Am b Hosp 03 Fee Schedule

of 25 04/08/2023

New York State Workers' Compensation Board

Hospitals - PAS Rates effective 1/1/2003

*** NOTE: Does NOT include the 8.18% Surcharge ***PAS PAS PAS PAS PAS PAS PAS PAS PAS PAS

Opcert Agency Mmisid 1 2 3 4 5 6 7 8 9 101623001 ADIRONDACK MEDICAL HOSP 00363213 $1,111.97 $931.52 $1,696.82 $2,202.65 $700.22 $1,522.59 $1,427.87 $737.69 $1,030.25 $1,410.38 0101005 ALB MED SO CLINICAL CAMPUS 01952712 $1,149.24 $961.53 $1,744.92 $2,247.60 $721.04 $1,581.32 $1,487.12 $752.70 $1,064.10 $1,465.73 0101000 ALBANY MEDICAL CENTER 00277716 $1,336.58 $1,112.45 $1,986.71 $2,473.59 $825.72 $1,876.49 $1,784.94 $828.15 $1,234.28 $1,743.99 3701000 ALBERT LINDLEY LEE 00354105 $1,134.89 $949.98 $1,726.40 $2,230.29 $713.01 $1,558.70 $1,464.30 $746.91 $1,051.07 $1,444.41 1624000 ALICE HYDE MEDICAL CTR 00354114 $1,109.94 $929.88 $1,694.21 $2,200.20 $699.08 $1,519.40 $1,424.64 $736.88 $1,028.42 $1,407.36 2801000 AMSTERDAM MEMORIAL HOSP 00381420 $1,149.24 $961.53 $1,744.92 $2,247.60 $721.04 $1,581.32 $1,487.12 $752.70 $1,064.10 $1,465.73 0701000 ARNOT OGDEN MEMORIAL 00363199 $1,111.49 $931.13 $1,696.20 $2,202.08 $699.95 $1,521.83 $1,427.10 $737.49 $1,029.81 $1,409.66 0501000 AUBURN MEMORIAL HOSPITAL 00347553 $1,084.13 $909.09 $1,660.88 $2,169.06 $684.65 $1,478.72 $1,383.60 $726.47 $1,004.96 $1,369.02 3801000 AURELIA OSBORN FOX 00279098 $1,145.43 $958.47 $1,740.00 $2,243.01 $718.91 $1,575.32 $1,481.06 $751.16 $1,060.64 $1,460.07 4720001 BASSETT HOSPITAL 00302429 $1,234.82 $1,030.47 $1,855.37 $2,350.85 $768.86 $1,716.15 $1,623.17 $787.17 $1,141.85 $1,592.85 7002001 BELLEVUE HOSPITAL CTR 00246039 $1,499.72 $1,243.85 $2,197.25 $2,670.39 $916.88 $2,133.53 $2,044.28 $893.85 $1,382.46 $1,986.30 4652001 BELLEVUE WOMAN'S HOSP 00354132 $1,149.24 $961.53 $1,744.92 $2,247.60 $721.04 $1,581.32 $1,487.12 $752.70 $1,064.10 $1,465.73 5501000 BENEDICTINE HOSPITAL 00274020 $1,143.83 $957.18 $1,737.95 $2,241.09 $718.02 $1,572.80 $1,478.52 $750.53 $1,059.20 $1,457.70 1427000 BERTRAND CHAFFEE HOSPITAL 00354150 $1,131.08 $946.92 $1,721.49 $2,225.70 $710.90 $1,552.71 $1,458.26 $745.38 $1,047.62 $1,438.77 7001041 BETH ISRAEL / KINGS HIGHWAY 00243105 $1,304.10 $1,086.29 $1,944.80 $2,434.43 $807.57 $1,825.32 $1,733.31 $815.07 $1,204.77 $1,695.77 7002004 BETH ISRAEL / NORTH DIVISION 00243105 $1,304.10 $1,086.29 $1,944.80 $2,434.43 $807.57 $1,825.32 $1,733.31 $815.07 $1,204.77 $1,695.77 7002002 BETH ISRAEL MEDICAL CTR 00243105 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 3535001 BON SECOURS COMM HOSP 00273905 $1,176.65 $983.61 $1,780.29 $2,280.68 $736.35 $1,624.50 $1,530.69 $763.74 $1,089.00 $1,506.45 7000001 BRONX-LEBANON HOSP CTR 00476022 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 7001002 BROOKDALE HOSP MED CTR 00243572 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 5123000 BROOKHAVEN MEMORIAL HOSP 00245529 $1,259.37 $1,050.26 $1,887.06 $2,380.47 $782.58 $1,754.84 $1,662.20 $797.06 $1,164.15 $1,629.32 7001003 BROOKLYN HOSPITAL CENTER 00243614 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 0601000 BROOKS MEMORIAL HOSPITAL 00381439 $1,121.63 $939.30 $1,709.28 $2,214.30 $705.62 $1,537.82 $1,443.23 $741.59 $1,039.02 $1,424.73 5120000 BRUNSWICK HOSPITAL CTR 00268295 $1,252.95 $1,045.08 $1,878.78 $2,372.72 $779.00 $1,744.73 $1,652.00 $794.48 $1,158.32 $1,619.79 7002003 CABRINI MEDICAL CENTER 00243132 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 4429000 CANTON-POTSDAM HOSPITAL 00354196 $1,111.97 $931.52 $1,696.82 $2,202.65 $700.22 $1,522.59 $1,427.87 $737.69 $1,030.25 $1,410.38 2238001 CARTHAGE AREA HOSPITAL 00310852 $1,122.12 $939.69 $1,709.93 $2,214.90 $705.89 $1,538.60 $1,444.01 $741.78 $1,039.47 $1,425.45 5263700 CATSKILL REGIONAL / G HERMANN 00273978 $1,143.26 $956.73 $1,737.21 $2,240.40 $717.69 $1,571.90 $1,477.62 $750.29 $1,058.67 $1,456.86 5263000 CATSKILL REGIONAL MED CTR 00273978 $1,143.83 $957.18 $1,737.95 $2,241.09 $718.02 $1,572.80 $1,478.52 $750.53 $1,059.20 $1,457.70 5401001 CAYUGA MEDICAL CENTER 00332729 $1,084.13 $909.09 $1,660.88 $2,169.06 $684.65 $1,478.72 $1,383.60 $726.47 $1,004.96 $1,369.02 5155000 CENTRAL SUFFOLK HOSPITAL 00274328 $1,259.37 $1,050.26 $1,887.06 $2,380.47 $782.58 $1,754.84 $1,662.20 $797.06 $1,164.15 $1,629.32 0901001 CHAMPLAIN VALLEY PHYS 00318814 $1,110.47 $930.32 $1,694.88 $2,200.85 $699.38 $1,520.24 $1,425.50 $737.09 $1,028.90 $1,408.16 0824000 CHENANGO MEMORIAL HOSP 00314723 $1,143.26 $956.73 $1,737.21 $2,240.40 $717.69 $1,571.90 $1,477.62 $750.29 $1,058.67 $1,456.86 7003000 CITY HOSPITAL CENTER 00246075 $1,499.72 $1,243.85 $2,197.25 $2,670.39 $916.88 $2,133.53 $2,044.28 $893.85 $1,382.46 $1,986.30 4401000 CLAXTON-HEPBURN MED CTR 00354072 $1,111.97 $931.52 $1,696.82 $2,202.65 $700.22 $1,522.59 $1,427.87 $737.69 $1,030.25 $1,410.38 3421000 CLIFTON SPRINGS HOSPITAL 00354641 $1,151.22 $963.14 $1,747.47 $2,250.00 $722.15 $1,584.44 $1,490.27 $753.50 $1,065.90 $1,468.68 7003005 CMC (MARY IMMACULATE) 00243861 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 7003008 CMC (ST JOHNS) 00244124 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 7003025 CMC (ST JOSEPHS) 00498531 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 1001000 COLUMBIA MEMORIAL HOSP 00335915 $1,135.59 $950.55 $1,727.31 $2,231.15 $713.42 $1,559.82 $1,465.43 $747.20 $1,051.71 $1,445.48 3301000 COMM GEN / GREATER SYRACUSE 00315004 $1,148.40 $960.86 $1,743.83 $2,246.60 $720.57 $1,579.98 $1,485.78 $752.36 $1,063.34 $1,464.48 5925000 COMM HOSP / DOBBS FERRY 00274066 $1,225.70 $1,023.12 $1,843.59 $2,339.84 $763.76 $1,701.78 $1,608.66 $783.50 $1,133.55 $1,579.31 2625000 COMMUNITY MEMORIAL HOSP 00354229 $1,149.21 $961.52 $1,744.88 $2,247.57 $721.02 $1,581.27 $1,487.07 $752.69 $1,064.07 $1,465.70 7001009 CONEY ISLAND HOSPITAL 00246066 $1,499.72 $1,243.85 $2,197.25 $2,670.39 $916.88 $2,133.53 $2,044.28 $893.85 $1,382.46 $1,986.30 5001000 CORNING HOSPITAL 00361739 $1,103.51 $924.71 $1,685.90 $2,192.45 $695.49 $1,509.26 $1,414.43 $734.28 $1,022.57 $1,397.81 1101000 CORTLAND MEMORIAL HOSP 00279176 $1,085.52 $910.22 $1,662.69 $2,170.76 $685.44 $1,480.92 $1,385.82 $727.04 $1,006.23 $1,371.11 3301008 CROUSE HOSPITAL 00279396 $1,151.39 $963.27 $1,747.68 $2,250.20 $722.24 $1,584.69 $1,490.52 $753.56 $1,066.05 $1,468.92

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Opcert Agency Mmisid 1 2 3 4 5 6 7 8 9 100226700 CUBA MEMORIAL HOSPITAL 00354238 $1,069.83 $897.59 $1,642.44 $2,151.83 $676.67 $1,456.20 $1,360.89 $720.72 $991.98 $1,347.80 1229000 DELAWARE VALLEY HOSPITAL 00347571 $1,143.26 $956.73 $1,737.21 $2,240.40 $717.69 $1,571.90 $1,477.62 $750.29 $1,058.67 $1,456.86 5127000 EASTERN LONG ISLAND HOSP 00274337 $1,259.37 $1,050.26 $1,887.06 $2,380.47 $782.58 $1,754.84 $1,662.20 $797.06 $1,164.15 $1,629.32 2221000 EJ NOBLE / ALEXANDRIA 00354265 $1,122.12 $939.69 $1,709.93 $2,214.90 $705.89 $1,538.60 $1,444.01 $741.78 $1,039.47 $1,425.45 4423000 EJ NOBLE / GOUVERNEUR 00354256 $1,109.94 $929.88 $1,694.21 $2,200.20 $699.08 $1,519.40 $1,424.64 $736.88 $1,028.42 $1,407.36 5526001 ELLENVILLE REGIONAL HOSP 02094860 $1,143.26 $956.73 $1,737.21 $2,240.40 $717.69 $1,571.90 $1,477.62 $750.29 $1,058.67 $1,456.86 4601001 ELLIS HOSPITAL 00347562 $1,148.43 $960.89 $1,743.89 $2,246.64 $720.59 $1,580.04 $1,485.84 $752.37 $1,063.37 $1,464.54 7001024 EPISCOPAL HEALTH SERVICES 00729382 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 1401005 ERIE COUNTY MEDICAL CTR 00245863 $1,318.29 $1,097.70 $1,963.10 $2,451.54 $815.51 $1,847.67 $1,755.86 $820.79 $1,217.66 $1,716.83 3202003 FAXTON-ST LUKES HEALTHCARE 00384309 $1,126.44 $943.17 $1,715.49 $2,220.11 $708.30 $1,545.38 $1,450.86 $743.51 $1,043.39 $1,431.86 7003001 FLUSHING HOSPITAL 00243843 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 2910000 FRANKLIN HOSP MED CTR 00268328 $1,259.37 $1,050.26 $1,887.06 $2,380.47 $782.58 $1,754.84 $1,662.20 $797.06 $1,164.15 $1,629.32 3429000 FREDERICK FERRIS THOMPSON 00362529 $1,151.22 $963.14 $1,747.47 $2,250.00 $722.15 $1,584.44 $1,490.27 $753.50 $1,065.90 $1,468.68 3402000 GENEVA GENERAL HOSPITAL 00378712 $1,151.22 $963.14 $1,747.47 $2,250.00 $722.15 $1,584.44 $1,490.27 $753.50 $1,065.90 $1,468.68 5601000 GLENS FALLS HOSPITAL 00314998 $1,125.08 $942.08 $1,713.74 $2,218.47 $707.54 $1,543.26 $1,448.72 $742.97 $1,042.16 $1,429.86 4329000 GOOD SAMARITAN / SUFFERN 00273941 $1,225.70 $1,023.12 $1,843.59 $2,339.84 $763.76 $1,701.78 $1,608.66 $783.50 $1,133.55 $1,579.31 5154001 GOOD SAMARITAN / WEST ISLIP 00274346 $1,259.37 $1,050.26 $1,887.06 $2,380.47 $782.58 $1,754.84 $1,662.20 $797.06 $1,164.15 $1,629.32 7002009 HARLEM HOSPITAL CENTER 00246108 $1,499.72 $1,243.85 $2,197.25 $2,670.39 $916.88 $2,133.53 $2,044.28 $893.85 $1,382.46 $1,986.30 4322000 HELEN HAYES HOSPITAL 00273950 $1,231.76 $1,028.00 $1,851.41 $2,347.14 $767.15 $1,711.32 $1,618.29 $785.93 $1,139.06 $1,588.29 2701001 HIGHLAND HOSP / ROCHESTER 00354307 $1,152.86 $964.46 $1,749.60 $2,251.98 $723.06 $1,587.03 $1,492.88 $754.16 $1,067.40 $1,471.11 7002012 HOSP FOR SPECIAL SURGERY 00243370 $1,316.30 $1,096.10 $1,960.52 $2,449.13 $814.38 $1,844.52 $1,752.69 $819.98 $1,215.84 $1,713.86 7002011 HOSPITAL FOR JOINT DISEASES 00243389 $1,316.30 $1,096.10 $1,960.52 $2,449.13 $814.38 $1,844.52 $1,752.69 $819.98 $1,215.84 $1,713.86 5901000 HUDSON VALLEY HOSP CTR 00274153 $1,225.70 $1,023.12 $1,843.59 $2,339.84 $763.76 $1,701.78 $1,608.66 $783.50 $1,133.55 $1,579.31 5153000 HUNTINGTON HOSP ASSOC 00274355 $1,259.37 $1,050.26 $1,887.06 $2,380.47 $782.58 $1,754.84 $1,662.20 $797.06 $1,164.15 $1,629.32 3154000 INTER-COMMUNITY MEMORIAL 00354325 $1,132.22 $947.82 $1,722.95 $2,227.07 $711.53 $1,554.50 $1,460.06 $745.85 $1,048.64 $1,440.45 7001046 INTERFAITH MEDICAL CTR 00734336 $1,316.30 $1,096.10 $1,960.52 $2,449.13 $814.38 $1,844.52 $1,752.69 $819.98 $1,215.84 $1,713.86 5022000 IRA DAVENPORT MEMORIAL 00332816 $1,101.53 $923.10 $1,683.35 $2,190.05 $694.38 $1,506.14 $1,411.26 $733.49 $1,020.77 $1,394.87 2906000 ISLAND MEDICAL CENTER 00273285 $1,252.95 $1,045.08 $1,878.78 $2,372.72 $779.00 $1,744.73 $1,652.00 $794.48 $1,158.32 $1,619.79 7000002 JACOBI MEDICAL CENTER 00246048 $1,499.72 $1,243.85 $2,197.25 $2,670.39 $916.88 $2,133.53 $2,044.28 $893.85 $1,382.46 $1,986.30 7003003 JAMAICA HOSPITAL 00243852 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 5149000 JOHN T MATHER MEMORIAL 00274364 $1,259.37 $1,050.26 $1,887.06 $2,380.47 $782.58 $1,754.84 $1,662.20 $797.06 $1,164.15 $1,629.32 0228000 JONES MEMORIAL 00354403 $1,069.83 $897.59 $1,642.44 $2,151.83 $676.67 $1,456.20 $1,360.89 $720.72 $991.98 $1,347.80 1401014 KALEIDA HLTH (BUFFALO GEN) 00361968 $1,318.29 $1,097.70 $1,963.10 $2,451.54 $815.51 $1,847.67 $1,755.86 $820.79 $1,217.66 $1,716.83 1401002 KALEIDA HLTH (CHILD OF BUFF) 00360614 $1,132.61 $948.14 $1,723.44 $2,227.55 $711.74 $1,555.10 $1,460.67 $746.00 $1,049.00 $1,441.02 3103000 KALEIDA HLTH (DEGRAFF) 00354247 $1,132.22 $947.82 $1,722.95 $2,227.07 $711.53 $1,554.50 $1,460.06 $745.85 $1,048.64 $1,440.45 1401009 KALEIDA HLTH (MILLARD) 00384643 $1,318.29 $1,097.70 $1,963.10 $2,451.54 $815.51 $1,847.67 $1,755.86 $820.79 $1,217.66 $1,716.83 1404000 KENMORE MERCY HOSPITAL 00354343 $1,130.33 $946.31 $1,720.50 $2,224.79 $710.46 $1,551.51 $1,457.04 $745.08 $1,046.93 $1,437.63 7001016 KINGS COUNTY HOSPITAL 00246117 $1,499.72 $1,243.85 $2,197.25 $2,670.39 $916.88 $2,133.53 $2,044.28 $893.85 $1,382.46 $1,986.30 7001033 KINGSBROOK JEWISH MEDICAL 00243669 $1,316.30 $1,096.10 $1,960.52 $2,449.13 $814.38 $1,844.52 $1,752.69 $819.98 $1,215.84 $1,713.86 5501001 KINGSTON HOSPITAL 00274048 $1,143.83 $957.18 $1,737.95 $2,241.09 $718.02 $1,572.80 $1,478.52 $750.53 $1,059.20 $1,457.70 2728001 LAKESIDE MEMORIAL HOSP 00279543 $1,151.22 $963.14 $1,747.47 $2,250.00 $722.15 $1,584.44 $1,490.27 $753.50 $1,065.90 $1,468.68 5922000 LAWRENCE HOSPITAL 00274093 $1,225.70 $1,023.12 $1,843.59 $2,339.84 $763.76 $1,701.78 $1,608.66 $783.50 $1,133.55 $1,579.31 7002017 LENOX HILL HOSPITAL 00243421 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 2424000 LEWIS COUNTY GENERAL 00354370 $1,122.12 $939.69 $1,709.93 $2,214.90 $705.89 $1,538.60 $1,444.01 $741.78 $1,039.47 $1,425.45 7000008 LINCOLN MEDICAL & MENTAL 00246126 $1,499.72 $1,243.85 $2,197.25 $2,670.39 $916.88 $2,133.53 $2,044.28 $893.85 $1,382.46 $1,986.30 2129000 LITTLE FALLS HOSPITAL 00310870 $1,127.21 $943.80 $1,716.48 $2,221.04 $708.72 $1,546.61 $1,452.09 $743.82 $1,044.09 $1,433.01 3101000 LOCKPORT MEMORIAL HOSP 00354389 $1,132.22 $947.82 $1,722.95 $2,227.07 $711.53 $1,554.50 $1,460.06 $745.85 $1,048.64 $1,440.45

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Opcert Agency Mmisid 1 2 3 4 5 6 7 8 9 102902000 LONG BEACH MEDICAL CTR 00245487 $1,259.37 $1,050.26 $1,887.06 $2,380.47 $782.58 $1,754.84 $1,662.20 $797.06 $1,164.15 $1,629.32 7001017 LONG ISLAND COLLEGE HOSP 00243678 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 7003004 LONG ISLAND JEWISH 00243903 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 7001019 LUTHERAN MEDICAL CENTER 00243729 $1,316.30 $1,096.10 $1,960.52 $2,449.13 $814.38 $1,844.52 $1,752.69 $819.98 $1,215.84 $1,713.86 7001020 MAIMONIDES MEDICAL CTR 00243641 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 7002019 MANHATTAN EYE EAR & THROAT 00243458 $1,300.95 $1,083.74 $1,940.72 $2,430.62 $805.80 $1,820.34 $1,728.29 $813.80 $1,201.91 $1,691.06 1226701 MARGARETVILLE MEMORIAL 00279387 $1,143.26 $956.73 $1,737.21 $2,240.40 $717.69 $1,571.90 $1,477.62 $750.29 $1,058.67 $1,456.86 3824000 MARY IMOGENE BASSETT 00305000 $1,328.18 $1,105.67 $1,975.86 $2,463.47 $821.03 $1,863.24 $1,771.58 $824.76 $1,226.64 $1,731.51 5721700 MARY MCCLELLAN HOSPITAL 00336952 $1,125.89 $942.72 $1,714.77 $2,219.43 $707.99 $1,544.52 $1,449.99 $743.30 $1,042.89 $1,431.05 4402000 MASSENA MEMORIAL HOSPITAL 00354398 $1,111.97 $931.52 $1,696.82 $2,202.65 $700.22 $1,522.59 $1,427.87 $737.69 $1,030.25 $1,410.38 3622000 MEDINA MEMORIAL HOSPITAL 00310898 $1,139.73 $953.88 $1,732.64 $2,236.14 $715.73 $1,566.33 $1,472.00 $748.86 $1,055.46 $1,451.61 0101003 MEMORIAL HOSP (ALBANY) 00364003 $1,149.24 $961.53 $1,744.92 $2,247.60 $721.04 $1,581.32 $1,487.12 $752.70 $1,064.10 $1,465.73 7002020 MEMORIAL HOSP FOR CANCER 00243467 $1,316.30 $1,096.10 $1,960.52 $2,449.13 $814.38 $1,844.52 $1,752.69 $819.98 $1,215.84 $1,713.86 1401008 MERCY HOSPITAL OF BUFFALO 00354412 $1,130.33 $946.31 $1,720.50 $2,224.79 $710.46 $1,551.51 $1,457.04 $745.08 $1,046.93 $1,437.63 2909000 MERCY MEDICAL CENTER 00274295 $1,259.37 $1,050.26 $1,887.06 $2,380.47 $782.58 $1,754.84 $1,662.20 $797.06 $1,164.15 $1,629.32 7002021 METROPOLITAN HOSPITAL CTR 00246135 $1,499.72 $1,243.85 $2,197.25 $2,670.39 $916.88 $2,133.53 $2,044.28 $893.85 $1,382.46 $1,986.30 7000006 MONTEFIORE HOSPITAL 00243554 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 1564701 MOSES-LUDINGTON HOSPITAL 00360930 $1,130.36 $946.34 $1,720.55 $2,224.83 $710.49 $1,551.57 $1,457.10 $745.10 $1,046.96 $1,437.69 7003015 MOUNT SINAI / WEST QUEENS 00243509 $1,304.10 $1,086.29 $1,944.80 $2,434.43 $807.57 $1,825.32 $1,733.31 $815.07 $1,204.77 $1,695.77 7002024 MOUNT SINAI HOSPITAL 00243509 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 3121001 MOUNT ST MARYS HOSPITAL 01746616 $1,131.45 $947.21 $1,721.96 $2,226.15 $711.09 $1,553.28 $1,458.84 $745.53 $1,047.95 $1,439.31 5903000 MOUNT VERNON HOSPITAL 00274117 $1,225.70 $1,023.12 $1,843.59 $2,339.84 $763.76 $1,701.78 $1,608.66 $783.50 $1,133.55 $1,579.31 2950002 NASSAU HEALTH CARE CORP 01962156 $1,453.16 $1,206.35 $2,137.16 $2,614.23 $890.87 $2,060.18 $1,970.27 $875.10 $1,340.18 $1,917.15 1701000 NATHAN LITTAUER HOSPITAL 00313924 $1,137.17 $951.81 $1,729.34 $2,233.05 $714.29 $1,562.30 $1,467.93 $747.84 $1,053.14 $1,447.80 2952006 NEW ISLAND HOSPITAL 01949875 $1,252.95 $1,045.08 $1,878.78 $2,372.72 $779.00 $1,744.73 $1,652.00 $794.48 $1,158.32 $1,619.79 3102000 NIAGARA FALLS MEMORIAL** 00354467 $1,131.45 $947.21 $1,721.96 $2,226.15 $711.09 $1,553.28 $1,458.84 $745.53 $1,047.95 $1,439.31 2527000 NICHOLAS H NOYES HOSP 00354476 $1,151.22 $963.14 $1,747.47 $2,250.00 $722.15 $1,584.44 $1,490.27 $753.50 $1,065.90 $1,468.68 7000024 NORTH CENTRAL BRONX 00246171 $1,499.72 $1,243.85 $2,197.25 $2,670.39 $916.88 $2,133.53 $2,044.28 $893.85 $1,382.46 $1,986.30 7002052 NORTH GENERAL HOSPITAL 00355142 $1,488.69 $1,234.97 $2,183.03 $2,657.10 $910.71 $2,116.16 $2,026.76 $889.41 $1,372.46 $1,969.94 7003013 NORTH SHORE / FOREST HILLS 00243889 $1,488.69 $1,234.97 $2,183.03 $2,657.10 $910.71 $2,116.16 $2,026.76 $889.41 $1,372.46 $1,969.94 2901000 NORTH SHORE / GLEN COVE 00274240 $1,259.37 $1,050.26 $1,887.06 $2,380.47 $782.58 $1,754.84 $1,662.20 $797.06 $1,164.15 $1,629.32 2952005 NORTH SHORE / PLAINVIEW 00274231 $1,259.37 $1,050.26 $1,887.06 $2,380.47 $782.58 $1,754.84 $1,662.20 $797.06 $1,164.15 $1,629.32 2951001 NORTH SHORE UNIVERSITY 00245510 $1,453.16 $1,206.35 $2,137.16 $2,614.23 $890.87 $2,060.18 $1,970.27 $875.10 $1,340.18 $1,917.15 1327000 NORTHERN DUTCHESS HOSP 00268300 $1,204.14 $1,005.77 $1,815.78 $2,313.84 $751.71 $1,667.82 $1,574.40 $774.81 $1,113.98 $1,547.28 5920000 NORTHERN WESTCHESTER 00274144 $1,225.70 $1,023.12 $1,843.59 $2,339.84 $763.76 $1,701.78 $1,608.66 $783.50 $1,133.55 $1,579.31 7001008 NY COMMUNITY / BROOKLYN 00243696 $1,304.10 $1,086.29 $1,944.80 $2,434.43 $807.57 $1,825.32 $1,733.31 $815.07 $1,204.77 $1,695.77 7002026 NY EYE & EAR INFIRMARY 00243476 $1,304.10 $1,086.29 $1,944.80 $2,434.43 $807.57 $1,825.32 $1,733.31 $815.07 $1,204.77 $1,695.77 7003010 NY MEDICAL CTR OF QUEENS 00244133 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 7001021 NY METHODIST HOSPITAL 00243701 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 7099003 NY PRESBY HOSP (ALLEN) 00243178 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 7002054 NY PRESBY HOSP (NY PAYNE) 00243518 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 7002030 NY PRESBY HOSP (PRESBY) 00243178 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 5906000 NY UNITED HOSPITAL 00274204 $1,225.70 $1,023.12 $1,843.59 $2,339.84 $763.76 $1,701.78 $1,608.66 $783.50 $1,133.55 $1,579.31 7002053 NY UNIV MED CTR (TISCH) 00273116 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 7000025 NY WESTCHESTER SQUARE 00273092 $1,304.10 $1,086.29 $1,944.80 $2,434.43 $807.57 $1,825.32 $1,733.31 $815.07 $1,204.77 $1,695.77 4324000 NYACK HOSPITAL 00243967 $1,225.70 $1,023.12 $1,843.59 $2,339.84 $763.76 $1,701.78 $1,608.66 $783.50 $1,133.55 $1,579.31 7002000 NYU DOWNTOWN HOSPITAL 00647269 $1,484.28 $1,231.41 $2,177.33 $2,651.76 $908.25 $2,109.20 $2,019.74 $887.63 $1,368.44 $1,963.37

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Opcert Agency Mmisid 1 2 3 4 5 6 7 8 9 100401001 OLEAN GENERAL HOSPITAL 00354632 $1,121.79 $939.42 $1,709.49 $2,214.50 $705.69 $1,538.06 $1,443.48 $741.65 $1,039.17 $1,424.96 2601001 ONEIDA CITY HOSPITAL 00310903 $1,149.21 $961.52 $1,744.88 $2,247.57 $721.02 $1,581.27 $1,487.07 $752.69 $1,064.07 $1,465.70 3523000 ORANGE REGIONAL MED CTR 00258379 $1,175.84 $982.97 $1,779.24 $2,279.69 $735.90 $1,623.21 $1,529.40 $763.41 $1,088.27 $1,505.24 3501000 ORANGE REGIONAL(MIDDLETOWN) 00258379 $1,175.84 $982.97 $1,779.24 $2,279.69 $735.90 $1,623.21 $1,529.40 $763.41 $1,088.27 $1,505.24 3702000 OSWEGO HOSPITAL 00354485 $1,134.11 $949.35 $1,725.39 $2,229.36 $712.58 $1,557.48 $1,463.07 $746.61 $1,050.36 $1,443.26 0301001 OUR LADY OF LOURDES HOSP 00337664 $1,114.91 $933.89 $1,700.61 $2,206.20 $701.85 $1,527.23 $1,432.55 $738.87 $1,032.92 $1,414.74 7000005 OUR LADY OF MERCY 00243563 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 1402000 OUR LADY OF VICTORY HOSP 00354494 $1,130.33 $946.31 $1,720.50 $2,224.79 $710.46 $1,551.51 $1,457.04 $745.08 $1,046.93 $1,437.63 2754001 PARK RIDGE HOSPITAL 00378721 $1,153.41 $964.91 $1,750.31 $2,252.64 $723.38 $1,587.89 $1,493.75 $754.38 $1,067.90 $1,471.94 7003020 PARKWAY HOSPITAL 00244151 $1,304.10 $1,086.29 $1,944.80 $2,434.43 $807.57 $1,825.32 $1,733.31 $815.07 $1,204.77 $1,695.77 7003006 PENINSULA HOSPITAL CTR 00243898 $1,316.30 $1,096.10 $1,960.52 $2,449.13 $814.38 $1,844.52 $1,752.69 $819.98 $1,215.84 $1,713.86 5932000 PHELPS MEMORIAL HOSPITAL 00274162 $1,225.70 $1,023.12 $1,843.59 $2,339.84 $763.76 $1,701.78 $1,608.66 $783.50 $1,133.55 $1,579.31 3950000 PUTNAM COMMUNITY HOSPITAL 00258360 $1,207.74 $1,008.66 $1,820.42 $2,318.18 $753.72 $1,673.49 $1,580.12 $776.25 $1,117.25 $1,552.62 7003007 QUEENS HOSPITAL CENTER 00246153 $1,499.72 $1,243.85 $2,197.25 $2,670.39 $916.88 $2,133.53 $2,044.28 $893.85 $1,382.46 $1,986.30 7004010 RICHMOND UNIVERSITY MEDICAL CENTER 00248820 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 2221001 RIVER HOSPITAL** 02392854 $1,122.12 $939.69 $1,709.93 $2,214.90 $705.89 $1,538.60 $1,444.01 $741.78 $1,039.47 $1,425.45 2701003 ROCHESTER GENERAL HOSP 00303315 $1,338.60 $1,114.07 $1,989.30 $2,476.04 $826.85 $1,879.67 $1,788.14 $828.96 $1,236.11 $1,746.99 3201002 ROME HOSPITAL AND MURPHY 00352534 $1,127.21 $943.80 $1,716.48 $2,221.04 $708.72 $1,546.61 $1,452.09 $743.82 $1,044.09 $1,433.01 1401010 ROSWELL PARK MEMORIAL 00354518 $1,133.10 $948.54 $1,724.10 $2,228.15 $712.02 $1,555.89 $1,461.47 $746.21 $1,049.45 $1,441.77 4102002 SAMARITAN HOSPITAL / TROY 00318805 $1,148.43 $960.89 $1,743.89 $2,246.64 $720.59 $1,580.04 $1,485.84 $752.37 $1,063.37 $1,464.54 2201000 SAMARITAN MEDICAL CENTER 00354316 $1,122.66 $940.14 $1,710.62 $2,215.55 $706.19 $1,539.45 $1,444.88 $741.99 $1,039.97 $1,426.26 4501000 SARATOGA HOSPITAL 00303282 $1,148.43 $960.89 $1,743.89 $2,246.64 $720.59 $1,580.04 $1,485.84 $752.37 $1,063.37 $1,464.54 4823000 SCHUYLER HOSPITAL 00363144 $1,101.53 $923.10 $1,683.35 $2,190.05 $694.38 $1,506.14 $1,411.26 $733.49 $1,020.77 $1,394.87 4102003 SETON HEALTH SYSTEMS 01534463 $1,148.43 $960.89 $1,743.89 $2,246.64 $720.59 $1,580.04 $1,485.84 $752.37 $1,063.37 $1,464.54 1401006 SHEEHAN MEMORIAL EMERG 00354545 $1,131.08 $946.92 $1,721.49 $2,225.70 $710.90 $1,552.71 $1,458.26 $745.38 $1,047.62 $1,438.77 7004006 SISTERS OF CHARITY (BAYLEY) 00652328 $1,316.30 $1,096.10 $1,960.52 $2,449.13 $814.38 $1,844.52 $1,752.69 $819.98 $1,215.84 $1,713.86 1401013 SISTERS OF CHARITY HOSP 00354563 $1,133.10 $948.54 $1,724.10 $2,228.15 $712.02 $1,555.89 $1,461.47 $746.21 $1,049.45 $1,441.77 6120000 SOLDIERS AND SAILORS 00336498 $1,083.60 $908.67 $1,660.22 $2,168.43 $684.36 $1,477.91 $1,382.78 $726.26 $1,004.49 $1,368.24 5904000 SOUND SHORE HOSPITAL 00274126 $1,419.18 $1,178.97 $2,093.31 $2,573.24 $871.88 $2,006.64 $1,916.25 $861.42 $1,309.31 $1,866.69 2950001 SOUTH NASSAU COMMUNITIES 00245496 $1,266.71 $1,056.17 $1,896.53 $2,389.32 $786.68 $1,766.40 $1,673.87 $800.01 $1,170.81 $1,640.22 5126000 SOUTHAMPTON HOSP ASSOC 00274406 $1,259.37 $1,050.26 $1,887.06 $2,380.47 $782.58 $1,754.84 $1,662.20 $797.06 $1,164.15 $1,629.32 5154000 SOUTHSIDE HOSPITAL 00268319 $1,259.37 $1,050.26 $1,887.06 $2,380.47 $782.58 $1,754.84 $1,662.20 $797.06 $1,164.15 $1,629.32 5902000 ST AGNES HOSPITAL 00274180 $1,232.73 $1,028.79 $1,852.68 $2,348.33 $767.69 $1,712.87 $1,619.85 $786.33 $1,139.94 $1,589.75 3529000 ST ANTHONY COMMUNITY 00273890 $1,176.65 $983.61 $1,780.29 $2,280.68 $736.35 $1,624.50 $1,530.69 $763.74 $1,089.00 $1,506.45 7000014 ST BARNABAS HOSPITAL 00243361 $1,316.30 $1,096.10 $1,960.52 $2,449.13 $814.38 $1,844.52 $1,752.69 $819.98 $1,215.84 $1,713.86 5157003 ST CATHERINE OF SIENA 02060942 $1,259.37 $1,050.26 $1,887.06 $2,380.47 $782.58 $1,754.84 $1,662.20 $797.06 $1,164.15 $1,629.32 5149001 ST CHARLES HOSPITAL 00274415 $1,259.37 $1,050.26 $1,887.06 $2,380.47 $782.58 $1,754.84 $1,662.20 $797.06 $1,164.15 $1,629.32 4601002 ST CLARE'S / SCHENECTADY 00361748 $1,148.43 $960.89 $1,743.89 $2,246.64 $720.59 $1,580.04 $1,485.84 $752.37 $1,063.37 $1,464.54 7002033 ST CLARES HOSP & HEALTH 00243201 $1,488.69 $1,234.97 $2,183.03 $2,657.10 $910.71 $2,116.16 $2,026.76 $889.41 $1,372.46 $1,969.94 3202002 ST ELIZABETH MED CTR 00279901 $1,126.44 $943.17 $1,715.49 $2,220.11 $708.30 $1,545.38 $1,450.86 $743.51 $1,043.39 $1,431.86 1302000 ST FRANCIS / POUGHKEEPSIE 00273845 $1,205.18 $1,006.59 $1,817.12 $2,315.09 $752.30 $1,669.46 $1,576.05 $775.23 $1,114.92 $1,548.83 2953000 ST FRANCIS HOSP / ROSLYN 00244046 $1,266.71 $1,056.17 $1,896.53 $2,389.32 $786.68 $1,766.40 $1,673.87 $800.01 $1,170.81 $1,640.22 5002001 ST JAMES MERCY HOSPITAL 00363162 $1,103.51 $924.71 $1,685.90 $2,192.45 $695.49 $1,509.26 $1,414.43 $734.28 $1,022.57 $1,397.81 5907001 ST JOHNS RIVERSIDE 00245501 $1,225.70 $1,023.12 $1,843.59 $2,339.84 $763.76 $1,701.78 $1,608.66 $783.50 $1,133.55 $1,579.31 1455000 ST JOSEPH HOSPITAL 00354581 $1,130.33 $946.31 $1,720.50 $2,224.79 $710.46 $1,551.51 $1,457.04 $745.08 $1,046.93 $1,437.63 0701001 ST JOSEPHS / ELMIRA 00363126 $1,111.49 $931.13 $1,696.20 $2,202.08 $699.95 $1,521.83 $1,427.10 $737.49 $1,029.81 $1,409.66 3301003 ST JOSEPHS HOSP & HEALTH 00315013 $1,336.56 $1,112.43 $1,986.69 $2,473.58 $825.71 $1,876.47 $1,784.91 $828.14 $1,234.26 $1,743.98

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Opcert Agency Mmisid 1 2 3 4 5 6 7 8 9 105907002 ST JOSEPHS OF YONKERS 00258920 $1,225.70 $1,023.12 $1,843.59 $2,339.84 $763.76 $1,701.78 $1,608.66 $783.50 $1,133.55 $1,579.31 3502000 ST LUKES / NEWBURGH 00273914 $1,175.84 $982.97 $1,779.24 $2,279.69 $735.90 $1,623.21 $1,529.40 $763.41 $1,088.27 $1,505.24 3522000 ST LUKES CORNWALL / CORNWALL 00273863 $1,176.65 $983.61 $1,780.29 $2,280.68 $736.35 $1,624.50 $1,530.69 $763.74 $1,089.00 $1,506.45 7002032 ST LUKES ROOSEVELT 00354967 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 2801001 ST MARYS AT AMSTERDAM 00351639 $1,148.43 $960.89 $1,743.89 $2,246.64 $720.59 $1,580.04 $1,485.84 $752.37 $1,063.37 $1,464.54 7001025 ST MARYS OF BROOKLYN 00729373 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 0101004 ST PETERS HOSPITAL 00318823 $1,336.58 $1,112.45 $1,986.71 $2,473.59 $825.72 $1,876.49 $1,784.94 $828.15 $1,234.28 $1,743.99 7002037 ST VINCENTS HOSPITAL 00243229 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 7001037 STATE UNIV / DOWNSTATE 00243590 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 5151001 STATE UNIV / STONY BROOK 00357795 $1,453.16 $1,206.35 $2,137.16 $2,614.23 $890.87 $2,060.18 $1,970.27 $875.10 $1,340.18 $1,917.15 7004003 STATEN ISLAND UNIV HOSPITAL 00244202 $1,505.12 $1,248.20 $2,204.22 $2,676.92 $919.89 $2,142.05 $2,052.87 $896.03 $1,387.37 $1,994.33 2701005 STRONG MEMORIAL HOSPITAL 00279034 $1,338.60 $1,114.07 $1,989.30 $2,476.04 $826.85 $1,879.67 $1,788.14 $828.96 $1,236.11 $1,746.99 3301007 SUNY HEALTH SCIENCE CENTER 00354590 $1,336.56 $1,112.43 $1,986.69 $2,473.58 $825.71 $1,876.47 $1,784.91 $828.14 $1,234.26 $1,743.98 1227000 THE HOSPITAL 00313951 $1,143.26 $956.73 $1,737.21 $2,240.40 $717.69 $1,571.90 $1,477.62 $750.29 $1,058.67 $1,456.86 0427000 TLC HEALTH NETWORK 00347544 $1,121.24 $938.99 $1,708.79 $2,213.84 $705.39 $1,537.20 $1,442.61 $741.42 $1,038.68 $1,424.15 0303001 UNITED HEALTH SERVICES 00614755 $1,117.74 $936.17 $1,704.27 $2,209.61 $703.44 $1,531.68 $1,437.05 $740.01 $1,035.50 $1,418.94 1801000 UNITED MEMORIAL (GENESEE) 00354283 $1,071.71 $899.09 $1,644.86 $2,154.08 $677.72 $1,459.14 $1,363.86 $721.47 $993.68 $1,350.57 1302001 VASSAR BROTHERS MED CTR 00273854 $1,203.24 $1,005.03 $1,814.61 $2,312.75 $751.22 $1,666.40 $1,572.96 $774.45 $1,113.15 $1,545.95 7001032 VICTORY MEMORIAL HOSPITAL 00243449 $1,304.10 $1,086.29 $1,944.80 $2,434.43 $807.57 $1,825.32 $1,733.31 $815.07 $1,204.77 $1,695.77 5820000 WAYNE HEALTH CARE 00354458 $1,151.22 $963.14 $1,747.47 $2,250.00 $722.15 $1,584.44 $1,490.27 $753.50 $1,065.90 $1,468.68 5957001 WESTCHESTER MEDICAL CTR 00274213 $1,419.18 $1,178.97 $2,093.31 $2,573.24 $871.88 $2,006.64 $1,916.25 $861.42 $1,309.31 $1,866.69 0632000 WESTFIELD MEMORIAL HOSP 00354614 $1,121.63 $939.30 $1,709.28 $2,214.30 $705.62 $1,537.82 $1,443.23 $741.59 $1,039.02 $1,424.73 5902001 WHITE PLAINS HOSPITAL 00274222 $1,225.70 $1,023.12 $1,843.59 $2,339.84 $763.76 $1,701.78 $1,608.66 $783.50 $1,133.55 $1,579.31 2908000 WINTHROP UNIVERSITY HOSP 00244211 $1,453.16 $1,206.35 $2,137.16 $2,614.23 $890.87 $2,060.18 $1,970.27 $875.10 $1,340.18 $1,917.15 0602001 WOMANS CHRISTIAN ASSOC 00354623 $1,120.86 $938.69 $1,708.31 $2,213.39 $705.18 $1,536.62 $1,442.01 $741.27 $1,038.33 $1,423.59 7001045 WOODHULL MEDICAL CENTER 00698866 $1,499.72 $1,243.85 $2,197.25 $2,670.39 $916.88 $2,133.53 $2,044.28 $893.85 $1,382.46 $1,986.30 7001035 WYCKOFF HEIGHTS HOSPITAL 00243825 $1,316.30 $1,096.10 $1,960.52 $2,449.13 $814.38 $1,844.52 $1,752.69 $819.98 $1,215.84 $1,713.86 6027000 WYOMING COUNTY COMMUNITY 00310889 $1,071.71 $899.09 $1,644.86 $2,154.08 $677.72 $1,459.14 $1,363.86 $721.47 $993.68 $1,350.57

3102000 NIAGARA FALLS** PAS 25 (Lithotripsy Rate) Effective 02/11/2003

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*** NOTE: Does NOT include the 8.18% Surcharge ***

Opcert Agency Mmisid1623001 ADIRONDACK MEDICAL HOSP 003632130101005 ALB MED SO CLINICAL CAMPUS 019527120101000 ALBANY MEDICAL CENTER 002777163701000 ALBERT LINDLEY LEE 003541051624000 ALICE HYDE MEDICAL CTR 003541142801000 AMSTERDAM MEMORIAL HOSP 003814200701000 ARNOT OGDEN MEMORIAL 003631990501000 AUBURN MEMORIAL HOSPITAL 003475533801000 AURELIA OSBORN FOX 002790984720001 BASSETT HOSPITAL 003024297002001 BELLEVUE HOSPITAL CTR 002460394652001 BELLEVUE WOMAN'S HOSP 003541325501000 BENEDICTINE HOSPITAL 002740201427000 BERTRAND CHAFFEE HOSPITAL 003541507001041 BETH ISRAEL / KINGS HIGHWAY 002431057002004 BETH ISRAEL / NORTH DIVISION 002431057002002 BETH ISRAEL MEDICAL CTR 002431053535001 BON SECOURS COMM HOSP 002739057000001 BRONX-LEBANON HOSP CTR 004760227001002 BROOKDALE HOSP MED CTR 002435725123000 BROOKHAVEN MEMORIAL HOSP 002455297001003 BROOKLYN HOSPITAL CENTER 002436140601000 BROOKS MEMORIAL HOSPITAL 003814395120000 BRUNSWICK HOSPITAL CTR 002682957002003 CABRINI MEDICAL CENTER 002431324429000 CANTON-POTSDAM HOSPITAL 003541962238001 CARTHAGE AREA HOSPITAL 003108525263700 CATSKILL REGIONAL / G HERMANN 002739785263000 CATSKILL REGIONAL MED CTR 002739785401001 CAYUGA MEDICAL CENTER 003327295155000 CENTRAL SUFFOLK HOSPITAL 002743280901001 CHAMPLAIN VALLEY PHYS 003188140824000 CHENANGO MEMORIAL HOSP 003147237003000 CITY HOSPITAL CENTER 002460754401000 CLAXTON-HEPBURN MED CTR 003540723421000 CLIFTON SPRINGS HOSPITAL 003546417003005 CMC (MARY IMMACULATE) 002438617003008 CMC (ST JOHNS) 002441247003025 CMC (ST JOSEPHS) 004985311001000 COLUMBIA MEMORIAL HOSP 003359153301000 COMM GEN / GREATER SYRACUSE 003150045925000 COMM HOSP / DOBBS FERRY 002740662625000 COMMUNITY MEMORIAL HOSP 003542297001009 CONEY ISLAND HOSPITAL 002460665001000 CORNING HOSPITAL 003617391101000 CORTLAND MEMORIAL HOSP 002791763301008 CROUSE HOSPITAL 00279396

PAS PAS PAS PAS PAS PAS PAS PAS PAS PAS

11 12 13 14 15 16 17 18 19 20$872.13 $732.68 $865.29 $2,114.90 $1,462.77 $982.05 $560.45 $680.93 $789.99 $603.63 $899.42 $760.34 $897.92 $2,157.38 $1,523.40 $1,018.11 $579.89 $707.88 $815.60 $627.20

$1,036.56 $899.36 $1,061.93 $2,370.87 $1,828.19 $1,199.40 $677.58 $843.35 $944.34 $745.65 $888.92 $749.69 $885.35 $2,141.03 $1,500.06 $1,004.22 $572.40 $697.50 $805.74 $618.12 $870.66 $731.18 $863.52 $2,112.60 $1,459.49 $980.09 $559.40 $679.47 $788.60 $602.36 $899.42 $760.34 $897.92 $2,157.38 $1,523.40 $1,018.11 $579.89 $707.88 $815.60 $627.20 $871.79 $732.33 $864.87 $2,114.36 $1,461.99 $981.59 $560.21 $680.58 $789.66 $603.33 $851.75 $712.02 $840.92 $2,083.17 $1,417.47 $955.10 $545.93 $660.80 $770.85 $586.04 $896.63 $757.52 $894.59 $2,153.04 $1,517.21 $1,014.42 $577.89 $705.12 $812.99 $624.80 $962.07 $823.85 $972.84 $2,254.91 $1,662.63 $1,100.93 $624.51 $769.77 $874.41 $681.32

$1,155.98 $1,020.42 $1,204.76 $2,556.78 $2,093.58 $1,357.28 $762.65 $961.32 $1,056.44 $848.79 $899.42 $760.34 $897.92 $2,157.38 $1,523.40 $1,018.11 $579.89 $707.88 $815.60 $627.20 $895.46 $756.33 $893.19 $2,151.21 $1,514.61 $1,012.88 $577.07 $703.97 $811.89 $623.78 $886.13 $746.87 $882.02 $2,136.69 $1,493.88 $1,000.55 $570.42 $694.76 $803.13 $615.72

$1,012.79 $875.27 $1,033.50 $2,333.87 $1,775.36 $1,167.98 $660.65 $819.87 $922.02 $725.12 $1,012.79 $875.27 $1,033.50 $2,333.87 $1,775.36 $1,167.98 $660.65 $819.87 $922.02 $725.12 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21

$919.49 $780.68 $921.92 $2,188.61 $1,568.00 $1,044.65 $594.18 $727.70 $834.44 $644.54 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21

$980.04 $842.07 $994.34 $2,282.88 $1,702.58 $1,124.70 $637.32 $787.53 $891.29 $696.84 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21

$879.21 $739.86 $873.75 $2,125.92 $1,478.49 $991.40 $565.49 $687.92 $796.64 $609.75 $975.35 $837.30 $988.73 $2,275.58 $1,692.14 $1,118.48 $633.98 $782.88 $886.88 $692.78

$1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $872.13 $732.68 $865.29 $2,114.90 $1,462.77 $982.05 $560.45 $680.93 $789.99 $603.63 $879.57 $740.22 $874.19 $2,126.48 $1,479.30 $991.88 $565.74 $688.28 $796.97 $610.05 $895.05 $755.91 $892.68 $2,150.57 $1,513.70 $1,012.34 $576.77 $703.56 $811.50 $623.42 $895.46 $756.33 $893.19 $2,151.21 $1,514.61 $1,012.88 $577.07 $703.97 $811.89 $623.78 $851.75 $712.02 $840.92 $2,083.17 $1,417.47 $955.10 $545.93 $660.80 $770.85 $586.04 $980.04 $842.07 $994.34 $2,282.88 $1,702.58 $1,124.70 $637.32 $787.53 $891.29 $696.84 $871.04 $731.58 $863.99 $2,113.20 $1,460.34 $980.60 $559.67 $679.85 $788.96 $602.69 $895.05 $755.91 $892.68 $2,150.57 $1,513.70 $1,012.34 $576.77 $703.56 $811.50 $623.42

$1,155.98 $1,020.42 $1,204.76 $2,556.78 $2,093.58 $1,357.28 $762.65 $961.32 $1,056.44 $848.79 $872.13 $732.68 $865.29 $2,114.90 $1,462.77 $982.05 $560.45 $680.93 $789.99 $603.63 $900.87 $761.81 $899.66 $2,159.64 $1,526.64 $1,020.03 $580.92 $709.32 $816.96 $628.46

$1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21

$889.43 $750.21 $885.98 $2,141.84 $1,501.22 $1,004.91 $572.78 $698.01 $806.22 $618.57 $898.80 $759.72 $897.18 $2,156.42 $1,522.04 $1,017.30 $579.45 $707.27 $815.03 $626.67 $955.40 $817.08 $964.86 $2,244.51 $1,647.80 $1,092.11 $619.76 $763.17 $868.14 $675.54 $899.40 $760.32 $897.90 $2,157.35 $1,523.37 $1,018.08 $579.87 $707.87 $815.58 $627.18

$1,155.98 $1,020.42 $1,204.76 $2,556.78 $2,093.58 $1,357.28 $762.65 $961.32 $1,056.44 $848.79 $865.95 $726.41 $857.88 $2,105.27 $1,449.02 $973.86 $556.04 $674.82 $784.17 $598.29 $852.78 $713.06 $842.13 $2,084.76 $1,419.75 $956.46 $546.66 $661.80 $771.83 $586.92 $900.99 $761.93 $899.79 $2,159.82 $1,526.90 $1,020.20 $581.00 $709.43 $817.08 $628.56

of 25 04/08/2023




Opcert Agency Mmisid0226700 CUBA MEMORIAL HOSPITAL 003542381229000 DELAWARE VALLEY HOSPITAL 003475715127000 EASTERN LONG ISLAND HOSP 002743372221000 EJ NOBLE / ALEXANDRIA 003542654423000 EJ NOBLE / GOUVERNEUR 003542565526001 ELLENVILLE REGIONAL HOSP 020948604601001 ELLIS HOSPITAL 003475627001024 EPISCOPAL HEALTH SERVICES 007293821401005 ERIE COUNTY MEDICAL CTR 002458633202003 FAXTON-ST LUKES HEALTHCARE 003843097003001 FLUSHING HOSPITAL 002438432910000 FRANKLIN HOSP MED CTR 002683283429000 FREDERICK FERRIS THOMPSON 003625293402000 GENEVA GENERAL HOSPITAL 003787125601000 GLENS FALLS HOSPITAL 003149984329000 GOOD SAMARITAN / SUFFERN 002739415154001 GOOD SAMARITAN / WEST ISLIP 002743467002009 HARLEM HOSPITAL CENTER 002461084322000 HELEN HAYES HOSPITAL 002739502701001 HIGHLAND HOSP / ROCHESTER 003543077002012 HOSP FOR SPECIAL SURGERY 002433707002011 HOSPITAL FOR JOINT DISEASES 002433895901000 HUDSON VALLEY HOSP CTR 002741535153000 HUNTINGTON HOSP ASSOC 002743553154000 INTER-COMMUNITY MEMORIAL 003543257001046 INTERFAITH MEDICAL CTR 007343365022000 IRA DAVENPORT MEMORIAL 003328162906000 ISLAND MEDICAL CENTER 002732857000002 JACOBI MEDICAL CENTER 002460487003003 JAMAICA HOSPITAL 002438525149000 JOHN T MATHER MEMORIAL 002743640228000 JONES MEMORIAL 003544031401014 KALEIDA HLTH (BUFFALO GEN) 003619681401002 KALEIDA HLTH (CHILD OF BUFF) 003606143103000 KALEIDA HLTH (DEGRAFF) 003542471401009 KALEIDA HLTH (MILLARD) 003846431404000 KENMORE MERCY HOSPITAL 003543437001016 KINGS COUNTY HOSPITAL 002461177001033 KINGSBROOK JEWISH MEDICAL 002436695501001 KINGSTON HOSPITAL 002740482728001 LAKESIDE MEMORIAL HOSP 002795435922000 LAWRENCE HOSPITAL 002740937002017 LENOX HILL HOSPITAL 002434212424000 LEWIS COUNTY GENERAL 003543707000008 LINCOLN MEDICAL & MENTAL 002461262129000 LITTLE FALLS HOSPITAL 003108703101000 LOCKPORT MEMORIAL HOSP 00354389


11 12 13 14 15 16 17 18 19 20$841.29 $701.42 $828.41 $2,066.88 $1,394.24 $941.28 $538.47 $650.46 $761.04 $576.99 $895.05 $755.91 $892.68 $2,150.57 $1,513.70 $1,012.34 $576.77 $703.56 $811.50 $623.42 $980.04 $842.07 $994.34 $2,282.88 $1,702.58 $1,124.70 $637.32 $787.53 $891.29 $696.84 $879.57 $740.22 $874.19 $2,126.48 $1,479.30 $991.88 $565.74 $688.28 $796.97 $610.05 $870.66 $731.18 $863.52 $2,112.60 $1,459.49 $980.09 $559.40 $679.47 $788.60 $602.36 $895.05 $755.91 $892.68 $2,150.57 $1,513.70 $1,012.34 $576.77 $703.56 $811.50 $623.42 $898.83 $759.75 $897.21 $2,156.46 $1,522.10 $1,017.33 $579.47 $707.30 $815.06 $626.69

$1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $1,023.17 $885.80 $1,045.92 $2,350.02 $1,798.43 $1,181.70 $668.04 $830.13 $931.77 $734.09

$882.72 $743.42 $877.95 $2,131.40 $1,486.31 $996.05 $567.99 $691.40 $799.94 $612.78 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21

$980.04 $842.07 $994.34 $2,282.88 $1,702.58 $1,124.70 $637.32 $787.53 $891.29 $696.84 $900.87 $761.81 $899.66 $2,159.64 $1,526.64 $1,020.03 $580.92 $709.32 $816.96 $628.46 $900.87 $761.81 $899.66 $2,159.64 $1,526.64 $1,020.03 $580.92 $709.32 $816.96 $628.46 $881.73 $742.41 $876.77 $2,129.85 $1,484.12 $994.74 $567.29 $690.42 $799.01 $611.93 $955.40 $817.08 $964.86 $2,244.51 $1,647.80 $1,092.11 $619.76 $763.17 $868.14 $675.54 $980.04 $842.07 $994.34 $2,282.88 $1,702.58 $1,124.70 $637.32 $787.53 $891.29 $696.84

$1,155.98 $1,020.42 $1,204.76 $2,556.78 $2,093.58 $1,357.28 $762.65 $961.32 $1,056.44 $848.79 $959.82 $821.57 $970.16 $2,251.41 $1,657.64 $1,097.96 $622.91 $767.55 $872.30 $679.37 $902.07 $763.04 $901.10 $2,161.50 $1,529.31 $1,021.62 $581.78 $710.51 $818.09 $629.49

$1,021.71 $884.31 $1,044.17 $2,347.76 $1,795.19 $1,179.78 $666.99 $828.68 $930.39 $732.83 $1,021.71 $884.31 $1,044.17 $2,347.76 $1,795.19 $1,179.78 $666.99 $828.68 $930.39 $732.83

$955.40 $817.08 $964.86 $2,244.51 $1,647.80 $1,092.11 $619.76 $763.17 $868.14 $675.54 $980.04 $842.07 $994.34 $2,282.88 $1,702.58 $1,124.70 $637.32 $787.53 $891.29 $696.84 $886.95 $747.71 $883.02 $2,137.98 $1,495.71 $1,001.64 $571.01 $695.57 $803.90 $616.44

$1,021.71 $884.31 $1,044.17 $2,347.76 $1,795.19 $1,179.78 $666.99 $828.68 $930.39 $732.83 $864.50 $724.94 $856.14 $2,103.00 $1,445.79 $971.94 $555.00 $673.38 $782.82 $597.03 $975.35 $837.30 $988.73 $2,275.58 $1,692.14 $1,118.48 $633.98 $782.88 $886.88 $692.78

$1,155.98 $1,020.42 $1,204.76 $2,556.78 $2,093.58 $1,357.28 $762.65 $961.32 $1,056.44 $848.79 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21

$980.04 $842.07 $994.34 $2,282.88 $1,702.58 $1,124.70 $637.32 $787.53 $891.29 $696.84 $841.29 $701.42 $828.41 $2,066.88 $1,394.24 $941.28 $538.47 $650.46 $761.04 $576.99

$1,023.17 $885.80 $1,045.92 $2,350.02 $1,798.43 $1,181.70 $668.04 $830.13 $931.77 $734.09 $887.24 $747.99 $883.35 $2,138.42 $1,496.34 $1,002.02 $571.22 $695.85 $804.17 $616.68 $886.95 $747.71 $883.02 $2,137.98 $1,495.71 $1,001.64 $571.01 $695.57 $803.90 $616.44

$1,023.17 $885.80 $1,045.92 $2,350.02 $1,798.43 $1,181.70 $668.04 $830.13 $931.77 $734.09 $885.57 $746.30 $881.36 $2,135.82 $1,492.64 $999.81 $570.02 $694.20 $802.61 $615.24

$1,155.98 $1,020.42 $1,204.76 $2,556.78 $2,093.58 $1,357.28 $762.65 $961.32 $1,056.44 $848.79 $1,021.71 $884.31 $1,044.17 $2,347.76 $1,795.19 $1,179.78 $666.99 $828.68 $930.39 $732.83

$895.46 $756.33 $893.19 $2,151.21 $1,514.61 $1,012.88 $577.07 $703.97 $811.89 $623.78 $900.87 $761.81 $899.66 $2,159.64 $1,526.64 $1,020.03 $580.92 $709.32 $816.96 $628.46 $955.40 $817.08 $964.86 $2,244.51 $1,647.80 $1,092.11 $619.76 $763.17 $868.14 $675.54

$1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $879.57 $740.22 $874.19 $2,126.48 $1,479.30 $991.88 $565.74 $688.28 $796.97 $610.05

$1,155.98 $1,020.42 $1,204.76 $2,556.78 $2,093.58 $1,357.28 $762.65 $961.32 $1,056.44 $848.79 $883.29 $744.00 $878.63 $2,132.28 $1,487.58 $996.80 $568.40 $691.95 $800.46 $613.28 $886.95 $747.71 $883.02 $2,137.98 $1,495.71 $1,001.64 $571.01 $695.57 $803.90 $616.44

of 25 04/08/2023




Opcert Agency Mmisid2902000 LONG BEACH MEDICAL CTR 002454877001017 LONG ISLAND COLLEGE HOSP 002436787003004 LONG ISLAND JEWISH 002439037001019 LUTHERAN MEDICAL CENTER 002437297001020 MAIMONIDES MEDICAL CTR 002436417002019 MANHATTAN EYE EAR & THROAT 002434581226701 MARGARETVILLE MEMORIAL 002793873824000 MARY IMOGENE BASSETT 003050005721700 MARY MCCLELLAN HOSPITAL 003369524402000 MASSENA MEMORIAL HOSPITAL 003543983622000 MEDINA MEMORIAL HOSPITAL 003108980101003 MEMORIAL HOSP (ALBANY) 003640037002020 MEMORIAL HOSP FOR CANCER 002434671401008 MERCY HOSPITAL OF BUFFALO 003544122909000 MERCY MEDICAL CENTER 002742957002021 METROPOLITAN HOSPITAL CTR 002461357000006 MONTEFIORE HOSPITAL 002435541564701 MOSES-LUDINGTON HOSPITAL 003609307003015 MOUNT SINAI / WEST QUEENS 002435097002024 MOUNT SINAI HOSPITAL 002435093121001 MOUNT ST MARYS HOSPITAL 017466165903000 MOUNT VERNON HOSPITAL 002741172950002 NASSAU HEALTH CARE CORP 019621561701000 NATHAN LITTAUER HOSPITAL 003139242952006 NEW ISLAND HOSPITAL 019498753102000 NIAGARA FALLS MEMORIAL** 003544672527000 NICHOLAS H NOYES HOSP 003544767000024 NORTH CENTRAL BRONX 002461717002052 NORTH GENERAL HOSPITAL 003551427003013 NORTH SHORE / FOREST HILLS 002438892901000 NORTH SHORE / GLEN COVE 002742402952005 NORTH SHORE / PLAINVIEW 002742312951001 NORTH SHORE UNIVERSITY 002455101327000 NORTHERN DUTCHESS HOSP 002683005920000 NORTHERN WESTCHESTER 002741447001008 NY COMMUNITY / BROOKLYN 002436967002026 NY EYE & EAR INFIRMARY 002434767003010 NY MEDICAL CTR OF QUEENS 002441337001021 NY METHODIST HOSPITAL 002437017099003 NY PRESBY HOSP (ALLEN) 002431787002054 NY PRESBY HOSP (NY PAYNE) 002435187002030 NY PRESBY HOSP (PRESBY) 002431785906000 NY UNITED HOSPITAL 002742047002053 NY UNIV MED CTR (TISCH) 002731167000025 NY WESTCHESTER SQUARE 002730924324000 NYACK HOSPITAL 002439677002000 NYU DOWNTOWN HOSPITAL 00647269


11 12 13 14 15 16 17 18 19 20$980.04 $842.07 $994.34 $2,282.88 $1,702.58 $1,124.70 $637.32 $787.53 $891.29 $696.84

$1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $1,021.71 $884.31 $1,044.17 $2,347.76 $1,795.19 $1,179.78 $666.99 $828.68 $930.39 $732.83 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $1,010.48 $872.91 $1,030.74 $2,330.27 $1,770.21 $1,164.92 $659.00 $817.59 $919.85 $723.12

$895.05 $755.91 $892.68 $2,150.57 $1,513.70 $1,012.34 $576.77 $703.56 $811.50 $623.42 $1,030.41 $893.13 $1,054.58 $2,361.29 $1,814.51 $1,191.27 $673.20 $837.27 $938.57 $740.34

$882.33 $743.01 $877.47 $2,130.77 $1,485.42 $995.52 $567.71 $690.99 $799.55 $612.44 $872.13 $732.68 $865.29 $2,114.90 $1,462.77 $982.05 $560.45 $680.93 $789.99 $603.63 $892.46 $753.29 $889.59 $2,146.53 $1,507.94 $1,008.92 $574.92 $701.00 $809.07 $621.18 $899.42 $760.34 $897.92 $2,157.38 $1,523.40 $1,018.11 $579.89 $707.88 $815.60 $627.20

$1,021.71 $884.31 $1,044.17 $2,347.76 $1,795.19 $1,179.78 $666.99 $828.68 $930.39 $732.83 $885.57 $746.30 $881.36 $2,135.82 $1,492.64 $999.81 $570.02 $694.20 $802.61 $615.24 $980.04 $842.07 $994.34 $2,282.88 $1,702.58 $1,124.70 $637.32 $787.53 $891.29 $696.84

$1,155.98 $1,020.42 $1,204.76 $2,556.78 $2,093.58 $1,357.28 $762.65 $961.32 $1,056.44 $848.79 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21

$885.60 $746.33 $881.39 $2,135.87 $1,492.70 $999.84 $570.05 $694.23 $802.62 $615.27 $1,012.79 $875.27 $1,033.50 $2,333.87 $1,775.36 $1,167.98 $660.65 $819.87 $922.02 $725.12 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21

$886.40 $747.14 $882.35 $2,137.11 $1,494.48 $1,000.91 $570.62 $695.03 $803.37 $615.96 $955.40 $817.08 $964.86 $2,244.51 $1,647.80 $1,092.11 $619.76 $763.17 $868.14 $675.54

$1,121.90 $985.88 $1,164.00 $2,503.73 $2,017.85 $1,312.23 $738.38 $927.66 $1,024.44 $819.36 $890.58 $751.38 $887.36 $2,143.62 $1,503.77 $1,006.43 $573.59 $699.15 $807.30 $619.56 $975.35 $837.30 $988.73 $2,275.58 $1,692.14 $1,118.48 $633.98 $782.88 $886.88 $692.78 $886.40 $747.14 $882.35 $2,137.11 $1,494.48 $1,000.91 $570.62 $695.03 $803.37 $615.96 $900.87 $761.81 $899.66 $2,159.64 $1,526.64 $1,020.03 $580.92 $709.32 $816.96 $628.46

$1,155.98 $1,020.42 $1,204.76 $2,556.78 $2,093.58 $1,357.28 $762.65 $961.32 $1,056.44 $848.79 $1,147.91 $1,012.25 $1,195.11 $2,544.23 $2,075.66 $1,346.61 $756.90 $953.36 $1,048.86 $841.82 $1,147.91 $1,012.25 $1,195.11 $2,544.23 $2,075.66 $1,346.61 $756.90 $953.36 $1,048.86 $841.82

$980.04 $842.07 $994.34 $2,282.88 $1,702.58 $1,124.70 $637.32 $787.53 $891.29 $696.84 $980.04 $842.07 $994.34 $2,282.88 $1,702.58 $1,124.70 $637.32 $787.53 $891.29 $696.84

$1,121.90 $985.88 $1,164.00 $2,503.73 $2,017.85 $1,312.23 $738.38 $927.66 $1,024.44 $819.36 $939.62 $801.09 $945.99 $2,219.94 $1,612.73 $1,071.24 $608.52 $747.59 $853.34 $661.92 $955.40 $817.08 $964.86 $2,244.51 $1,647.80 $1,092.11 $619.76 $763.17 $868.14 $675.54

$1,012.79 $875.27 $1,033.50 $2,333.87 $1,775.36 $1,167.98 $660.65 $819.87 $922.02 $725.12 $1,012.79 $875.27 $1,033.50 $2,333.87 $1,775.36 $1,167.98 $660.65 $819.87 $922.02 $725.12 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21

$955.40 $817.08 $964.86 $2,244.51 $1,647.80 $1,092.11 $619.76 $763.17 $868.14 $675.54 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $1,012.79 $875.27 $1,033.50 $2,333.87 $1,775.36 $1,167.98 $660.65 $819.87 $922.02 $725.12

$955.40 $817.08 $964.86 $2,244.51 $1,647.80 $1,092.11 $619.76 $763.17 $868.14 $675.54 $1,144.68 $1,008.96 $1,191.24 $2,539.19 $2,068.47 $1,342.34 $754.59 $950.16 $1,045.83 $839.03

of 25 04/08/2023




Opcert Agency Mmisid0401001 OLEAN GENERAL HOSPITAL 003546322601001 ONEIDA CITY HOSPITAL 003109033523000 ORANGE REGIONAL MED CTR 002583793501000 ORANGE REGIONAL(MIDDLETOWN) 002583793702000 OSWEGO HOSPITAL 003544850301001 OUR LADY OF LOURDES HOSP 003376647000005 OUR LADY OF MERCY 002435631402000 OUR LADY OF VICTORY HOSP 003544942754001 PARK RIDGE HOSPITAL 003787217003020 PARKWAY HOSPITAL 002441517003006 PENINSULA HOSPITAL CTR 002438985932000 PHELPS MEMORIAL HOSPITAL 002741623950000 PUTNAM COMMUNITY HOSPITAL 002583607003007 QUEENS HOSPITAL CENTER 002461537004010 RICHMOND UNIVERSITY MEDICAL CENTER 002488202221001 RIVER HOSPITAL** 023928542701003 ROCHESTER GENERAL HOSP 003033153201002 ROME HOSPITAL AND MURPHY 003525341401010 ROSWELL PARK MEMORIAL 003545184102002 SAMARITAN HOSPITAL / TROY 003188052201000 SAMARITAN MEDICAL CENTER 003543164501000 SARATOGA HOSPITAL 003032824823000 SCHUYLER HOSPITAL 003631444102003 SETON HEALTH SYSTEMS 015344631401006 SHEEHAN MEMORIAL EMERG 003545457004006 SISTERS OF CHARITY (BAYLEY) 006523281401013 SISTERS OF CHARITY HOSP 003545636120000 SOLDIERS AND SAILORS 003364985904000 SOUND SHORE HOSPITAL 002741262950001 SOUTH NASSAU COMMUNITIES 002454965126000 SOUTHAMPTON HOSP ASSOC 002744065154000 SOUTHSIDE HOSPITAL 002683195902000 ST AGNES HOSPITAL 002741803529000 ST ANTHONY COMMUNITY 002738907000014 ST BARNABAS HOSPITAL 002433615157003 ST CATHERINE OF SIENA 020609425149001 ST CHARLES HOSPITAL 002744154601002 ST CLARE'S / SCHENECTADY 003617487002033 ST CLARES HOSP & HEALTH 002432013202002 ST ELIZABETH MED CTR 002799011302000 ST FRANCIS / POUGHKEEPSIE 002738452953000 ST FRANCIS HOSP / ROSLYN 002440465002001 ST JAMES MERCY HOSPITAL 003631625907001 ST JOHNS RIVERSIDE 002455011455000 ST JOSEPH HOSPITAL 003545810701001 ST JOSEPHS / ELMIRA 003631263301003 ST JOSEPHS HOSP & HEALTH 00315013


11 12 13 14 15 16 17 18 19 20$879.33 $739.97 $873.89 $2,126.09 $1,478.75 $991.55 $565.58 $688.04 $796.74 $609.84 $899.40 $760.32 $897.90 $2,157.35 $1,523.37 $1,018.08 $579.87 $707.87 $815.58 $627.18 $918.89 $780.08 $921.20 $2,187.69 $1,566.68 $1,043.85 $593.75 $727.11 $833.88 $644.01 $918.89 $780.08 $921.20 $2,187.69 $1,566.68 $1,043.85 $593.75 $727.11 $833.88 $644.01 $888.35 $749.12 $884.67 $2,140.14 $1,498.80 $1,003.47 $572.00 $696.95 $805.20 $617.64 $874.29 $734.87 $867.86 $2,118.26 $1,467.56 $984.89 $561.98 $683.06 $792.02 $605.49

$1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $885.57 $746.30 $881.36 $2,135.82 $1,492.64 $999.81 $570.02 $694.20 $802.61 $615.24 $902.48 $763.44 $901.58 $2,162.13 $1,530.20 $1,022.16 $582.06 $710.90 $818.48 $629.84

$1,012.79 $875.27 $1,033.50 $2,333.87 $1,775.36 $1,167.98 $660.65 $819.87 $922.02 $725.12 $1,021.71 $884.31 $1,044.17 $2,347.76 $1,795.19 $1,179.78 $666.99 $828.68 $930.39 $732.83

$955.40 $817.08 $964.86 $2,244.51 $1,647.80 $1,092.11 $619.76 $763.17 $868.14 $675.54 $942.24 $803.75 $949.14 $2,224.04 $1,618.58 $1,074.72 $610.40 $750.18 $855.80 $664.19

$1,155.98 $1,020.42 $1,204.76 $2,556.78 $2,093.58 $1,357.28 $762.65 $961.32 $1,056.44 $848.79 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21

$879.57 $740.22 $874.19 $2,126.48 $1,479.30 $991.88 $565.74 $688.28 $796.97 $610.05 $1,038.03 $900.86 $1,063.70 $2,373.17 $1,831.47 $1,201.35 $678.63 $844.82 $945.72 $746.93

$883.29 $744.00 $878.63 $2,132.28 $1,487.58 $996.80 $568.40 $691.95 $800.46 $613.28 $887.61 $748.37 $883.80 $2,138.99 $1,497.17 $1,002.50 $571.47 $696.21 $804.51 $617.00 $898.83 $759.75 $897.21 $2,156.46 $1,522.10 $1,017.33 $579.47 $707.30 $815.06 $626.69 $879.96 $740.63 $874.65 $2,127.09 $1,480.19 $992.40 $566.03 $688.67 $797.34 $610.40 $898.83 $759.75 $897.21 $2,156.46 $1,522.10 $1,017.33 $579.47 $707.30 $815.06 $626.69 $864.50 $724.94 $856.14 $2,103.00 $1,445.79 $971.94 $555.00 $673.38 $782.82 $597.03 $898.83 $759.75 $897.21 $2,156.46 $1,522.10 $1,017.33 $579.47 $707.30 $815.06 $626.69 $886.13 $746.87 $882.02 $2,136.69 $1,493.88 $1,000.55 $570.42 $694.76 $803.13 $615.72

$1,021.71 $884.31 $1,044.17 $2,347.76 $1,795.19 $1,179.78 $666.99 $828.68 $930.39 $732.83 $887.61 $748.37 $883.80 $2,138.99 $1,497.17 $1,002.50 $571.47 $696.21 $804.51 $617.00 $851.37 $711.63 $840.45 $2,082.59 $1,416.63 $954.60 $545.66 $660.42 $770.51 $585.71

$1,097.03 $960.66 $1,134.26 $2,465.01 $1,962.57 $1,279.34 $720.65 $903.09 $1,001.10 $797.87 $985.41 $847.52 $1,000.77 $2,291.25 $1,714.52 $1,131.80 $641.15 $792.83 $896.33 $701.48 $980.04 $842.07 $994.34 $2,282.88 $1,702.58 $1,124.70 $637.32 $787.53 $891.29 $696.84 $980.04 $842.07 $994.34 $2,282.88 $1,702.58 $1,124.70 $637.32 $787.53 $891.29 $696.84 $960.54 $822.30 $971.01 $2,252.52 $1,659.24 $1,098.92 $623.43 $768.26 $872.97 $680.00 $919.49 $780.68 $921.92 $2,188.61 $1,568.00 $1,044.65 $594.18 $727.70 $834.44 $644.54

$1,021.71 $884.31 $1,044.17 $2,347.76 $1,795.19 $1,179.78 $666.99 $828.68 $930.39 $732.83 $980.04 $842.07 $994.34 $2,282.88 $1,702.58 $1,124.70 $637.32 $787.53 $891.29 $696.84 $980.04 $842.07 $994.34 $2,282.88 $1,702.58 $1,124.70 $637.32 $787.53 $891.29 $696.84 $898.83 $759.75 $897.21 $2,156.46 $1,522.10 $1,017.33 $579.47 $707.30 $815.06 $626.69

$1,147.91 $1,012.25 $1,195.11 $2,544.23 $2,075.66 $1,346.61 $756.90 $953.36 $1,048.86 $841.82 $882.72 $743.42 $877.95 $2,131.40 $1,486.31 $996.05 $567.99 $691.40 $799.94 $612.78 $940.37 $801.86 $946.89 $2,221.13 $1,614.42 $1,072.25 $609.06 $748.34 $854.04 $662.57 $985.41 $847.52 $1,000.77 $2,291.25 $1,714.52 $1,131.80 $641.15 $792.83 $896.33 $701.48 $865.95 $726.41 $857.88 $2,105.27 $1,449.02 $973.86 $556.04 $674.82 $784.17 $598.29 $955.40 $817.08 $964.86 $2,244.51 $1,647.80 $1,092.11 $619.76 $763.17 $868.14 $675.54 $885.57 $746.30 $881.36 $2,135.82 $1,492.64 $999.81 $570.02 $694.20 $802.61 $615.24 $871.79 $732.33 $864.87 $2,114.36 $1,461.99 $981.59 $560.21 $680.58 $789.66 $603.33

$1,036.55 $899.36 $1,061.93 $2,370.86 $1,828.16 $1,199.40 $677.57 $843.35 $944.33 $745.64

of 25 04/08/2023




Opcert Agency Mmisid5907002 ST JOSEPHS OF YONKERS 002589203502000 ST LUKES / NEWBURGH 002739143522000 ST LUKES CORNWALL / CORNWALL 002738637002032 ST LUKES ROOSEVELT 003549672801001 ST MARYS AT AMSTERDAM 003516397001025 ST MARYS OF BROOKLYN 007293730101004 ST PETERS HOSPITAL 003188237002037 ST VINCENTS HOSPITAL 002432297001037 STATE UNIV / DOWNSTATE 002435905151001 STATE UNIV / STONY BROOK 003577957004003 STATEN ISLAND UNIV HOSPITAL 002442022701005 STRONG MEMORIAL HOSPITAL 002790343301007 SUNY HEALTH SCIENCE CENTER 003545901227000 THE HOSPITAL 003139510427000 TLC HEALTH NETWORK 003475440303001 UNITED HEALTH SERVICES 006147551801000 UNITED MEMORIAL (GENESEE) 003542831302001 VASSAR BROTHERS MED CTR 002738547001032 VICTORY MEMORIAL HOSPITAL 002434495820000 WAYNE HEALTH CARE 003544585957001 WESTCHESTER MEDICAL CTR 002742130632000 WESTFIELD MEMORIAL HOSP 003546145902001 WHITE PLAINS HOSPITAL 002742222908000 WINTHROP UNIVERSITY HOSP 002442110602001 WOMANS CHRISTIAN ASSOC 003546237001045 WOODHULL MEDICAL CENTER 006988667001035 WYCKOFF HEIGHTS HOSPITAL 002438256027000 WYOMING COUNTY COMMUNITY 00310889


11 12 13 14 15 16 17 18 19 20$955.40 $817.08 $964.86 $2,244.51 $1,647.80 $1,092.11 $619.76 $763.17 $868.14 $675.54 $918.89 $780.08 $921.20 $2,187.69 $1,566.68 $1,043.85 $593.75 $727.11 $833.88 $644.01 $919.49 $780.68 $921.92 $2,188.61 $1,568.00 $1,044.65 $594.18 $727.70 $834.44 $644.54

$1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $898.83 $759.75 $897.21 $2,156.46 $1,522.10 $1,017.33 $579.47 $707.30 $815.06 $626.69

$1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $1,036.56 $899.36 $1,061.93 $2,370.87 $1,828.19 $1,199.40 $677.58 $843.35 $944.34 $745.65 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $1,121.90 $985.88 $1,164.00 $2,503.73 $2,017.85 $1,312.23 $738.38 $927.66 $1,024.44 $819.36 $1,159.94 $1,024.43 $1,209.48 $2,562.95 $2,102.37 $1,362.51 $765.47 $965.24 $1,060.16 $852.21 $1,038.03 $900.86 $1,063.70 $2,373.17 $1,831.47 $1,201.35 $678.63 $844.82 $945.72 $746.93 $1,036.55 $899.36 $1,061.93 $2,370.86 $1,828.16 $1,199.40 $677.57 $843.35 $944.33 $745.64

$895.05 $755.91 $892.68 $2,150.57 $1,513.70 $1,012.34 $576.77 $703.56 $811.50 $623.42 $878.93 $739.56 $873.41 $2,125.47 $1,477.86 $991.02 $565.29 $687.63 $796.37 $609.50 $876.36 $736.97 $870.35 $2,121.48 $1,472.16 $987.63 $563.46 $685.11 $793.95 $607.29 $842.66 $702.80 $830.04 $2,069.01 $1,397.27 $943.08 $539.45 $651.81 $762.32 $578.18 $938.96 $800.42 $945.20 $2,218.92 $1,611.26 $1,070.37 $608.04 $746.93 $852.71 $661.34

$1,012.79 $875.27 $1,033.50 $2,333.87 $1,775.36 $1,167.98 $660.65 $819.87 $922.02 $725.12 $900.87 $761.81 $899.66 $2,159.64 $1,526.64 $1,020.03 $580.92 $709.32 $816.96 $628.46

$1,097.03 $960.66 $1,134.26 $2,465.01 $1,962.57 $1,279.34 $720.65 $903.09 $1,001.10 $797.87 $879.21 $739.86 $873.75 $2,125.92 $1,478.49 $991.40 $565.49 $687.92 $796.64 $609.75 $955.40 $817.08 $964.86 $2,244.51 $1,647.80 $1,092.11 $619.76 $763.17 $868.14 $675.54

$1,121.90 $985.88 $1,164.00 $2,503.73 $2,017.85 $1,312.23 $738.38 $927.66 $1,024.44 $819.36 $878.66 $739.29 $873.08 $2,125.05 $1,477.26 $990.66 $565.10 $687.36 $796.11 $609.27

$1,155.98 $1,020.42 $1,204.76 $2,556.78 $2,093.58 $1,357.28 $762.65 $961.32 $1,056.44 $848.79 $1,021.71 $884.31 $1,044.17 $2,347.76 $1,795.19 $1,179.78 $666.99 $828.68 $930.39 $732.83

$842.66 $702.80 $830.04 $2,069.01 $1,397.27 $943.08 $539.45 $651.81 $762.32 $578.18

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21 22 23 24 25 26 27 28 29 30$1,504.26 $1,194.15 $610.13 $652.58 $4,128.27 $672.39 $1,436.64 $894.12 $1,038.60 $1,085.04 $1,539.51 $1,238.18 $628.88 $672.86 $0.00 $692.99 $1,495.07 $926.04 $1,073.60 $1,123.56 $1,716.63 $1,459.46 $723.09 $774.80 $0.00 $796.55 $1,788.75 $1,086.54 $1,249.50 $1,317.14 $1,525.94 $1,221.21 $621.65 $665.06 $0.00 $685.05 $1,472.57 $913.76 $1,060.13 $1,108.73 $1,502.36 $1,191.75 $609.11 $651.48 $4,125.05 $671.27 $1,433.46 $892.38 $1,036.71 $1,082.96 $1,539.51 $1,238.18 $628.88 $672.86 $0.00 $692.99 $1,495.07 $926.04 $1,073.60 $1,123.56 $1,503.81 $1,193.58 $609.89 $652.32 $0.00 $672.12 $1,435.89 $893.70 $1,038.15 $1,084.55 $1,477.94 $1,161.26 $596.12 $637.43 $0.00 $656.99 $1,392.99 $870.26 $1,012.46 $1,056.27 $1,535.91 $1,233.68 $626.96 $670.79 $0.00 $690.89 $1,489.10 $922.79 $1,070.03 $1,119.62 $1,620.42 $1,339.26 $671.91 $719.43 $0.00 $740.30 $1,629.23 $999.36 $1,153.95 $1,211.99 $1,870.88 $1,652.15 $805.13 $863.55 $0.00 $886.73 $2,044.50 $1,226.31 $1,402.67 $1,485.69 $1,539.51 $1,238.18 $628.88 $672.86 $0.00 $692.99 $1,495.07 $926.04 $1,073.60 $1,123.56 $1,534.40 $1,231.79 $626.15 $669.92 $0.00 $690.00 $1,486.59 $921.42 $1,068.53 $1,117.97 $1,522.34 $1,216.73 $619.74 $662.99 $0.00 $682.95 $1,466.61 $910.49 $1,056.56 $1,104.80 $1,685.93 $1,421.10 $706.76 $757.13 $0.00 $778.59 $1,737.84 $1,058.73 $1,219.01 $1,283.58 $1,685.93 $1,421.10 $706.76 $757.13 $0.00 $778.59 $1,737.84 $1,058.73 $1,219.01 $1,283.58 $1,875.99 $1,658.54 $807.84 $866.49 $0.00 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,565.42 $1,270.55 $642.66 $687.78 $0.00 $708.14 $1,538.04 $949.53 $1,099.34 $1,151.88 $1,875.99 $1,658.54 $807.84 $866.49 $0.00 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,875.99 $1,658.54 $807.84 $866.49 $0.00 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,643.64 $1,368.26 $684.26 $732.78 $0.00 $753.87 $1,667.72 $1,020.41 $1,177.01 $1,237.35 $1,875.99 $1,658.54 $807.84 $866.49 $4,752.98 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,513.41 $1,205.57 $614.99 $657.84 $0.00 $677.73 $1,451.79 $902.40 $1,047.68 $1,095.03 $1,637.57 $1,360.68 $681.03 $729.29 $0.00 $750.32 $1,657.67 $1,014.90 $1,170.98 $1,230.72 $1,875.99 $1,658.54 $807.84 $866.49 $4,752.98 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,504.26 $1,194.15 $610.13 $652.58 $4,128.27 $672.39 $1,436.64 $894.12 $1,038.60 $1,085.04 $1,513.88 $1,206.15 $615.24 $658.11 $0.00 $678.00 $1,452.56 $902.82 $1,048.14 $1,095.54 $1,533.86 $1,231.11 $625.86 $669.62 $0.00 $689.69 $1,485.71 $920.93 $1,067.99 $1,117.38 $1,534.40 $1,231.79 $626.15 $669.92 $0.00 $690.00 $1,486.59 $921.42 $1,068.53 $1,117.97 $1,477.94 $1,161.26 $596.12 $637.43 $0.00 $656.99 $1,392.99 $870.26 $1,012.46 $1,056.27 $1,643.64 $1,368.26 $684.26 $732.78 $0.00 $753.87 $1,667.72 $1,020.41 $1,177.01 $1,237.35 $1,502.85 $1,192.38 $609.38 $651.77 $4,125.90 $671.55 $1,434.30 $892.83 $1,037.21 $1,083.50 $1,533.86 $1,231.11 $625.86 $669.62 $0.00 $689.69 $1,485.71 $920.93 $1,067.99 $1,117.38 $1,870.88 $1,652.15 $805.13 $863.55 $4,744.38 $886.73 $2,044.50 $1,226.31 $1,402.67 $1,485.69 $1,504.26 $1,194.15 $610.13 $652.58 $4,128.27 $672.39 $1,436.64 $894.12 $1,038.60 $1,085.04 $1,541.39 $1,240.52 $629.87 $673.94 $0.00 $694.08 $1,498.17 $927.75 $1,075.46 $1,125.60 $1,875.99 $1,658.54 $807.84 $866.49 $4,752.98 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,875.99 $1,658.54 $807.84 $866.49 $4,752.98 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,875.99 $1,658.54 $807.84 $866.49 $4,752.98 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,526.61 $1,222.05 $622.01 $665.45 $0.00 $685.44 $1,473.68 $914.36 $1,060.79 $1,109.46 $1,538.72 $1,237.17 $628.44 $672.41 $0.00 $692.52 $1,493.75 $925.32 $1,072.82 $1,122.69 $1,611.80 $1,328.49 $667.32 $714.47 $0.00 $735.26 $1,614.93 $991.55 $1,145.39 $1,202.57 $1,539.48 $1,238.15 $628.86 $672.84 $0.00 $692.97 $1,495.02 $926.03 $1,073.58 $1,123.53 $1,870.88 $1,652.15 $805.13 $863.55 $4,744.38 $886.73 $2,044.50 $1,226.31 $1,402.67 $1,485.69 $1,496.27 $1,184.16 $605.87 $647.99 $0.00 $667.71 $1,423.38 $886.88 $1,030.67 $1,076.31 $1,479.27 $1,162.92 $596.82 $638.19 $0.00 $657.77 $1,395.18 $871.46 $1,013.78 $1,057.73 $1,541.54 $1,240.71 $629.96 $674.03 $0.00 $694.17 $1,498.43 $927.89 $1,075.62 $1,125.77

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21 22 23 24 25 26 27 28 29 30$1,464.44 $1,144.38 $588.93 $629.66 $0.00 $649.10 $1,370.58 $858.02 $999.05 $1,041.51 $1,533.86 $1,231.11 $625.86 $669.62 $0.00 $689.69 $1,485.71 $920.93 $1,067.99 $1,117.38 $1,643.64 $1,368.26 $684.26 $732.78 $0.00 $753.87 $1,667.72 $1,020.41 $1,177.01 $1,237.35 $1,513.88 $1,206.15 $615.24 $658.11 $0.00 $678.00 $1,452.56 $902.82 $1,048.14 $1,095.54 $1,502.36 $1,191.75 $609.11 $651.48 $0.00 $671.27 $1,433.46 $892.38 $1,036.71 $1,082.96 $1,533.86 $1,231.11 $625.86 $669.62 $0.00 $689.69 $1,485.71 $920.93 $1,067.99 $1,117.38 $1,538.75 $1,237.22 $628.47 $672.42 $4,186.22 $692.54 $1,493.81 $925.35 $1,072.85 $1,122.72 $1,875.99 $1,658.54 $807.84 $866.49 $0.00 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,699.34 $1,437.86 $713.88 $764.84 $0.00 $786.44 $1,760.09 $1,070.88 $1,232.33 $1,298.24 $1,517.94 $1,211.24 $617.40 $660.45 $0.00 $680.39 $1,459.32 $906.51 $1,052.19 $1,100.00 $1,875.99 $1,658.54 $807.84 $866.49 $4,752.98 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,643.64 $1,368.26 $684.26 $732.78 $0.00 $753.87 $1,667.72 $1,020.41 $1,177.01 $1,237.35 $1,541.39 $1,240.52 $629.87 $673.94 $0.00 $694.08 $1,498.17 $927.75 $1,075.46 $1,125.60 $1,541.39 $1,240.52 $629.87 $673.94 $0.00 $694.08 $1,498.17 $927.75 $1,075.46 $1,125.60 $1,516.67 $1,209.65 $616.73 $659.72 $0.00 $679.64 $1,457.21 $905.36 $1,050.92 $1,098.60 $1,611.80 $1,328.49 $667.32 $714.47 $0.00 $735.26 $1,614.93 $991.55 $1,145.39 $1,202.57 $1,643.64 $1,368.26 $684.26 $732.78 $0.00 $753.87 $1,667.72 $1,020.41 $1,177.01 $1,237.35 $1,870.88 $1,652.15 $805.13 $863.55 $0.00 $886.73 $2,044.50 $1,226.31 $1,402.67 $1,485.69 $1,617.53 $1,335.63 $670.37 $717.75 $0.00 $738.60 $1,624.41 $996.74 $1,151.07 $1,208.81 $1,542.93 $1,242.45 $630.69 $674.84 $0.00 $695.00 $1,500.75 $929.15 $1,077.00 $1,127.30 $1,697.45 $1,435.49 $712.88 $763.76 $0.00 $785.33 $1,756.95 $1,069.17 $1,230.45 $1,296.17 $1,697.45 $1,435.49 $712.88 $763.76 $0.00 $785.33 $1,756.95 $1,069.17 $1,230.45 $1,296.17 $1,611.80 $1,328.49 $667.32 $714.47 $0.00 $735.26 $1,614.93 $991.55 $1,145.39 $1,202.57 $1,643.64 $1,368.26 $684.26 $732.78 $0.00 $753.87 $1,667.72 $1,020.41 $1,177.01 $1,237.35 $1,523.42 $1,218.06 $620.31 $663.60 $0.00 $683.58 $1,468.38 $911.46 $1,057.62 $1,105.97 $1,697.45 $1,435.49 $712.88 $763.76 $0.00 $785.33 $1,756.95 $1,069.17 $1,230.45 $1,296.17 $1,494.39 $1,181.82 $604.88 $646.91 $0.00 $666.62 $1,420.26 $885.17 $1,028.81 $1,074.26 $1,637.57 $1,360.68 $681.03 $729.29 $0.00 $750.32 $1,657.67 $1,014.90 $1,170.98 $1,230.72 $1,870.88 $1,652.15 $805.13 $863.55 $4,744.38 $886.73 $2,044.50 $1,226.31 $1,402.67 $1,485.69 $1,875.99 $1,658.54 $807.84 $866.49 $0.00 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,643.64 $1,368.26 $684.26 $732.78 $0.00 $753.87 $1,667.72 $1,020.41 $1,177.01 $1,237.35 $1,464.44 $1,144.38 $588.93 $629.66 $0.00 $649.10 $1,370.58 $858.02 $999.05 $1,041.51 $1,699.34 $1,437.86 $713.88 $764.84 $4,456.11 $786.44 $1,760.09 $1,070.88 $1,232.33 $1,298.24 $1,523.78 $1,218.53 $620.51 $663.81 $0.00 $683.79 $1,468.98 $911.79 $1,057.98 $1,106.37 $1,523.42 $1,218.06 $620.31 $663.60 $0.00 $683.58 $1,468.38 $911.46 $1,057.62 $1,105.97 $1,699.34 $1,437.86 $713.88 $764.84 $0.00 $786.44 $1,760.09 $1,070.88 $1,232.33 $1,298.24 $1,521.62 $1,215.83 $619.35 $662.57 $0.00 $682.53 $1,465.41 $909.84 $1,055.84 $1,104.02 $1,870.88 $1,652.15 $805.13 $863.55 $4,744.38 $886.73 $2,044.50 $1,226.31 $1,402.67 $1,485.69 $1,697.45 $1,435.49 $712.88 $763.76 $0.00 $785.33 $1,756.95 $1,069.17 $1,230.45 $1,296.17 $1,534.40 $1,231.79 $626.15 $669.92 $0.00 $690.00 $1,486.59 $921.42 $1,068.53 $1,117.97 $1,541.39 $1,240.52 $629.87 $673.94 $0.00 $694.08 $1,498.17 $927.75 $1,075.46 $1,125.60 $1,611.80 $1,328.49 $667.32 $714.47 $0.00 $735.26 $1,614.93 $991.55 $1,145.39 $1,202.57 $1,875.99 $1,658.54 $807.84 $866.49 $0.00 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,513.88 $1,206.15 $615.24 $658.11 $0.00 $678.00 $1,452.56 $902.82 $1,048.14 $1,095.54 $1,870.88 $1,652.15 $805.13 $863.55 $0.00 $886.73 $2,044.50 $1,226.31 $1,402.67 $1,485.69 $1,518.68 $1,212.15 $617.79 $660.87 $0.00 $680.81 $1,460.54 $907.17 $1,052.93 $1,100.79 $1,523.42 $1,218.06 $620.31 $663.60 $0.00 $683.58 $1,468.38 $911.46 $1,057.62 $1,105.97

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21 22 23 24 25 26 27 28 29 30$1,643.64 $1,368.26 $684.26 $732.78 $0.00 $753.87 $1,667.72 $1,020.41 $1,177.01 $1,237.35 $1,875.99 $1,658.54 $807.84 $866.49 $4,752.98 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,875.99 $1,658.54 $807.84 $866.49 $4,752.98 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,697.45 $1,435.49 $712.88 $763.76 $4,452.93 $785.33 $1,756.95 $1,069.17 $1,230.45 $1,296.17 $1,875.99 $1,658.54 $807.84 $866.49 $0.00 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,682.94 $1,417.37 $705.17 $755.40 $0.00 $776.85 $1,732.89 $1,056.02 $1,216.04 $1,280.31 $1,533.86 $1,231.11 $625.86 $669.62 $0.00 $689.69 $1,485.71 $920.93 $1,067.99 $1,117.38 $1,708.68 $1,449.53 $718.86 $770.22 $0.00 $791.90 $1,775.58 $1,079.34 $1,241.61 $1,308.45 $1,517.43 $1,210.59 $617.13 $660.15 $0.00 $680.07 $1,458.45 $906.05 $1,051.68 $1,099.43 $1,504.26 $1,194.15 $610.13 $652.58 $4,128.27 $672.39 $1,436.64 $894.12 $1,038.60 $1,085.04 $1,530.51 $1,226.94 $624.09 $667.68 $0.00 $687.74 $1,480.16 $917.90 $1,064.67 $1,113.74 $1,539.51 $1,238.18 $628.88 $672.86 $4,187.49 $692.99 $1,495.07 $926.04 $1,073.60 $1,123.56 $1,697.45 $1,435.49 $712.88 $763.76 $0.00 $785.33 $1,756.95 $1,069.17 $1,230.45 $1,296.17 $1,521.62 $1,215.83 $619.35 $662.57 $0.00 $682.53 $1,465.41 $909.84 $1,055.84 $1,104.02 $1,643.64 $1,368.26 $684.26 $732.78 $4,362.50 $753.87 $1,667.72 $1,020.41 $1,177.01 $1,237.35 $1,870.88 $1,652.15 $805.13 $863.55 $0.00 $886.73 $2,044.50 $1,226.31 $1,402.67 $1,485.69 $1,875.99 $1,658.54 $807.84 $866.49 $4,752.98 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,521.66 $1,215.87 $619.38 $662.60 $0.00 $682.55 $1,465.47 $909.87 $1,055.88 $1,104.05 $1,685.93 $1,421.10 $706.76 $757.13 $0.00 $778.59 $1,737.84 $1,058.73 $1,219.01 $1,283.58 $1,875.99 $1,658.54 $807.84 $866.49 $4,752.98 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,522.70 $1,217.16 $619.92 $663.18 $0.00 $683.16 $1,467.18 $910.80 $1,056.90 $1,105.19 $1,611.80 $1,328.49 $667.32 $714.47 $0.00 $735.26 $1,614.93 $991.55 $1,145.39 $1,202.57 $1,826.87 $1,597.16 $781.71 $838.22 $0.00 $860.99 $1,971.53 $1,186.43 $1,358.96 $1,437.59 $1,528.10 $1,223.91 $622.80 $666.29 $0.00 $686.31 $1,476.14 $915.71 $1,062.27 $1,111.08 $1,637.57 $1,360.68 $681.03 $729.29 $0.00 $750.32 $1,657.67 $1,014.90 $1,170.98 $1,230.72 $1,522.70 $1,217.16 $619.92 $663.18 $4,159.23 $683.16 $1,467.18 $910.80 $1,056.90 $1,105.19 $1,541.39 $1,240.52 $629.87 $673.94 $0.00 $694.08 $1,498.17 $927.75 $1,075.46 $1,125.60 $1,870.88 $1,652.15 $805.13 $863.55 $0.00 $886.73 $2,044.50 $1,226.31 $1,402.67 $1,485.69 $1,860.45 $1,639.13 $799.58 $857.55 $4,726.86 $880.64 $2,027.22 $1,216.86 $1,392.32 $1,474.31 $1,860.45 $1,639.13 $799.58 $857.55 $0.00 $880.64 $2,027.22 $1,216.86 $1,392.32 $1,474.31 $1,643.64 $1,368.26 $684.26 $732.78 $0.00 $753.87 $1,667.72 $1,020.41 $1,177.01 $1,237.35 $1,643.64 $1,368.26 $684.26 $732.78 $0.00 $753.87 $1,667.72 $1,020.41 $1,177.01 $1,237.35 $1,826.87 $1,597.16 $781.71 $838.22 $4,670.42 $860.99 $1,971.53 $1,186.43 $1,358.96 $1,437.59 $1,591.43 $1,303.02 $656.48 $702.74 $0.00 $723.33 $1,581.14 $973.08 $1,125.15 $1,180.29 $1,611.80 $1,328.49 $667.32 $714.47 $0.00 $735.26 $1,614.93 $991.55 $1,145.39 $1,202.57 $1,685.93 $1,421.10 $706.76 $757.13 $0.00 $778.59 $1,737.84 $1,058.73 $1,219.01 $1,283.58 $1,685.93 $1,421.10 $706.76 $757.13 $0.00 $778.59 $1,737.84 $1,058.73 $1,219.01 $1,283.58 $1,875.99 $1,658.54 $807.84 $866.49 $0.00 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,875.99 $1,658.54 $807.84 $866.49 $0.00 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,875.99 $1,658.54 $807.84 $866.49 $0.00 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,875.99 $1,658.54 $807.84 $866.49 $4,752.98 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,875.99 $1,658.54 $807.84 $866.49 $4,752.98 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,611.80 $1,328.49 $667.32 $714.47 $0.00 $735.26 $1,614.93 $991.55 $1,145.39 $1,202.57 $1,875.99 $1,658.54 $807.84 $866.49 $0.00 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,685.93 $1,421.10 $706.76 $757.13 $0.00 $778.59 $1,737.84 $1,058.73 $1,219.01 $1,283.58 $1,611.80 $1,328.49 $667.32 $714.47 $0.00 $735.26 $1,614.93 $991.55 $1,145.39 $1,202.57 $1,856.28 $1,633.91 $797.36 $855.15 $0.00 $878.19 $2,020.31 $1,213.08 $1,388.18 $1,469.75

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21 22 23 24 25 26 27 28 29 30$1,513.55 $1,205.75 $615.06 $657.93 $4,143.87 $677.81 $1,452.03 $902.52 $1,047.83 $1,095.20 $1,539.48 $1,238.15 $628.86 $672.84 $0.00 $692.97 $1,495.02 $926.03 $1,073.58 $1,123.53 $1,564.65 $1,269.59 $642.24 $687.33 $0.00 $707.69 $1,536.77 $948.83 $1,098.57 $1,151.04 $1,564.65 $1,269.59 $642.24 $687.33 $4,229.75 $707.69 $1,536.77 $948.83 $1,098.57 $1,151.04 $1,525.20 $1,220.30 $621.26 $664.64 $0.00 $684.63 $1,471.35 $913.08 $1,059.39 $1,107.93 $1,507.05 $1,197.62 $611.61 $654.18 $0.00 $674.01 $1,441.25 $896.64 $1,041.36 $1,088.09 $1,875.99 $1,658.54 $807.84 $866.49 $0.00 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,521.62 $1,215.83 $619.35 $662.57 $0.00 $682.53 $1,465.41 $909.84 $1,055.84 $1,104.02 $1,543.46 $1,243.10 $630.98 $675.14 $0.00 $695.30 $1,501.61 $929.63 $1,077.53 $1,127.87 $1,685.93 $1,421.10 $706.76 $757.13 $0.00 $778.59 $1,737.84 $1,058.73 $1,219.01 $1,283.58 $1,697.45 $1,435.49 $712.88 $763.76 $0.00 $785.33 $1,756.95 $1,069.17 $1,230.45 $1,296.17 $1,611.80 $1,328.49 $667.32 $714.47 $0.00 $735.26 $1,614.93 $991.55 $1,145.39 $1,202.57 $1,594.82 $1,307.27 $658.29 $704.69 $0.00 $725.33 $1,586.78 $976.17 $1,128.53 $1,184.00 $1,870.88 $1,652.15 $805.13 $863.55 $0.00 $886.73 $2,044.50 $1,226.31 $1,402.67 $1,485.69 $1,875.99 $1,658.54 $807.84 $866.49 $0.00 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,513.88 $1,206.15 $615.24 $658.11 $0.00 $678.00 $1,452.56 $902.82 $1,048.14 $1,095.54 $1,718.54 $1,461.84 $724.10 $775.89 $0.00 $797.66 $1,791.92 $1,088.28 $1,251.39 $1,319.21 $1,518.68 $1,212.15 $617.79 $660.87 $0.00 $680.81 $1,460.54 $907.17 $1,052.93 $1,100.79 $1,524.26 $1,219.11 $620.76 $664.08 $0.00 $684.08 $1,469.78 $912.23 $1,058.46 $1,106.90 $1,538.75 $1,237.22 $628.47 $672.42 $0.00 $692.54 $1,493.81 $925.35 $1,072.85 $1,122.72 $1,514.39 $1,206.78 $615.51 $658.41 $4,145.27 $678.30 $1,453.41 $903.29 $1,048.65 $1,096.10 $1,538.75 $1,237.22 $628.47 $672.42 $0.00 $692.54 $1,493.81 $925.35 $1,072.85 $1,122.72 $1,494.39 $1,181.82 $604.88 $646.91 $0.00 $666.62 $1,420.26 $885.17 $1,028.81 $1,074.26 $1,538.75 $1,237.22 $628.47 $672.42 $4,186.22 $692.54 $1,493.81 $925.35 $1,072.85 $1,122.72 $1,522.34 $1,216.73 $619.74 $662.99 $0.00 $682.95 $1,466.61 $910.49 $1,056.56 $1,104.80 $1,697.45 $1,435.49 $712.88 $763.76 $0.00 $785.33 $1,756.95 $1,069.17 $1,230.45 $1,296.17 $1,524.26 $1,219.11 $620.76 $664.08 $0.00 $684.08 $1,469.78 $912.23 $1,058.46 $1,106.90 $1,477.46 $1,160.64 $595.86 $637.16 $0.00 $656.70 $1,392.17 $869.82 $1,011.98 $1,055.75 $1,794.74 $1,557.02 $764.63 $819.74 $0.00 $842.21 $1,918.25 $1,157.31 $1,327.05 $1,402.49 $1,650.57 $1,376.93 $687.95 $736.77 $0.00 $757.92 $1,679.22 $1,026.69 $1,183.89 $1,244.94 $1,643.64 $1,368.26 $684.26 $732.78 $0.00 $753.87 $1,667.72 $1,020.41 $1,177.01 $1,237.35 $1,643.64 $1,368.26 $684.26 $732.78 $0.00 $753.87 $1,667.72 $1,020.41 $1,177.01 $1,237.35 $1,618.46 $1,336.79 $670.86 $718.29 $0.00 $739.14 $1,625.96 $997.58 $1,152.00 $1,209.83 $1,565.42 $1,270.55 $642.66 $687.78 $0.00 $708.14 $1,538.04 $949.53 $1,099.34 $1,151.88 $1,697.45 $1,435.49 $712.88 $763.76 $0.00 $785.33 $1,756.95 $1,069.17 $1,230.45 $1,296.17 $1,643.64 $1,368.26 $684.26 $732.78 $0.00 $753.87 $1,667.72 $1,020.41 $1,177.01 $1,237.35 $1,643.64 $1,368.26 $684.26 $732.78 $0.00 $753.87 $1,667.72 $1,020.41 $1,177.01 $1,237.35 $1,538.75 $1,237.22 $628.47 $672.42 $0.00 $692.54 $1,493.81 $925.35 $1,072.85 $1,122.72 $1,860.45 $1,639.13 $799.58 $857.55 $0.00 $880.64 $2,027.22 $1,216.86 $1,392.32 $1,474.31 $1,517.94 $1,211.24 $617.40 $660.45 $0.00 $680.39 $1,459.32 $906.51 $1,052.19 $1,100.00 $1,592.40 $1,304.25 $657.00 $703.29 $4,276.38 $723.92 $1,582.76 $973.97 $1,126.13 $1,181.36 $1,650.57 $1,376.93 $687.95 $736.77 $0.00 $757.92 $1,679.22 $1,026.69 $1,183.89 $1,244.94 $1,496.27 $1,184.16 $605.87 $647.99 $0.00 $667.71 $1,423.38 $886.88 $1,030.67 $1,076.31 $1,611.80 $1,328.49 $667.32 $714.47 $0.00 $735.26 $1,614.93 $991.55 $1,145.39 $1,202.57 $1,521.62 $1,215.83 $619.35 $662.57 $0.00 $682.53 $1,465.41 $909.84 $1,055.84 $1,104.02 $1,503.81 $1,193.58 $609.89 $652.32 $4,127.51 $672.12 $1,435.89 $893.70 $1,038.15 $1,084.55 $1,716.62 $1,459.44 $723.08 $774.78 $0.00 $796.55 $1,788.74 $1,086.54 $1,249.49 $1,317.12

of 25 04/08/2023






21 22 23 24 25 26 27 28 29 30$1,611.80 $1,328.49 $667.32 $714.47 $4,308.98 $735.26 $1,614.93 $991.55 $1,145.39 $1,202.57 $1,564.65 $1,269.59 $642.24 $687.33 $4,229.75 $707.69 $1,536.77 $948.83 $1,098.57 $1,151.04 $1,565.42 $1,270.55 $642.66 $687.78 $4,231.05 $708.14 $1,538.04 $949.53 $1,099.34 $1,151.88 $1,875.99 $1,658.54 $807.84 $866.49 $0.00 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,538.75 $1,237.22 $628.47 $672.42 $0.00 $692.54 $1,493.81 $925.35 $1,072.85 $1,122.72 $1,875.99 $1,658.54 $807.84 $866.49 $0.00 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,716.63 $1,459.46 $723.09 $774.80 $4,485.17 $796.55 $1,788.75 $1,086.54 $1,249.50 $1,317.14 $1,875.99 $1,658.54 $807.84 $866.49 $0.00 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,875.99 $1,658.54 $807.84 $866.49 $4,752.98 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,826.87 $1,597.16 $781.71 $838.22 $4,670.42 $860.99 $1,971.53 $1,186.43 $1,358.96 $1,437.59 $1,875.99 $1,658.54 $807.84 $866.49 $0.00 $889.71 $2,052.98 $1,230.95 $1,407.74 $1,491.27 $1,718.54 $1,461.84 $724.10 $775.89 $4,488.38 $797.66 $1,791.92 $1,088.28 $1,251.39 $1,319.21 $1,716.62 $1,459.44 $723.08 $774.78 $4,485.15 $796.55 $1,788.74 $1,086.54 $1,249.49 $1,317.12 $1,533.86 $1,231.11 $625.86 $669.62 $0.00 $689.69 $1,485.71 $920.93 $1,067.99 $1,117.38 $1,513.04 $1,205.10 $614.79 $657.63 $0.00 $677.51 $1,451.18 $902.06 $1,047.32 $1,094.63 $1,509.72 $1,200.96 $613.04 $655.73 $0.00 $675.57 $1,445.69 $899.06 $1,044.03 $1,091.01 $1,466.21 $1,146.59 $589.88 $630.68 $0.00 $650.13 $1,373.52 $859.62 $1,000.80 $1,043.45 $1,590.56 $1,301.96 $656.03 $702.24 $0.00 $722.84 $1,579.73 $972.32 $1,124.30 $1,179.36 $1,685.93 $1,421.10 $706.76 $757.13 $4,433.57 $778.59 $1,737.84 $1,058.73 $1,219.01 $1,283.58 $1,541.39 $1,240.52 $629.87 $673.94 $0.00 $694.08 $1,498.17 $927.75 $1,075.46 $1,125.60 $1,794.74 $1,557.02 $764.63 $819.74 $0.00 $842.21 $1,918.25 $1,157.31 $1,327.05 $1,402.49 $1,513.41 $1,205.57 $614.99 $657.84 $0.00 $677.73 $1,451.79 $902.40 $1,047.68 $1,095.03 $1,611.80 $1,328.49 $667.32 $714.47 $0.00 $735.26 $1,614.93 $991.55 $1,145.39 $1,202.57 $1,826.87 $1,597.16 $781.71 $838.22 $0.00 $860.99 $1,971.53 $1,186.43 $1,358.96 $1,437.59 $1,512.69 $1,204.67 $614.60 $657.42 $0.00 $677.31 $1,450.59 $901.74 $1,046.97 $1,094.25 $1,870.88 $1,652.15 $805.13 $863.55 $0.00 $886.73 $2,044.50 $1,226.31 $1,402.67 $1,485.69 $1,697.45 $1,435.49 $712.88 $763.76 $0.00 $785.33 $1,756.95 $1,069.17 $1,230.45 $1,296.17 $1,466.21 $1,146.59 $589.88 $630.68 $0.00 $650.13 $1,373.52 $859.62 $1,000.80 $1,043.45

of 25 04/08/2023






31 32 33 34 35 36 37 38 39 40$787.04 $709.61 $1,385.91 $1,100.67 $1,452.59 $1,515.77 $974.70 $999.47 $1,680.14 $768.51 $813.89 $729.24 $1,440.50 $1,136.27 $1,504.25 $1,566.81 $1,009.47 $1,032.87 $1,748.21 $796.61 $948.81 $827.96 $1,714.88 $1,315.25 $1,763.97 $1,823.45 $1,184.25 $1,200.80 $2,090.37 $937.83 $803.55 $721.68 $1,419.47 $1,122.56 $1,484.36 $1,547.16 $996.09 $1,020.00 $1,722.00 $785.78 $785.58 $708.54 $1,382.94 $1,098.74 $1,449.78 $1,512.99 $972.81 $997.65 $1,676.45 $766.98 $813.89 $729.24 $1,440.50 $1,136.27 $1,504.25 $1,566.81 $1,009.47 $1,032.87 $1,748.21 $796.61 $786.69 $709.35 $1,385.21 $1,100.21 $1,451.93 $1,515.11 $974.27 $999.03 $1,679.27 $768.14 $766.98 $694.94 $1,345.13 $1,074.06 $1,413.98 $1,477.62 $948.74 $974.51 $1,629.29 $747.51 $811.14 $727.25 $1,434.92 $1,132.64 $1,498.97 $1,561.61 $1,005.92 $1,029.47 $1,741.26 $793.73 $875.52 $774.35 $1,565.84 $1,218.03 $1,622.90 $1,684.05 $1,089.32 $1,109.58 $1,904.52 $861.12

$1,066.31 $913.91 $1,953.81 $1,471.10 $1,990.13 $2,046.93 $1,336.44 $1,347.03 $2,388.32 $1,060.82 $813.89 $729.24 $1,440.50 $1,136.27 $1,504.25 $1,566.81 $1,009.47 $1,032.87 $1,748.21 $796.61 $809.99 $726.41 $1,432.58 $1,131.11 $1,496.76 $1,559.42 $1,004.43 $1,028.03 $1,738.34 $792.53 $800.81 $719.69 $1,413.90 $1,118.93 $1,479.09 $1,541.94 $992.54 $1,016.60 $1,715.06 $782.91 $925.43 $810.84 $1,667.31 $1,284.23 $1,718.96 $1,778.97 $1,153.95 $1,171.70 $2,031.06 $913.35 $925.43 $810.84 $1,667.31 $1,284.23 $1,718.96 $1,778.97 $1,153.95 $1,171.70 $2,031.06 $913.35

$1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90 $833.63 $743.69 $1,480.64 $1,162.46 $1,542.26 $1,604.37 $1,035.05 $1,057.44 $1,798.28 $817.26

$1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90 $1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90

$893.21 $787.28 $1,601.81 $1,241.49 $1,656.93 $1,717.70 $1,112.22 $1,131.60 $1,949.36 $879.63 $1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90

$794.00 $714.71 $1,400.06 $1,109.90 $1,465.98 $1,529.00 $983.72 $1,008.12 $1,697.79 $775.79 $888.59 $783.89 $1,592.40 $1,235.36 $1,648.04 $1,708.89 $1,106.24 $1,125.84 $1,937.64 $874.79

$1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90 $787.04 $709.61 $1,385.91 $1,100.67 $1,452.59 $1,515.77 $974.70 $999.47 $1,680.14 $768.51 $794.36 $714.96 $1,400.78 $1,110.36 $1,466.66 $1,529.67 $984.18 $1,008.57 $1,698.69 $776.16 $809.58 $726.11 $1,431.74 $1,130.57 $1,495.97 $1,558.64 $1,003.91 $1,027.52 $1,737.30 $792.09 $809.99 $726.41 $1,432.58 $1,131.11 $1,496.76 $1,559.42 $1,004.43 $1,028.03 $1,738.34 $792.53 $766.98 $694.94 $1,345.13 $1,074.06 $1,413.98 $1,477.62 $948.74 $974.51 $1,629.29 $747.51 $893.21 $787.28 $1,601.81 $1,241.49 $1,656.93 $1,717.70 $1,112.22 $1,131.60 $1,949.36 $879.63 $785.96 $708.83 $1,383.72 $1,099.23 $1,450.52 $1,513.71 $973.31 $998.13 $1,677.41 $767.37 $809.58 $726.11 $1,431.74 $1,130.57 $1,495.97 $1,558.64 $1,003.91 $1,027.52 $1,737.30 $792.09

$1,066.31 $913.91 $1,953.81 $1,471.10 $1,990.13 $2,046.93 $1,336.44 $1,347.03 $2,388.32 $1,060.82 $787.04 $709.61 $1,385.91 $1,100.67 $1,452.59 $1,515.77 $974.70 $999.47 $1,680.14 $768.51 $815.31 $730.29 $1,443.41 $1,138.17 $1,507.01 $1,569.54 $1,011.33 $1,034.66 $1,751.84 $798.09

$1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90 $1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90 $1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90

$804.06 $722.06 $1,420.52 $1,123.23 $1,485.35 $1,548.14 $996.75 $1,020.65 $1,723.29 $786.32 $813.27 $728.81 $1,439.27 $1,135.47 $1,503.09 $1,565.67 $1,008.69 $1,032.12 $1,746.68 $795.96 $868.95 $769.53 $1,552.49 $1,209.32 $1,610.25 $1,671.56 $1,080.81 $1,101.41 $1,887.86 $854.24 $813.86 $729.23 $1,440.45 $1,136.25 $1,504.22 $1,566.78 $1,009.46 $1,032.86 $1,748.16 $796.58

$1,066.31 $913.91 $1,953.81 $1,471.10 $1,990.13 $2,046.93 $1,336.44 $1,347.03 $2,388.32 $1,060.82 $780.95 $705.15 $1,373.52 $1,092.59 $1,440.86 $1,504.17 $966.81 $991.89 $1,664.70 $762.14 $768.00 $695.67 $1,347.18 $1,075.40 $1,415.93 $1,479.54 $950.04 $975.77 $1,631.85 $748.58 $815.43 $730.38 $1,443.63 $1,138.32 $1,507.23 $1,569.75 $1,011.48 $1,034.79 $1,752.14 $798.23

of 25 04/08/2023






31 32 33 34 35 36 37 38 39 40$756.69 $687.41 $1,324.20 $1,060.41 $1,394.18 $1,458.05 $935.40 $961.70 $1,603.19 $736.74 $809.58 $726.11 $1,431.74 $1,130.57 $1,495.97 $1,558.64 $1,003.91 $1,027.52 $1,737.30 $792.09 $893.21 $787.28 $1,601.81 $1,241.49 $1,656.93 $1,717.70 $1,112.22 $1,131.60 $1,949.36 $879.63 $794.36 $714.96 $1,400.78 $1,110.36 $1,466.66 $1,529.67 $984.18 $1,008.57 $1,698.69 $776.16 $785.58 $708.54 $1,382.94 $1,098.74 $1,449.78 $1,512.99 $972.81 $997.65 $1,676.45 $766.98 $809.58 $726.11 $1,431.74 $1,130.57 $1,495.97 $1,558.64 $1,003.91 $1,027.52 $1,737.30 $792.09 $813.30 $728.82 $1,439.31 $1,135.50 $1,503.14 $1,565.72 $1,008.72 $1,032.15 $1,746.75 $795.99

$1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90 $935.64 $818.31 $1,688.09 $1,297.77 $1,738.61 $1,798.40 $1,167.18 $1,184.40 $2,056.97 $924.05 $797.46 $717.23 $1,407.09 $1,114.49 $1,472.64 $1,535.58 $988.20 $1,012.44 $1,706.57 $779.42

$1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90 $893.21 $787.28 $1,601.81 $1,241.49 $1,656.93 $1,717.70 $1,112.22 $1,131.60 $1,949.36 $879.63 $815.31 $730.29 $1,443.41 $1,138.17 $1,507.01 $1,569.54 $1,011.33 $1,034.66 $1,751.84 $798.09 $815.31 $730.29 $1,443.41 $1,138.17 $1,507.01 $1,569.54 $1,011.33 $1,034.66 $1,751.84 $798.09 $796.49 $716.52 $1,405.11 $1,113.20 $1,470.77 $1,533.74 $986.94 $1,011.23 $1,704.09 $778.40 $868.95 $769.53 $1,552.49 $1,209.32 $1,610.25 $1,671.56 $1,080.81 $1,101.41 $1,887.86 $854.24 $893.21 $787.28 $1,601.81 $1,241.49 $1,656.93 $1,717.70 $1,112.22 $1,131.60 $1,949.36 $879.63

$1,066.31 $913.91 $1,953.81 $1,471.10 $1,990.13 $2,046.93 $1,336.44 $1,347.03 $2,388.32 $1,060.82 $873.32 $772.73 $1,561.34 $1,215.09 $1,618.64 $1,679.85 $1,086.45 $1,106.84 $1,898.91 $858.81 $816.50 $731.16 $1,445.81 $1,139.73 $1,509.29 $1,571.79 $1,012.86 $1,036.13 $1,754.84 $799.34 $934.20 $817.26 $1,685.16 $1,295.87 $1,735.85 $1,795.67 $1,165.32 $1,182.62 $2,053.32 $922.53 $934.20 $817.26 $1,685.16 $1,295.87 $1,735.85 $1,795.67 $1,165.32 $1,182.62 $2,053.32 $922.53 $868.95 $769.53 $1,552.49 $1,209.32 $1,610.25 $1,671.56 $1,080.81 $1,101.41 $1,887.86 $854.24 $893.21 $787.28 $1,601.81 $1,241.49 $1,656.93 $1,717.70 $1,112.22 $1,131.60 $1,949.36 $879.63 $801.62 $720.27 $1,415.57 $1,120.01 $1,480.65 $1,543.50 $993.60 $1,017.62 $1,717.13 $783.77 $934.20 $817.26 $1,685.16 $1,295.87 $1,735.85 $1,795.67 $1,165.32 $1,182.62 $2,053.32 $922.53 $779.52 $704.12 $1,370.61 $1,090.70 $1,438.11 $1,501.46 $964.97 $990.11 $1,661.07 $760.64 $888.59 $783.89 $1,592.40 $1,235.36 $1,648.04 $1,708.89 $1,106.24 $1,125.84 $1,937.64 $874.79

$1,066.31 $913.91 $1,953.81 $1,471.10 $1,990.13 $2,046.93 $1,336.44 $1,347.03 $2,388.32 $1,060.82 $1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90

$893.21 $787.28 $1,601.81 $1,241.49 $1,656.93 $1,717.70 $1,112.22 $1,131.60 $1,949.36 $879.63 $756.69 $687.41 $1,324.20 $1,060.41 $1,394.18 $1,458.05 $935.40 $961.70 $1,603.19 $736.74 $935.64 $818.31 $1,688.09 $1,297.77 $1,738.61 $1,798.40 $1,167.18 $1,184.40 $2,056.97 $924.05 $801.90 $720.48 $1,416.14 $1,120.38 $1,481.19 $1,544.03 $993.96 $1,017.96 $1,717.83 $784.07 $801.62 $720.27 $1,415.57 $1,120.01 $1,480.65 $1,543.50 $993.60 $1,017.62 $1,717.13 $783.77 $935.64 $818.31 $1,688.09 $1,297.77 $1,738.61 $1,798.40 $1,167.18 $1,184.40 $2,056.97 $924.05 $800.25 $719.28 $1,412.79 $1,118.19 $1,478.03 $1,540.91 $991.83 $1,015.92 $1,713.66 $782.34

$1,066.31 $913.91 $1,953.81 $1,471.10 $1,990.13 $2,046.93 $1,336.44 $1,347.03 $2,388.32 $1,060.82 $934.20 $817.26 $1,685.16 $1,295.87 $1,735.85 $1,795.67 $1,165.32 $1,182.62 $2,053.32 $922.53 $809.99 $726.41 $1,432.58 $1,131.11 $1,496.76 $1,559.42 $1,004.43 $1,028.03 $1,738.34 $792.53 $815.31 $730.29 $1,443.41 $1,138.17 $1,507.01 $1,569.54 $1,011.33 $1,034.66 $1,751.84 $798.09 $868.95 $769.53 $1,552.49 $1,209.32 $1,610.25 $1,671.56 $1,080.81 $1,101.41 $1,887.86 $854.24

$1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90 $794.36 $714.96 $1,400.78 $1,110.36 $1,466.66 $1,529.67 $984.18 $1,008.57 $1,698.69 $776.16

$1,066.31 $913.91 $1,953.81 $1,471.10 $1,990.13 $2,046.93 $1,336.44 $1,347.03 $2,388.32 $1,060.82 $798.02 $717.65 $1,408.23 $1,115.22 $1,473.72 $1,536.65 $988.92 $1,013.13 $1,707.98 $780.00 $801.62 $720.27 $1,415.57 $1,120.01 $1,480.65 $1,543.50 $993.60 $1,017.62 $1,717.13 $783.77

of 25 04/08/2023






31 32 33 34 35 36 37 38 39 40$893.21 $787.28 $1,601.81 $1,241.49 $1,656.93 $1,717.70 $1,112.22 $1,131.60 $1,949.36 $879.63

$1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90 $1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90

$934.20 $817.26 $1,685.16 $1,295.87 $1,735.85 $1,795.67 $1,165.32 $1,182.62 $2,053.32 $922.53 $1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90

$923.15 $809.18 $1,662.69 $1,281.20 $1,714.56 $1,774.64 $1,151.01 $1,168.86 $2,025.29 $910.97 $809.58 $726.11 $1,431.74 $1,130.57 $1,495.97 $1,558.64 $1,003.91 $1,027.52 $1,737.30 $792.09 $942.75 $823.53 $1,702.56 $1,307.22 $1,752.32 $1,811.94 $1,176.41 $1,193.27 $2,075.01 $931.50 $797.06 $716.94 $1,406.30 $1,113.96 $1,471.88 $1,534.83 $987.69 $1,011.95 $1,705.56 $779.00 $787.04 $709.61 $1,385.91 $1,100.67 $1,452.59 $1,515.77 $974.70 $999.47 $1,680.14 $768.51 $807.03 $724.23 $1,426.56 $1,127.19 $1,491.06 $1,553.79 $1,000.61 $1,024.35 $1,730.84 $789.44 $813.89 $729.24 $1,440.50 $1,136.27 $1,504.25 $1,566.81 $1,009.47 $1,032.87 $1,748.21 $796.61 $934.20 $817.26 $1,685.16 $1,295.87 $1,735.85 $1,795.67 $1,165.32 $1,182.62 $2,053.32 $922.53 $800.25 $719.28 $1,412.79 $1,118.19 $1,478.03 $1,540.91 $991.83 $1,015.92 $1,713.66 $782.34 $893.21 $787.28 $1,601.81 $1,241.49 $1,656.93 $1,717.70 $1,112.22 $1,131.60 $1,949.36 $879.63

$1,066.31 $913.91 $1,953.81 $1,471.10 $1,990.13 $2,046.93 $1,336.44 $1,347.03 $2,388.32 $1,060.82 $1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90

$800.28 $719.30 $1,412.84 $1,118.24 $1,478.09 $1,540.95 $991.86 $1,015.95 $1,713.74 $782.37 $925.43 $810.84 $1,667.31 $1,284.23 $1,718.96 $1,778.97 $1,153.95 $1,171.70 $2,031.06 $913.35

$1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90 $801.08 $719.88 $1,414.44 $1,119.29 $1,479.60 $1,542.45 $992.88 $1,016.93 $1,715.73 $783.20 $868.95 $769.53 $1,552.49 $1,209.32 $1,610.25 $1,671.56 $1,080.81 $1,101.41 $1,887.86 $854.24

$1,032.78 $889.38 $1,885.62 $1,426.62 $1,925.58 $1,983.15 $1,293.02 $1,305.30 $2,303.30 $1,025.72 $805.19 $722.88 $1,422.81 $1,124.75 $1,487.52 $1,550.28 $998.22 $1,022.06 $1,726.17 $787.50 $888.59 $783.89 $1,592.40 $1,235.36 $1,648.04 $1,708.89 $1,106.24 $1,125.84 $1,937.64 $874.79 $801.08 $719.88 $1,414.44 $1,119.29 $1,479.60 $1,542.45 $992.88 $1,016.93 $1,715.73 $783.20 $815.31 $730.29 $1,443.41 $1,138.17 $1,507.01 $1,569.54 $1,011.33 $1,034.66 $1,751.84 $798.09

$1,066.31 $913.91 $1,953.81 $1,471.10 $1,990.13 $2,046.93 $1,336.44 $1,347.03 $2,388.32 $1,060.82 $1,058.37 $908.10 $1,937.67 $1,460.57 $1,974.84 $2,031.83 $1,326.15 $1,337.15 $2,368.19 $1,052.51 $1,058.37 $908.10 $1,937.67 $1,460.57 $1,974.84 $2,031.83 $1,326.15 $1,337.15 $2,368.19 $1,052.51

$893.21 $787.28 $1,601.81 $1,241.49 $1,656.93 $1,717.70 $1,112.22 $1,131.60 $1,949.36 $879.63 $893.21 $787.28 $1,601.81 $1,241.49 $1,656.93 $1,717.70 $1,112.22 $1,131.60 $1,949.36 $879.63

$1,032.78 $889.38 $1,885.62 $1,426.62 $1,925.58 $1,983.15 $1,293.02 $1,305.30 $2,303.30 $1,025.72 $853.43 $758.18 $1,520.91 $1,188.72 $1,580.37 $1,642.04 $1,060.70 $1,082.09 $1,848.50 $837.99 $868.95 $769.53 $1,552.49 $1,209.32 $1,610.25 $1,671.56 $1,080.81 $1,101.41 $1,887.86 $854.24 $925.43 $810.84 $1,667.31 $1,284.23 $1,718.96 $1,778.97 $1,153.95 $1,171.70 $2,031.06 $913.35 $925.43 $810.84 $1,667.31 $1,284.23 $1,718.96 $1,778.97 $1,153.95 $1,171.70 $2,031.06 $913.35

$1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90 $1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90 $1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90 $1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90 $1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90

$868.95 $769.53 $1,552.49 $1,209.32 $1,610.25 $1,671.56 $1,080.81 $1,101.41 $1,887.86 $854.24 $1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90

$925.43 $810.84 $1,667.31 $1,284.23 $1,718.96 $1,778.97 $1,153.95 $1,171.70 $2,031.06 $913.35 $868.95 $769.53 $1,552.49 $1,209.32 $1,610.25 $1,671.56 $1,080.81 $1,101.41 $1,887.86 $854.24

$1,055.19 $905.78 $1,931.21 $1,456.35 $1,968.72 $2,025.78 $1,322.04 $1,333.19 $2,360.12 $1,049.18

of 25 04/08/2023






31 32 33 34 35 36 37 38 39 40$794.12 $714.78 $1,400.28 $1,110.05 $1,466.19 $1,529.21 $983.87 $1,008.27 $1,698.08 $775.91 $813.86 $729.23 $1,440.45 $1,136.25 $1,504.22 $1,566.78 $1,009.46 $1,032.86 $1,748.16 $796.58 $833.04 $743.27 $1,479.45 $1,161.68 $1,541.13 $1,603.25 $1,034.28 $1,056.72 $1,796.79 $816.65 $833.04 $743.27 $1,479.45 $1,161.68 $1,541.13 $1,603.25 $1,034.28 $1,056.72 $1,796.79 $816.65 $802.98 $721.28 $1,418.34 $1,121.82 $1,483.28 $1,546.10 $995.36 $1,019.31 $1,720.58 $785.19 $789.15 $711.17 $1,390.22 $1,103.48 $1,456.67 $1,519.79 $977.45 $1,002.11 $1,685.51 $770.72

$1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90 $800.25 $719.28 $1,412.79 $1,118.19 $1,478.03 $1,540.91 $991.83 $1,015.92 $1,713.66 $782.34 $816.89 $731.45 $1,446.62 $1,140.26 $1,510.04 $1,572.54 $1,013.37 $1,036.62 $1,755.84 $799.76 $925.43 $810.84 $1,667.31 $1,284.23 $1,718.96 $1,778.97 $1,153.95 $1,171.70 $2,031.06 $913.35 $934.20 $817.26 $1,685.16 $1,295.87 $1,735.85 $1,795.67 $1,165.32 $1,182.62 $2,053.32 $922.53 $868.95 $769.53 $1,552.49 $1,209.32 $1,610.25 $1,671.56 $1,080.81 $1,101.41 $1,887.86 $854.24 $856.02 $760.07 $1,526.18 $1,192.16 $1,585.35 $1,646.96 $1,064.06 $1,085.31 $1,855.05 $840.71

$1,066.31 $913.91 $1,953.81 $1,471.10 $1,990.13 $2,046.93 $1,336.44 $1,347.03 $2,388.32 $1,060.82 $1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90

$794.36 $714.96 $1,400.78 $1,110.36 $1,466.66 $1,529.67 $984.18 $1,008.57 $1,698.69 $776.16 $950.27 $829.02 $1,717.83 $1,317.17 $1,766.76 $1,826.22 $1,186.13 $1,202.61 $2,094.05 $939.35 $798.02 $717.65 $1,408.23 $1,115.22 $1,473.72 $1,536.65 $988.92 $1,013.13 $1,707.98 $780.00 $802.26 $720.75 $1,416.87 $1,120.86 $1,481.90 $1,544.72 $994.43 $1,018.41 $1,718.75 $784.44 $813.30 $728.82 $1,439.31 $1,135.50 $1,503.14 $1,565.72 $1,008.72 $1,032.15 $1,746.75 $795.99 $794.75 $715.25 $1,401.57 $1,110.89 $1,467.42 $1,530.42 $984.69 $1,009.05 $1,699.68 $776.57 $813.30 $728.82 $1,439.31 $1,135.50 $1,503.14 $1,565.72 $1,008.72 $1,032.15 $1,746.75 $795.99 $779.52 $704.12 $1,370.61 $1,090.70 $1,438.11 $1,501.46 $964.97 $990.11 $1,661.07 $760.64 $813.30 $728.82 $1,439.31 $1,135.50 $1,503.14 $1,565.72 $1,008.72 $1,032.15 $1,746.75 $795.99 $800.81 $719.69 $1,413.90 $1,118.93 $1,479.09 $1,541.94 $992.54 $1,016.60 $1,715.06 $782.91 $934.20 $817.26 $1,685.16 $1,295.87 $1,735.85 $1,795.67 $1,165.32 $1,182.62 $2,053.32 $922.53 $802.26 $720.75 $1,416.87 $1,120.86 $1,481.90 $1,544.72 $994.43 $1,018.41 $1,718.75 $784.44 $766.61 $694.67 $1,344.36 $1,073.57 $1,413.27 $1,476.90 $948.24 $974.04 $1,628.34 $747.12

$1,008.30 $871.47 $1,835.87 $1,394.16 $1,878.48 $1,936.61 $1,261.31 $1,274.84 $2,241.23 $1,000.11 $898.49 $791.15 $1,612.55 $1,248.50 $1,667.12 $1,727.75 $1,119.08 $1,138.17 $1,962.77 $885.17 $893.21 $787.28 $1,601.81 $1,241.49 $1,656.93 $1,717.70 $1,112.22 $1,131.60 $1,949.36 $879.63 $893.21 $787.28 $1,601.81 $1,241.49 $1,656.93 $1,717.70 $1,112.22 $1,131.60 $1,949.36 $879.63 $874.02 $773.24 $1,562.78 $1,216.04 $1,620.00 $1,681.20 $1,087.37 $1,107.72 $1,900.70 $859.55 $833.63 $743.69 $1,480.64 $1,162.46 $1,542.26 $1,604.37 $1,035.05 $1,057.44 $1,798.28 $817.26 $934.20 $817.26 $1,685.16 $1,295.87 $1,735.85 $1,795.67 $1,165.32 $1,182.62 $2,053.32 $922.53 $893.21 $787.28 $1,601.81 $1,241.49 $1,656.93 $1,717.70 $1,112.22 $1,131.60 $1,949.36 $879.63 $893.21 $787.28 $1,601.81 $1,241.49 $1,656.93 $1,717.70 $1,112.22 $1,131.60 $1,949.36 $879.63 $813.30 $728.82 $1,439.31 $1,135.50 $1,503.14 $1,565.72 $1,008.72 $1,032.15 $1,746.75 $795.99

$1,058.37 $908.10 $1,937.67 $1,460.57 $1,974.84 $2,031.83 $1,326.15 $1,337.15 $2,368.19 $1,052.51 $797.46 $717.23 $1,407.09 $1,114.49 $1,472.64 $1,535.58 $988.20 $1,012.44 $1,706.57 $779.42 $854.18 $758.72 $1,522.43 $1,189.71 $1,581.81 $1,643.45 $1,061.67 $1,083.02 $1,850.39 $838.77 $898.49 $791.15 $1,612.55 $1,248.50 $1,667.12 $1,727.75 $1,119.08 $1,138.17 $1,962.77 $885.17 $780.95 $705.15 $1,373.52 $1,092.59 $1,440.86 $1,504.17 $966.81 $991.89 $1,664.70 $762.14 $868.95 $769.53 $1,552.49 $1,209.32 $1,610.25 $1,671.56 $1,080.81 $1,101.41 $1,887.86 $854.24 $800.25 $719.28 $1,412.79 $1,118.19 $1,478.03 $1,540.91 $991.83 $1,015.92 $1,713.66 $782.34 $786.69 $709.35 $1,385.21 $1,100.21 $1,451.93 $1,515.11 $974.27 $999.03 $1,679.27 $768.14 $948.80 $827.94 $1,714.86 $1,315.23 $1,763.96 $1,823.43 $1,184.24 $1,200.80 $2,090.34 $937.82

of 25 04/08/2023






31 32 33 34 35 36 37 38 39 40$868.95 $769.53 $1,552.49 $1,209.32 $1,610.25 $1,671.56 $1,080.81 $1,101.41 $1,887.86 $854.24 $833.04 $743.27 $1,479.45 $1,161.68 $1,541.13 $1,603.25 $1,034.28 $1,056.72 $1,796.79 $816.65 $833.63 $743.69 $1,480.64 $1,162.46 $1,542.26 $1,604.37 $1,035.05 $1,057.44 $1,798.28 $817.26

$1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90 $813.30 $728.82 $1,439.31 $1,135.50 $1,503.14 $1,565.72 $1,008.72 $1,032.15 $1,746.75 $795.99

$1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90 $948.81 $827.96 $1,714.88 $1,315.25 $1,763.97 $1,823.45 $1,184.25 $1,200.80 $2,090.37 $937.83

$1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90 $1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90 $1,032.78 $889.38 $1,885.62 $1,426.62 $1,925.58 $1,983.15 $1,293.02 $1,305.30 $2,303.30 $1,025.72 $1,070.21 $916.76 $1,961.73 $1,476.26 $1,997.63 $2,054.34 $1,341.48 $1,351.88 $2,398.19 $1,064.90

$950.27 $829.02 $1,717.83 $1,317.17 $1,766.76 $1,826.22 $1,186.13 $1,202.61 $2,094.05 $939.35 $948.80 $827.94 $1,714.86 $1,315.23 $1,763.96 $1,823.43 $1,184.24 $1,200.80 $2,090.34 $937.82 $809.58 $726.11 $1,431.74 $1,130.57 $1,495.97 $1,558.64 $1,003.91 $1,027.52 $1,737.30 $792.09 $793.73 $714.50 $1,399.49 $1,109.52 $1,465.44 $1,528.47 $983.36 $1,007.78 $1,697.09 $775.50 $791.19 $712.65 $1,394.36 $1,106.18 $1,460.58 $1,523.67 $980.09 $1,004.64 $1,690.68 $772.86 $758.04 $688.40 $1,326.93 $1,062.20 $1,396.77 $1,460.61 $937.14 $963.38 $1,606.61 $738.15 $852.78 $757.70 $1,519.59 $1,187.87 $1,579.11 $1,640.79 $1,059.86 $1,081.28 $1,846.83 $837.32 $925.43 $810.84 $1,667.31 $1,284.23 $1,718.96 $1,778.97 $1,153.95 $1,171.70 $2,031.06 $913.35 $815.31 $730.29 $1,443.41 $1,138.17 $1,507.01 $1,569.54 $1,011.33 $1,034.66 $1,751.84 $798.09

$1,008.30 $871.47 $1,835.87 $1,394.16 $1,878.48 $1,936.61 $1,261.31 $1,274.84 $2,241.23 $1,000.11 $794.00 $714.71 $1,400.06 $1,109.90 $1,465.98 $1,529.00 $983.72 $1,008.12 $1,697.79 $775.79 $868.95 $769.53 $1,552.49 $1,209.32 $1,610.25 $1,671.56 $1,080.81 $1,101.41 $1,887.86 $854.24

$1,032.78 $889.38 $1,885.62 $1,426.62 $1,925.58 $1,983.15 $1,293.02 $1,305.30 $2,303.30 $1,025.72 $793.46 $714.30 $1,398.95 $1,109.16 $1,464.93 $1,527.96 $983.01 $1,007.45 $1,696.40 $775.22

$1,066.31 $913.91 $1,953.81 $1,471.10 $1,990.13 $2,046.93 $1,336.44 $1,347.03 $2,388.32 $1,060.82 $934.20 $817.26 $1,685.16 $1,295.87 $1,735.85 $1,795.67 $1,165.32 $1,182.62 $2,053.32 $922.53 $758.04 $688.40 $1,326.93 $1,062.20 $1,396.77 $1,460.61 $937.14 $963.38 $1,606.61 $738.15

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PAS PAS PAS

41 42 45$1,218.00 $906.21 $7,696.82 $1,269.33 $932.69 $7,744.92 $1,527.35 $1,065.72 $7,986.71 $1,249.56 $922.49 $7,726.40 $1,215.21 $904.77 $7,694.21 $1,269.33 $932.69 $7,744.92 $1,217.34 $905.87 $7,696.20 $1,179.65 $886.44 $7,660.88 $1,264.08 $929.97 $7,740.00 $1,387.20 $993.47 $7,855.37 $1,752.02 $1,181.58 $8,197.25 $1,269.33 $932.69 $7,744.92 $1,261.88 $928.85 $7,737.95 $1,244.33 $919.79 $7,721.49 $1,482.62 $1,042.67 $7,944.80 $1,482.62 $1,042.67 $7,944.80 $1,759.46 $1,185.42 $8,204.22 $1,307.09 $952.14 $7,780.29 $1,759.46 $1,185.42 $8,204.22 $1,759.46 $1,185.42 $8,204.22 $1,421.01 $1,010.90 $7,887.06 $1,759.46 $1,185.42 $8,204.22 $1,231.31 $913.08 $7,709.28 $1,412.18 $1,006.34 $7,878.78 $1,759.46 $1,185.42 $8,204.22 $1,218.00 $906.21 $7,696.82 $1,231.98 $913.43 $7,709.93 $1,261.10 $928.44 $7,737.21 $1,261.88 $928.85 $7,737.95 $1,179.65 $886.44 $7,660.88 $1,421.01 $1,010.90 $7,887.06 $1,215.95 $905.15 $7,694.88 $1,261.10 $928.44 $7,737.21 $1,752.02 $1,181.58 $8,197.25 $1,218.00 $906.21 $7,696.82 $1,272.06 $934.10 $7,747.47 $1,759.46 $1,185.42 $8,204.22 $1,759.46 $1,185.42 $8,204.22 $1,759.46 $1,185.42 $8,204.22 $1,250.54 $923.00 $7,727.31 $1,268.18 $932.09 $7,743.83 $1,374.63 $986.99 $7,843.59 $1,269.29 $932.66 $7,744.88 $1,752.02 $1,181.58 $8,197.25 $1,206.35 $900.21 $7,685.90 $1,181.58 $887.43 $7,662.69 $1,272.29 $934.20 $7,747.68

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PAS PAS PAS

41 42 45$1,159.97 $876.29 $7,642.44 $1,261.10 $928.44 $7,737.21 $1,421.01 $1,010.90 $7,887.06 $1,231.98 $913.43 $7,709.93 $1,215.21 $904.77 $7,694.21 $1,261.10 $928.44 $7,737.21 $1,268.22 $932.12 $7,743.89 $1,759.46 $1,185.42 $8,204.22 $1,502.15 $1,052.73 $7,963.10 $1,237.92 $916.49 $7,715.49 $1,759.46 $1,185.42 $8,204.22 $1,421.01 $1,010.90 $7,887.06 $1,272.06 $934.10 $7,747.47 $1,272.06 $934.10 $7,747.47 $1,236.06 $915.53 $7,713.74 $1,374.63 $986.99 $7,843.59 $1,421.01 $1,010.90 $7,887.06 $1,752.02 $1,181.58 $8,197.25 $1,382.97 $991.28 $7,851.41 $1,274.33 $935.25 $7,749.60 $1,499.40 $1,051.32 $7,960.52 $1,499.40 $1,051.32 $7,960.52 $1,374.63 $986.99 $7,843.59 $1,421.01 $1,010.90 $7,887.06 $1,245.89 $920.60 $7,722.95 $1,499.40 $1,051.32 $7,960.52 $1,203.62 $898.80 $7,683.35 $1,412.18 $1,006.34 $7,878.78 $1,752.02 $1,181.58 $8,197.25 $1,759.46 $1,185.42 $8,204.22 $1,421.01 $1,010.90 $7,887.06 $1,159.97 $876.29 $7,642.44 $1,502.15 $1,052.73 $7,963.10 $1,246.41 $920.87 $7,723.44 $1,245.89 $920.60 $7,722.95 $1,502.15 $1,052.73 $7,963.10 $1,243.28 $919.25 $7,720.50 $1,752.02 $1,181.58 $8,197.25 $1,499.40 $1,051.32 $7,960.52 $1,261.88 $928.85 $7,737.95 $1,272.06 $934.10 $7,747.47 $1,374.63 $986.99 $7,843.59 $1,759.46 $1,185.42 $8,204.22 $1,231.98 $913.43 $7,709.93 $1,752.02 $1,181.58 $8,197.25 $1,238.99 $917.04 $7,716.48 $1,245.89 $920.60 $7,722.95

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PAS PAS PAS

41 42 45$1,421.01 $1,010.90 $7,887.06 $1,759.46 $1,185.42 $8,204.22 $1,759.46 $1,185.42 $8,204.22 $1,499.40 $1,051.32 $7,960.52 $1,759.46 $1,185.42 $8,204.22 $1,478.27 $1,040.42 $7,940.72 $1,261.10 $928.44 $7,737.21 $1,515.77 $1,059.75 $7,975.86 $1,237.17 $916.10 $7,714.77 $1,218.00 $906.21 $7,696.82 $1,256.24 $925.92 $7,732.64 $1,269.33 $932.69 $7,744.92 $1,499.40 $1,051.32 $7,960.52 $1,243.28 $919.25 $7,720.50 $1,421.01 $1,010.90 $7,887.06 $1,752.02 $1,181.58 $8,197.25 $1,759.46 $1,185.42 $8,204.22 $1,243.32 $919.28 $7,720.55 $1,482.62 $1,042.67 $7,944.80 $1,759.46 $1,185.42 $8,204.22 $1,244.84 $920.06 $7,721.96 $1,374.63 $986.99 $7,843.59 $1,687.91 $1,148.52 $8,137.16 $1,252.70 $924.11 $7,729.34 $1,412.18 $1,006.34 $7,878.78 $1,244.84 $920.06 $7,721.96 $1,272.06 $934.10 $7,747.47 $1,752.02 $1,181.58 $8,197.25 $1,736.84 $1,173.75 $8,183.03 $1,736.84 $1,173.75 $8,183.03 $1,421.01 $1,010.90 $7,887.06 $1,421.01 $1,010.90 $7,887.06 $1,687.91 $1,148.52 $8,137.16 $1,344.95 $971.67 $7,815.78 $1,374.63 $986.99 $7,843.59 $1,482.62 $1,042.67 $7,944.80 $1,482.62 $1,042.67 $7,944.80 $1,759.46 $1,185.42 $8,204.22 $1,759.46 $1,185.42 $8,204.22 $1,759.46 $1,185.42 $8,204.22 $1,759.46 $1,185.42 $8,204.22 $1,759.46 $1,185.42 $8,204.22 $1,374.63 $986.99 $7,843.59 $1,759.46 $1,185.42 $8,204.22 $1,482.62 $1,042.67 $7,944.80 $1,374.63 $986.99 $7,843.59 $1,730.76 $1,170.62 $8,177.33

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PAS PAS PAS

41 42 45$1,231.52 $913.19 $7,709.49 $1,269.29 $932.66 $7,744.88 $1,305.96 $951.57 $7,779.24 $1,305.96 $951.57 $7,779.24 $1,248.50 $921.93 $7,725.39 $1,222.05 $908.30 $7,700.61 $1,759.46 $1,185.42 $8,204.22 $1,243.28 $919.25 $7,720.50 $1,275.08 $935.64 $7,750.31 $1,482.62 $1,042.67 $7,944.80 $1,499.40 $1,051.32 $7,960.52 $1,374.63 $986.99 $7,843.59 $1,349.90 $974.22 $7,820.42 $1,752.02 $1,181.58 $8,197.25 $1,759.46 $1,185.42 $8,204.22 $1,231.98 $913.43 $7,709.93 $1,530.12 $1,067.16 $7,989.30 $1,238.99 $917.04 $7,716.48 $1,247.12 $921.23 $7,724.10 $1,268.22 $932.12 $7,743.89 $1,232.73 $913.82 $7,710.62 $1,268.22 $932.12 $7,743.89 $1,203.62 $898.80 $7,683.35 $1,268.22 $932.12 $7,743.89 $1,244.33 $919.79 $7,721.49 $1,499.40 $1,051.32 $7,960.52 $1,247.12 $921.23 $7,724.10 $1,178.94 $886.07 $7,660.22 $1,641.11 $1,124.39 $8,093.31 $1,431.12 $1,016.10 $7,896.53 $1,421.01 $1,010.90 $7,887.06 $1,421.01 $1,010.90 $7,887.06 $1,384.32 $991.98 $7,852.68 $1,307.09 $952.14 $7,780.29 $1,499.40 $1,051.32 $7,960.52 $1,421.01 $1,010.90 $7,887.06 $1,421.01 $1,010.90 $7,887.06 $1,268.22 $932.12 $7,743.89 $1,736.84 $1,173.75 $8,183.03 $1,237.92 $916.49 $7,715.49 $1,346.37 $972.41 $7,817.12 $1,431.12 $1,016.10 $7,896.53 $1,206.35 $900.21 $7,685.90 $1,374.63 $986.99 $7,843.59 $1,243.28 $919.25 $7,720.50 $1,217.34 $905.87 $7,696.20 $1,527.32 $1,065.72 $7,986.69

of 25 04/08/2023





PAS PAS PAS

41 42 45$1,374.63 $986.99 $7,843.59 $1,305.96 $951.57 $7,779.24 $1,307.09 $952.14 $7,780.29 $1,759.46 $1,185.42 $8,204.22 $1,268.22 $932.12 $7,743.89 $1,759.46 $1,185.42 $8,204.22 $1,527.35 $1,065.72 $7,986.71 $1,759.46 $1,185.42 $8,204.22 $1,759.46 $1,185.42 $8,204.22 $1,687.91 $1,148.52 $8,137.16 $1,759.46 $1,185.42 $8,204.22 $1,530.12 $1,067.16 $7,989.30 $1,527.32 $1,065.72 $7,986.69 $1,261.10 $928.44 $7,737.21 $1,230.78 $912.80 $7,708.79 $1,225.95 $910.31 $7,704.27 $1,162.55 $877.62 $7,644.86 $1,343.70 $971.03 $7,814.61 $1,482.62 $1,042.67 $7,944.80 $1,272.06 $934.10 $7,747.47 $1,641.11 $1,124.39 $8,093.31 $1,231.31 $913.08 $7,709.28 $1,374.63 $986.99 $7,843.59 $1,687.91 $1,148.52 $8,137.16 $1,230.26 $912.54 $7,708.31 $1,752.02 $1,181.58 $8,197.25 $1,499.40 $1,051.32 $7,960.52 $1,162.55 $877.62 $7,644.86

Am b Hosp 03 Fee Schedule

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Transcript of Am b Hosp 03 Fee Schedule