4K |
| 73502 |
|
268 |
250 |
$4K |
| D1206 |
|
244 |
151 |
$4K |
| 95251 |
|
504 |
463 |
$4K |
| G2066 |
Inter devc remote 30d |
310 |
269 |
$3K |
| 77067 |
|
58 |
56 |
$3K |
| 99477 |
|
15 |
13 |
$3K |
| 92014 |
|
48 |
46 |
$3K |
| G0179 |
Md recertification hha pt |
463 |
429 |
$3K |
| 29065 |
|
54 |
51 |
$3K |
| 11720 |
|
446 |
395 |
$3K |
| 85027 |
|
572 |
530 |
$3K |
| 84165 |
|
264 |
252 |
$3K |
| 85018 |
|
1,436 |
1,375 |
$3K |
| 82728 |
|
389 |
345 |
$3K |
| 80050 |
|
88 |
84 |
$3K |
| 95974 |
|
37 |
28 |
$3K |
| 87807 |
|
264 |
254 |
$3K |
| 99490 |
Ccm add 20min |
671 |
610 |
$3K |
| 82607 |
|
349 |
308 |
$3K |
| 76801 |
|
71 |
68 |
$3K |
| 88189 |
|
53 |
44 |
$3K |
| 99384 |
|
27 |
25 |
$3K |
| 90674 |
|
170 |
153 |
$2K |
| 92012 |
|
59 |
50 |
$2K |
| 97802 |
|
177 |
102 |
$2K |
| 99308 |
|
798 |
578 |
$2K |
| 77072 |
|
218 |
207 |
$2K |
| 90734 |
|
1,599 |
1,528 |
$2K |
| 73590 |
|
286 |
232 |
$2K |
| 58301 |
|
37 |
34 |
$2K |
| 27096 |
|
36 |
36 |
$2K |
| 90633 |
|
3,455 |
3,296 |
$2K |
| 92015 |
|
116 |
102 |
$2K |
| 92556 |
|
88 |
81 |
$2K |
| 64642 |
|
32 |
29 |
$2K |
| J3301 |
Triamcinolone acet inj nos |
449 |
389 |
$2K |
| 92020 |
|
46 |
39 |
$2K |
| 87426 |
|
53 |
53 |
$2K |
| 93244 |
|
124 |
124 |
$2K |
| 31575 |
|
26 |
25 |
$2K |
| 99336 |
|
324 |
224 |
$2K |
| 43264 |
|
12 |
12 |
$2K |
| 80048 |
|
259 |
231 |
$2K |
| 95813 |
|
40 |
37 |
$2K |
| 99417 |
Prolong home eval add 15m |
146 |
79 |
$2K |
| 86140 |
|
451 |
414 |
$2K |
| 99310 |
Prolong nursin fac eval 15m |
74 |
63 |
$2K |
| 92201 |
|
137 |
68 |
$2K |
| 83540 |
|
514 |
449 |
$2K |
| J1030 |
Methylprednisolone 40 mg inj |
48 |
41 |
$2K |
| 90656 |
|
152 |
144 |
$2K |
| 11982 |
|
26 |
24 |
$2K |
| 83550 |
|
308 |
274 |
$2K |
| H0031 |
Mh health assess by non-md |
12 |
12 |
$2K |
| 88309 |
|
13 |
12 |
$1K |
| 90710 |
|
1,561 |
1,499 |
$1K |
| G2211 |
Complex e/m visit add on |
1,082 |
1,016 |
$1K |
| 90681 |
|
2,637 |
2,506 |
$1K |
| 95874 |
|
57 |
54 |
$1K |
| 51798 |
|
185 |
167 |
$1K |
| G0444 |
Depression screen annual |
398 |
348 |
$1K |
| 92551 |
|
144 |
132 |
$1K |
| 73090 |
|
203 |
143 |
$1K |
| 90473 |
|
83 |
78 |
$1K |
| 93272 |
|
52 |
50 |
$1K |
| J1100 |
Dexamethasone sodium phos |
963 |
863 |
$1K |
| 64490 |
|
14 |
13 |
$1K |
| 83861 |
|
23 |
12 |
$947.48 |
| 99226 |
|
16 |
16 |
$944.25 |
| 93227 |
|
101 |
96 |
$928.97 |
| G0180 |
Md certification hha patient |
121 |
113 |
$918.86 |
| 64643 |
|
19 |
13 |
$859.15 |
| 99348 |
|
64 |
44 |
$848.60 |
| 77063 |
|
57 |
55 |
$846.75 |
| 85651 |
|
249 |
232 |
$835.47 |
| 76825 |
|
12 |
12 |
$701.30 |
| 93295 |
|
80 |
65 |
$700.09 |
| 76827 |
|
25 |
25 |
$662.06 |
| 86334 |
|
59 |
55 |
$656.54 |
| 1090F |
|
202 |
175 |
$643.58 |
| 71046 |
|
42 |
39 |
$620.11 |
| 90381 |
|
43 |
42 |
$594.00 |
| 64491 |
|
14 |
13 |
$581.73 |
| 64492 |
|
13 |
12 |
$547.72 |
| Q4010 |
Cast sup sht arm adult fbrgl |
41 |
40 |
$525.56 |
| 94640 |
|
85 |
81 |
$491.41 |
| 95819 |
|
12 |
12 |
$488.75 |
| 74018 |
|
35 |
31 |
$456.17 |
| 99307 |
|
204 |
146 |
$451.30 |
| 82962 |
|
164 |
139 |
$450.31 |
| 92134 |
|
37 |
37 |
$442.81 |
| 88300 |
|
138 |
135 |
$432.65 |
| 90672 |
|
80 |
74 |
$424.79 |
| 99282 |
|
12 |
12 |
$369.36 |
| 93880 |
|
12 |
12 |
$331.71 |
| 93294 |
|
130 |
106 |
$320.08 |
| J0696 |
Ceftriaxone sodium injection |
211 |
101 |
$303.27 |
| 94664 |
|
29 |
28 |
$302.53 |
| 73560 |
|
42 |
38 |
$293.10 |
| 90480 |
|
12 |
12 |
$280.00 |
| 1101F |
|
8,072 |
7,292 |
$275.38 |
| 51797 |
|
14 |
12 |
$260.32 |
| 90696 |
|
1,434 |
1,377 |
$250.60 |
| G0296 |
Visit to determ ldct elig |
12 |
12 |
$245.10 |
| 93299 |
|
13 |
12 |
$221.23 |
| 94618 |
|
15 |
15 |
$212.03 |
| G8510 |
Scr dep neg, no plan reqd |
2,135 |
1,985 |
$210.52 |
| 88313 |
|
14 |
13 |
$209.20 |
| 90685 |
|
13 |
13 |
$180.42 |
| 82977 |
|
30 |
28 |
$169.49 |
| 51784 |
|
16 |
12 |
$163.31 |
| J1040 |
Methylprednisolone 80 mg inj |
15 |
13 |
$151.44 |
| 90661 |
|
59 |
42 |
$144.00 |
| 51741 |
|
33 |
25 |
$137.92 |
| G0438 |
Ppps, initial visit |
92 |
92 |
$137.69 |
| G0127 |
Trim nail(s) |
15 |
12 |
$129.62 |
| 82746 |
|
20 |
16 |
$125.01 |
| 73552 |
|
12 |
12 |
$114.79 |
| 82248 |
|
12 |
12 |
$111.14 |
| 95970 |
|
12 |
12 |
$104.74 |
| 84481 |
|
13 |
12 |
$96.06 |
| 82043 |
|
28 |
27 |
$87.36 |
| 80076 |
|
26 |
26 |
$78.38 |
| 76514 |
|
13 |
12 |
$72.82 |
| 93288 |
|
17 |
13 |
$71.61 |
| 73140 |
|
29 |
25 |
$69.11 |
| 82950 |
|
17 |
15 |
$62.28 |
| 99439 |
|
13 |
12 |
$60.59 |
| 77080 |
|
13 |
13 |
$49.85 |
| 87210 |
|
13 |
12 |
$48.98 |
| 82570 |
|
13 |
12 |
$48.44 |
| 90707 |
|
1,422 |
1,369 |
$47.16 |
| 99173 |
|
16 |
15 |
$35.02 |
| 84156 |
|
14 |
12 |
$27.76 |
| 36416 |
|
53 |
48 |
$24.00 |
| G0008 |
Admin influenza virus vac |
12 |
12 |
$18.65 |
| 76376 |
|
150 |
143 |
$16.11 |
| 98968 |
|
14 |
12 |
$7.75 |
| J7613 |
Albuterol non-comp unit |
44 |
41 |
$5.00 |
| 3074F |
|
1,233 |
1,063 |
$2.16 |
| 3077F |
|
781 |
698 |
$1.59 |
| 3075F |
|
605 |
559 |
$1.11 |
| 0071A |
|
281 |
220 |
$0.19 |
| 90716 |
|
1,356 |
1,292 |
$0.17 |
| 90700 |
|
1,441 |
1,372 |
$0.16 |
| 3078F |
|
1,299 |
1,106 |
$0.05 |
| 3080F |
|
519 |
469 |
$0.02 |
| 0004A |
|
21 |
20 |
$0.01 |
| 99000 |
|
602 |
582 |
$0.00 |
| G8433 |
Scr for dep not cpt doc rsn |
1,081 |
979 |
$0.00 |
| G0439 |
Ppps, subseq visit |
157 |
128 |
$0.00 |
| 3008F |
|
819 |
794 |
$0.00 |
| 0072A |
|
154 |
109 |
$0.00 |
| 0111A |
|
48 |
33 |
$0.00 |
| 3079F |
|
915 |
833 |
$0.00 |
| 91307 |
|
33 |
32 |
$0.00 |
| 0064A |
|
35 |
26 |
$0.00 |
| 1111F |
|
28 |
25 |
$0.00 |
| 99459 |
|
47 |
45 |
$0.00 |
| 0001A |
|
14 |
12 |
$0.00 |
| 1123F |
|
21 |
16 |
$0.00 |
| G8431 |
Pos clin depres scrn f/u doc |
704 |
643 |
$0.00 |
| D1999 |
|
52 |
36 |
$0.00 |
| J1050 |
Medroxyprogesterone acetate |
23 |
23 |
$0.00 |
| 3288F |
|
111 |
95 |
$0.00 |
| 1100F |
|
81 |
77 |
$0.00 |