State prevailing rates

Please note that the CHAMPUS Maximum Allowable Charges (CMAC) take precedence over the state prevailing rates listed below.

Latest update: 08-01-2018
CPT code State Provider class Modifier Current pricing Effective date Past pricing Past effective date
0359T FL 01 00 $500.00 02/04/16
0359T FL 04 00 $500.00 02/04/16
0360T FL 01 00 $62.50 02/04/16
0360T FL 04 00 $62.50 02/04/16
0361T FL 01 00 $62.50 02/04/16
0361T FL 04 00 $62.50 02/04/16
0364T FL 01 00 $62.50 05/25/17
0364T FL 04 00 $62.50 05/25/17
0365T FL 01 00 $62.50 02/04/16
0365T FL 04 00 $62.50 02/04/16
0368T FL 01 00 $62.50 02/04/16
0368T FL 04 00 $62.50 02/04/16
0369T FL 01 00 $62.50 02/04/16
0369T FL 04 00 $62.50 02/04/16
0370T FL 01 00 $125.00 02/04/16
0370T FL 04 00 $125.00 02/04/16
15876 FL 01 00 $2,496.40 05/25/17
15876 FL 04 00 $2,496.40 05/25/17
15878 FL 01 00 $1,344.20 05/25/17
15878 FL 04 00 $1,344.20 05/25/17
15879 FL 01 00 $1,536.20 05/25/17
15879 FL 04 00 $1,397.10 05/25/17
17380 FL 01 00 $450.00 02/04/16
17380 FL 04 00 $450.00 02/04/16
24940 FL 01 00 $1,698.00 05/25/17
24940 FL 04 00 $1,536.80 05/25/17
32850 FL 01 00 $3,629.40 05/25/17
32850 FL 04 00 $3,629.40 05/25/17
33940 FL 01 00 $2,938.10 05/25/17
33940 FL 04 00 $2,938.10 05/25/17
36468 FL 01 00 $450.00 02/04/16
36468 FL 04 00 $450.00 02/04/16
45390 FL 01 00 $1,265.00 02/04/16
45390 FL 04 00 $1,265.00 02/04/16
50300 FL 01 00 $1,132.00 05/25/17
50300 FL 04 00 $1,082.80 05/25/17
58974 FL 01 00 $1,200.00 02/04/16 $750.00 06/17/14
58974 FL 04 00 $750.00 02/04/16
65767 FL 01 00 $2,924.60 05/25/17
65767 FL 04 00 $2,924.60 05/25/17
69090 FL 01 00 $65.00 05/08/17
69090 FL 04 00 $50.00 02/04/16 $75.00 06/17/14
73530 FL 01 00 $982.80 05/25/17
73530 FL 04 00 $982.80 05/25/17
74328 FL 01 00 $848.96 05/25/17
74328 FL 01 TC $812.70 05/25/17
74328 FL 04 00 $843.52 05/25/17
74328 FL 04 TC $812.70 05/25/17
74330 FL 01 00 $1,929.47 05/25/17
74330 FL 01 TC $1,883.00 05/25/17
74330 FL 04 00 $1,922.50 05/25/17
74330 FL 04 TC $1,883.00 05/25/17
75894 FL 01 00 $1,832.00 05/25/17
75894 FL 04 00 $1,832.00 05/25/17
76001 FL 01 00 $3,500.00 05/25/17 $1,627.00 11/12/15
76001 FL 01 TC $1,060.22 05/25/17
76001 FL 04 00 $1,095.96 05/25/17
76001 FL 04 TC $1,060.22 05/25/17
76998 FL 01 00 $538.00 02/04/16
76998 FL 01 TC $908.75 02/04/16
76998 FL 04 00 $275.00 02/04/16
76998 FL 04 TC $908.75 02/04/16
77371 FL 01 00 $57,449.00 05/25/17
77371 FL 04 00 $57,449.00 05/25/17
77385 FL 01 00 $1,500.00 02/04/16
77385 FL 04 00 $1,500.00 02/04/16
77386 FL 01 00 $1,533.21 02/04/16
77386 FL 04 00 $1,533.21 02/04/16
80300 FL 01 00 $352.00 02/04/16
80300 FL 01 QW $110.00 02/04/16
80300 FL 04 00 $352.00 02/04/16
80300 FL 04 QW $110.00 02/04/16
80301 FL 01 00 $250.00 02/04/16
80301 FL 04 00 $250.00 02/04/16
80303 FL 01 00 $188.00 02/04/16
80303 FL 04 00 $188.00 02/04/16
80320 FL 01 00 $80.00 02/04/16
80320 FL 04 00 $80.00 02/04/16
80324 FL 01 00 $32.49 02/04/16
80324 FL 01 59 $52.81 02/04/16
80324 FL 04 00 $32.49 02/04/16
80324 FL 04 59 $52.81 02/04/16
80325 FL 01 00 $106.80 02/04/16
80325 FL 04 00 $106.80 02/04/16
80327 FL 01 00 $87.70 02/04/16
80327 FL 04 00 $87.70 02/04/16
80337 FL 01 00 $210.86 02/04/16
80337 FL 04 00 $210.86 02/04/16
80345 FL 01 00 $46.86 02/04/16
80345 FL 04 00 $46.86 02/04/16
80346 FL 01 00 $76.00 02/04/16
80346 FL 04 00 $76.00 02/04/16
80347 FL 01 00 $25.17 02/04/16
80347 FL 04 00 $25.17 02/04/16
80348 FL 01 00 $40.00 02/04/16
80348 FL 04 00 $40.00 02/04/16
80349 FL 01 00 $36.00 02/04/16
80349 FL 04 00 $36.00 02/04/16
80353 FL 01 00 $52.00 02/04/16
80353 FL 01 59 $52.07 02/04/16
80353 FL 04 00 $52.00 02/04/16
80353 FL 04 59 $52.07 02/04/16
80354 FL 01 00 $40.00 02/04/16
80354 FL 04 00 $40.00 02/04/16
80355 FL 01 00 $50.00 02/04/16
80355 FL 04 00 $50.00 02/04/16
80356 FL 01 00 $40.00 02/04/16
80356 FL 04 00 $40.00 02/04/16
80357 FL 01 00 $73.89 02/04/16
80357 FL 04 00 $73.89 02/04/16
80358 FL 01 00 $54.47 02/04/16
80358 FL 01 59 $112.24 02/04/16
80358 FL 04 00 $54.47 02/04/16
80358 FL 04 59 $112.24 02/04/16
80359 FL 01 00 $32.49 02/04/16
80359 FL 04 00 $32.49 02/04/16
80361 FL 01 00 $60.00 02/04/16
80361 FL 01 59 $68.40 02/04/16
80361 FL 04 00 $60.00 02/04/16
80361 FL 04 59 $68.40 02/04/16
80362 FL 01 00 $32.49 02/04/16
80362 FL 04 00 $32.49 02/04/16
80363 FL 01 00 $159.24 02/04/16
80363 FL 04 00 $159.24 02/04/16
80364 FL 01 00 $125.00 02/04/16
80364 FL 04 00 $125.00 02/04/16
80365 FL 01 00 $75.00 02/04/16
80365 FL 04 00 $75.00 02/04/16
80366 FL 01 00 $100.00 02/04/16
80366 FL 04 00 $100.00 02/04/16
80367 FL 01 00 $79.62 02/04/16
80367 FL 04 00 $79.62 02/04/16
80369 FL 01 00 $36.00 02/04/16
80369 FL 04 00 $36.00 02/04/16
80372 FL 01 00 $32.49 02/04/16
80372 FL 04 00 $32.49 02/04/16
80373 FL 01 00 $60.00 02/04/16
80373 FL 04 00 $60.00 02/04/16
81228 FL 01 00 $1,715.00 02/04/16
81228 FL 04 00 $930.00 02/04/16
81229 FL 01 00 $2,870.40 02/04/16
81229 FL 04 00 $2,870.40 02/04/16
81405 FL 01 00 $1,479.00 02/04/16
81405 FL 04 00 $1,479.00 02/04/16
81503 FL 01 00 $703.04 05/25/17
81503 FL 04 00 $703.04 05/25/17
86860 FL 01 00 $155.00 05/08/17
86860 FL 04 00 $18.00 05/25/17
86891 FL 01 00 $2,529.00 05/08/17
86891 FL 01 26 $2,500.00 05/25/17
86891 FL 01 TC $3,750.00 05/25/17
86891 FL 04 00 $2,299.00 05/25/17
86891 FL 04 26 $2,500.00 05/25/17
86891 FL 04 TC $3,750.00 05/25/17
86930 FL 01 00 $41.30 05/25/17
86930 FL 04 00 $28.70 05/25/17
86931 FL 01 00 $48.75 05/25/17
86931 FL 04 00 $33.90 05/25/17
86932 FL 01 00 $87.60 05/25/17
86932 FL 04 00 $60.90 05/25/17
86950 FL 01 00 $65.60 05/25/17
86950 FL 04 00 $45.60 05/25/17
86970 FL 01 00 $32.90 05/25/17
86970 FL 04 00 $22.90 05/25/17
86971 FL 01 00 $39.00 05/25/17
86971 FL 04 00 $27.10 05/25/17
86975 FL 01 00 $29.25 05/25/17
86975 FL 04 00 $20.30 05/25/17
86976 FL 01 00 $212.00 05/25/17
86976 FL 04 00 $212.00 05/25/17
86978 FL 01 00 $292.00 05/08/17
86978 FL 04 00 $13.60 05/25/17
89240 FL 01 00 $50.00 05/25/17
89240 FL 04 00 $50.00 05/25/17
89255 FL 01 00 $564.00 02/04/16
89255 FL 04 00 $564.00 02/04/16
90650 FL 01 00 $250.00 05/25/17
90650 FL 04 00 $250.00 05/25/17
90666 FL 01 00 $27.29 02/04/16
90666 FL 04 00 $27.29 02/04/16
90681 FL 01 00 $250.00 05/25/17
90681 FL 04 00 $250.00 05/25/17
90696 FL 01 00 $150.00 05/25/17
90696 FL 04 00 $150.00 05/25/17
90736 FL 01 00 $254.35 07/20/17
90736 FL 04 00 $254.35 07/20/17
90993 FL 04 00 $4,831.00 05/25/17
90999 FL 01 00 $4,715.81 05/08/17
90999 FL 04 00 $3,988.00 05/25/17
92534 FL 01 00 $22.00 05/25/17
92534 FL 04 00 $22.00 05/25/17
92594 FL 01 00 $58.30 05/25/17
92594 FL 04 00 $58.30 05/25/17
92978 FL 01 00 $4,659.73 05/25/17
92978 FL 01 TC $4,560.60 05/25/17
92978 FL 04 00 $4,644.86 05/25/17
92978 FL 04 TC $4,560.60 05/25/17
93299 FL 01 00 $100.00 05/08/17
93299 FL 04 00 $81.00 05/08/17 $100.00 11/13/15
93609 FL 01 00 $6,385.05 05/25/17
93609 FL 01 TC $6,100.00 05/25/17
93609 FL 04 00 $6,342.29 05/25/17
93609 FL 04 TC $6,100.00 05/25/17
93620 FL 01 00 $9,923.80 05/25/17
93620 FL 01 TC $9,260.00 05/25/17
93620 FL 04 00 $9,824.23 05/25/17
93620 FL 04 TC $9,260.00 05/25/17
93621 FL 01 00 $10,296.29 05/25/17
93621 FL 01 TC $10,176.00 05/25/17
93621 FL 04 00 $10,278.25 05/25/17
93621 FL 04 TC $10,176.00 05/25/17
93623 FL 01 00 $6,228.98 05/25/17
93623 FL 01 TC $6,066.00 05/25/17
93623 FL 04 00 $6,204.53 05/25/17
93623 FL 04 TC $6,066.00 05/25/17
93641 FL 01 00 $2,675.24 05/25/17
93641 FL 01 TC $2,337.00 05/25/17
93641 FL 04 00 $2,624.50 05/25/17
93641 FL 04 TC $2,337.00 05/25/17
99000 FL 01 00 $22.00 05/08/17
99000 FL 04 00 $22.00 05/08/17
99001 FL 01 00 $100.00 05/08/17
99001 FL 04 00 $23.00 05/25/17
99002 FL 01 00 $50.00 05/25/17
99002 FL 04 00 $10.00 05/25/17
99071 FL 04 00 $3.00 02/04/16
99148 FL 01 26 $45.60 05/25/17
99148 FL 01 TC $68.40 05/25/17
99148 FL 04 26 $45.60 05/25/17
99148 FL 04 TC $68.40 05/25/17
99500 FL 01 00 $250.00 05/08/17
99500 FL 04 00 $250.00 05/25/17
99504 FL 01 00 $1,500.00 05/25/17
99504 FL 04 00 $1,500.00 05/25/17
A0110 FL 01 00 $150.00 05/25/17
A0110 FL 04 00 $150.00 05/25/17
A0120 FL 01 00 $45.00 05/25/17
A0120 FL 04 00 $45.00 05/25/17
A0130 FL 01 00 $100.00 05/25/17
A0130 FL 04 00 $100.00 05/25/17
A0225 FL 01 00 $350.00 05/25/17
A0225 FL 04 00 $350.00 05/25/17
A0380 FL 01 00 $4.00 05/25/17
A0380 FL 04 00 $4.00 05/25/17
A0382 FL 01 00 $26.00 05/25/17
A0382 FL 04 00 $26.00 05/25/17
A0384 FL 01 00 $95.00 05/25/17
A0384 FL 04 00 $95.00 05/25/17
A0390 FL 01 00 $4.00 05/25/17
A0390 FL 04 00 $4.00 05/25/17
A0392 FL 01 00 $52.50 05/25/17
A0392 FL 04 00 $52.50 05/25/17
A0394 FL 01 00 $80.00 05/25/17
A0394 FL 04 00 $80.00 05/25/17
A0396 FL 01 00 $20.00 05/25/17
A0396 FL 04 00 $20.00 05/25/17
A0398 FL 01 00 $50.00 05/25/17
A0398 FL 04 00 $50.00 05/25/17
A0420 FL 01 00 $130.00 02/04/16
A0420 FL 04 00 $130.00 02/04/16
A0422 FL 01 00 $20.00 05/25/17
A0422 FL 04 00 $20.00 05/25/17
A0424 FL 01 00 $300.00 05/25/17
A0424 FL 04 00 $300.00 05/25/17
A0430 FL 01 00 $1,682.95 04/09/18 $1,979.94 12/08/16
A0430 FL 01 00 $2,329.34 12/11/15
A0430 FL 04 00 $1,682.95 04/09/18 $1,979.94 12/08/16
A0430 FL 04 00 $2,329.34 12/11/15
A0431 FL 01 00 $2,088.03 04/09/18 $2,456.50 12/08/16
A0431 FL 01 00 $2,890.00 12/11/15
A0431 FL 04 00 $2,088.03 04/09/18 $2,456.50 12/08/16
A0431 FL 04 00 $2,890.00 12/11/15
A0435 FL 01 00 $10.44 04/09/18 $12.28 12/08/16
A0435 FL 01 00 $14.45 12/11/15
A0435 FL 04 00 $10.44 04/09/18 $12.28 12/08/16
A0435 FL 04 00 $14.45 12/11/15
A0436 FL 01 00 $41.76 04/09/18 $49.13 12/08/16
A0436 FL 01 00 $57.80 12/11/15
A0436 FL 04 00 $41.76 04/09/18 $49.13 12/08/16
A0436 FL 04 00 $57.80 12/11/15
A0888 FL 01 00 $44.57 02/04/16
A0888 FL 04 00 $44.57 02/04/16
A0998 FL 01 00 $125.00 02/04/16
A0998 FL 04 00 $125.00 02/04/16
A4206 FL 01 00 $2.25 05/08/17
A4206 FL 04 00 $2.25 05/08/17
A4207 FL 01 00 $.40 05/25/17
A4207 FL 04 00 $.40 05/25/17
A4208 FL 01 00 $5.00 05/08/17
A4208 FL 04 00 $5.00 05/08/17
A4209 FL 01 00 $25.00 05/08/17
A4209 FL 04 00 $25.00 05/08/17
A4210 FL 01 00 $.84 05/25/17
A4210 FL 04 00 $.84 05/25/17
A4211 FL 01 00 $25.00 05/08/17
A4211 FL 04 00 $25.00 05/08/17
A4212 FL 01 00 $38.00 05/08/17 $15.00 11/13/15
A4212 FL 04 00 $38.00 05/08/17 $15.00 11/13/15
A4213 FL 01 00 $4.86 05/08/17
A4213 FL 04 00 $4.86 05/08/17
A4215 FL 01 00 $25.00 05/08/17
A4215 FL 04 00 $25.00 05/08/17
A4218 FL 01 00 $10.00 05/08/17
A4218 FL 04 00 $10.00 05/08/17
A4220 FL 01 00 $180.00 05/08/17 $100.00 11/13/15
A4220 FL 04 00 $180.00 05/08/17 $100.00 11/13/15
A4223 FL 01 00 $150.00 05/08/17 $120.00 11/13/15
A4223 FL 04 00 $150.00 05/08/17 $120.00 11/13/15
A4230 FL 01 00 $61.90 05/08/17
A4230 FL 04 00 $61.90 05/08/17
A4231 FL 01 00 $56.04 05/08/17
A4231 FL 04 00 $56.04 05/08/17
A4232 FL 01 00 $8.63 05/08/17
A4232 FL 04 00 $8.63 05/08/17
A4244 FL 01 00 $2.75 05/08/17
A4244 FL 04 00 $2.75 05/08/17
A4245 FL 01 00 $12.50 05/08/17
A4245 FL 04 00 $12.50 05/08/17
A4246 FL 01 00 $3.00 05/25/17
A4246 FL 04 00 $3.00 05/25/17
A4247 FL 01 00 $25.00 05/08/17
A4247 FL 04 00 $25.00 05/08/17 $5.00 11/14/15
A4248 FL 01 00 $269.01 05/08/17
A4248 FL 04 00 $269.01 05/08/17
A4250 FL 01 00 $70.88 05/25/17 $41.30 11/14/15
A4250 FL 04 00 $70.88 05/25/17
A4262 FL 01 00 $140.00 05/25/17
A4262 FL 04 00 $140.00 05/25/17
A4263 FL 01 00 $125.00 05/08/17
A4263 FL 04 00 $125.00 05/08/17
A4270 FL 01 00 $50.00 05/25/17
A4270 FL 04 00 $50.00 05/25/17
A4281 FL 01 00 $10.00 11/14/15
A4281 FL 01 NU $10.00 05/08/17
A4281 FL 04 00 $10.00 11/14/15
A4281 FL 04 NU $10.00 05/08/17
A4282 FL 01 00 $40.00 05/08/17
A4282 FL 04 00 $40.00 05/08/17
A4283 FL 01 00 $10.00 05/25/17
A4283 FL 01 NU $10.00 05/08/17
A4283 FL 04 00 $10.00 05/25/17
A4283 FL 04 NU $10.00 05/08/17
A4284 FL 01 00 $10.00 05/25/17
A4284 FL 01 NU $10.00 05/08/17
A4284 FL 04 00 $10.00 05/25/17
A4284 FL 04 NU $10.00 05/08/17
A4285 FL 01 00 $10.00 05/25/17
A4285 FL 01 NU $10.00 05/08/17
A4285 FL 04 00 $10.00 05/25/17
A4285 FL 04 NU $10.00 05/08/17
A4286 FL 01 00 $10.00 05/25/17
A4286 FL 01 NU $10.00 05/08/17
A4286 FL 04 00 $10.00 05/25/17
A4286 FL 04 NU $10.00 05/08/17
A4300 FL 01 00 $25.00 05/08/17
A4300 FL 04 00 $25.00 05/08/17
A4305 FL 01 00 $80.00 05/08/17
A4305 FL 04 00 $80.00 05/08/17
A4306 FL 01 00 $250.00 05/08/17 $200.00 11/16/15
A4306 FL 04 00 $250.00 05/08/17 $200.00 11/16/15
A4450 FL 01 00 $42.80 05/08/17
A4450 FL 04 00 $42.80 05/08/17
A4452 FL 01 00 $25.80 05/08/17
A4452 FL 04 00 $25.80 05/08/17
A4465 FL 01 00 $4.95 05/25/17
A4465 FL 04 00 $4.95 05/25/17
A4466 FL 01 00 $185.00 05/25/17
A4466 FL 04 00 $57.00 05/25/17
A4467 FL 01 00 $20.00 05/08/17
A4467 FL 04 00 $20.00 05/08/17
A4470 FL 01 00 $4.95 05/25/17
A4470 FL 04 00 $4.95 05/25/17
A4480 FL 01 00 $18.00 05/25/17
A4480 FL 04 00 $18.00 05/25/17
A4483 FL 01 00 $8.36 05/25/17
A4483 FL 04 00 $8.36 05/25/17
A4490 FL 01 00 $30.00 05/25/17
A4490 FL 04 00 $30.00 05/25/17
A4495 FL 01 00 $21.25 05/25/17
A4495 FL 04 00 $21.25 05/25/17
A4500 FL 01 00 $93.00 05/25/17
A4500 FL 04 00 $93.00 05/25/17
A4510 FL 01 00 $80.00 05/25/17
A4510 FL 04 00 $80.00 05/25/17
A4550 FL 01 00 $136.00 05/08/17
A4550 FL 04 00 $136.00 05/08/17
A4554 FL 01 00 $5.34 05/08/17
A4554 FL 04 00 $5.34 05/08/17
A4566 FL 01 00 $40.00 05/05/17
A4566 FL 04 00 $40.00 05/05/17
A4570 FL 01 00 $100.00 05/08/17
A4570 FL 04 00 $100.00 05/08/17
A4580 FL 01 00 $117.00 05/08/17 $100.00 11/16/15
A4580 FL 04 00 $117.00 05/08/17 $100.00 11/16/15
A4590 FL 01 00 $89.00 05/08/17 $81.00 11/16/15
A4590 FL 04 00 $89.00 05/08/17 $81.00 11/16/15
A4606 FL 01 00 $42.00 05/08/17
A4606 FL 04 00 $42.00 05/08/17
A4611 FL 01 00 $500.00 05/25/17
A4611 FL 01 NU $636.86 05/08/17
A4611 FL 04 00 $500.00 05/25/17
A4611 FL 04 NU $636.86 05/08/17
A4612 FL 01 00 $200.00 05/25/17
A4612 FL 01 NU $269.41 05/08/17
A4612 FL 04 00 $200.00 05/25/17
A4612 FL 04 NU $269.41 05/08/17
A4613 FL 01 00 $350.00 05/25/17
A4613 FL 01 NU $350.00 05/08/17
A4613 FL 04 00 $350.00 05/25/17
A4613 FL 04 NU $350.00 05/08/17
A4627 FL 01 00 $50.00 05/08/17 $40.00 11/16/15
A4627 FL 04 00 $50.00 05/08/17 $40.00 11/16/15
A4638 FL 01 00 $9.00 05/25/17
A4638 FL 04 00 $9.00 05/25/17
A4641 FL 01 00 $180.00 05/25/17
A4641 FL 04 00 $180.00 05/25/17
A4642 FL 01 00 $2.00 05/25/17
A4642 FL 04 00 $2.00 05/25/17
A4648 FL 01 RT $100.00 02/04/16
A4648 FL 04 RT $100.00 02/04/16
A4650 FL 01 00 $195.31 05/25/17
A4650 FL 04 00 $195.31 05/25/17
A4651 FL 01 00 $2.00 05/25/17
A4651 FL 04 00 $2.00 05/25/17
A4657 FL 01 00 $84.30 05/08/17 $67.50 11/16/15
A4657 FL 04 00 $84.30 05/08/17 $67.50 11/16/15
A4660 FL 01 00 $128.50 05/25/17
A4660 FL 04 00 $128.50 05/25/17
A4663 FL 01 00 $34.00 05/25/17
A4663 FL 04 00 $34.00 05/25/17
A4670 FL 01 00 $99.99 05/08/17
A4670 FL 04 00 $99.99 05/08/17
A4680 FL 01 00 $9.00 05/25/17
A4680 FL 04 00 $9.00 05/25/17
A4690 FL 01 00 $461.25 05/25/17
A4690 FL 04 00 $461.25 05/25/17
A4706 FL 01 00 $23.98 05/25/17
A4706 FL 04 00 $23.98 05/25/17
A4707 FL 01 00 $8.54 05/25/17
A4707 FL 04 00 $8.54 05/25/17
A4714 FL 01 00 $25.82 05/25/17
A4714 FL 04 00 $25.82 05/25/17
A4722 FL 01 00 $56.25 05/25/17
A4722 FL 04 00 $56.25 05/25/17
A4725 FL 01 00 $55.80 05/25/17
A4725 FL 04 00 $55.80 05/25/17
A4730 FL 01 00 $1.89 05/25/17
A4730 FL 04 00 $1.89 05/25/17
A4750 FL 01 00 $25.00 05/25/17
A4750 FL 04 00 $25.00 05/25/17
A4755 FL 01 00 $25.00 05/25/17
A4755 FL 04 00 $25.00 05/25/17
A4760 FL 01 00 $7.00 05/25/17
A4760 FL 04 00 $7.00 05/25/17
A4765 FL 01 00 $2.00 05/25/17
A4765 FL 04 00 $2.00 05/25/17
A4770 FL 01 00 $18.90 05/25/17
A4770 FL 04 00 $18.90 05/25/17
A4771 FL 01 00 $10.60 05/25/17
A4771 FL 04 00 $10.60 05/25/17
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A9582 FL 04 00 $7,227.00 05/25/17
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B4157 FL 04 00 $11.35 05/25/17
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C1717 FL 04 00 $144.00 05/25/17
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C1753 FL 04 00 $2,400.00 05/25/17
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C1758 FL 04 00 $136.00 05/08/17 $121.00 11/17/15
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C1760 FL 04 00 $1,452.25 05/25/17
C1762 FL 01 00 $9,286.00 05/08/17
C1762 FL 04 00 $9,286.00 05/08/17
C1763 FL 01 00 $4,600.00 05/08/17
C1763 FL 04 00 $4,600.00 05/08/17
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C1764 FL 04 00 $13,154.00 05/25/17
C1766 FL 01 00 $159.00 05/25/17
C1766 FL 04 00 $159.00 05/25/17
C1767 FL 01 00 $41,889.55 05/25/17
C1767 FL 04 00 $41,889.55 05/25/17
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C1769 FL 04 00 $314.00 05/08/17
C1771 FL 01 00 $5,005.00 05/08/17
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C1772 FL 01 00 $33,600.00 05/25/17
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C1776 FL 04 00 $15,888.60 05/08/17
C1778 FL 01 00 $8,600.00 05/08/17
C1778 FL 04 00 $8,600.00 05/08/17
C1780 FL 01 00 $930.00 05/25/17
C1780 FL 04 00 $930.00 05/25/17
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C1781 FL 04 00 $1,466.30 05/08/17
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C1785 FL 01 00 $25,099.00 05/25/17
C1785 FL 04 00 $25,099.00 05/25/17
C1787 FL 01 00 $3,868.20 05/25/17
C1787 FL 04 00 $3,868.20 05/25/17
C1788 FL 01 00 $1,612.00 05/08/17
C1788 FL 04 00 $1,612.00 05/08/17
C1789 FL 01 00 $2,775.00 05/25/17
C1789 FL 04 00 $3,750.00 05/08/17
C1813 FL 01 00 $32,425.30 05/25/17
C1813 FL 04 00 $32,425.30 05/25/17
C1817 FL 01 00 $15,000.00 05/25/17
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C1822 FL 04 00 $25,000.00 05/08/17
C1874 FL 01 00 $10,077.80 05/25/17
C1874 FL 04 00 $10,077.80 05/25/17
C1876 FL 01 00 $5,279.80 05/25/17
C1876 FL 04 00 $5,279.80 05/25/17
C1880 FL 01 00 $4,921.88 05/25/17
C1880 FL 04 00 $4,921.88 05/25/17
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C1882 FL 04 00 $67,601.00 05/25/17
C1884 FL 01 00 $6,607.00 05/25/17
C1884 FL 04 00 $6,607.00 05/25/17
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C1885 FL 04 00 $104.94 05/25/17
C1886 FL 01 00 $4,270.00 05/25/17
C1886 FL 04 00 $4,270.00 05/25/17
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C1887 FL 04 00 $952.00 05/05/17
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C1888 FL 04 00 $3,956.00 05/25/17
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C1893 FL 04 00 $214.16 05/25/17
C1894 FL 01 00 $495.00 05/08/17 $323.00 11/17/15
C1894 FL 04 00 $495.00 05/08/17 $323.00 11/17/15
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C1895 FL 04 00 $23,287.00 05/25/17
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C1898 FL 04 00 $2,988.60 05/25/17
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C2614 FL 04 00 $5,140.00 05/25/17
C2617 FL 01 00 $750.00 05/08/17
C2617 FL 04 00 $750.00 05/08/17
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C2626 FL 04 00 $698.88 05/25/17
C2629 FL 01 00 $71.00 05/25/17
C2629 FL 04 00 $71.00 05/25/17
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C2630 FL 04 00 $5,150.00 05/25/17
C2638 FL 01 00 $594.00 05/25/17
C2638 FL 04 00 $594.00 05/25/17
C2641 FL 01 00 $167.00 05/25/17
C2641 FL 04 00 $167.00 05/25/17
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C8900 FL 04 00 $2,355.76 05/25/17
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C8905 FL 04 26 $1,951.00 05/25/17
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C8907 FL 04 26 $4,566.00 05/25/17
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C8911 FL 04 26 $4,618.00 05/25/17
C8914 FL 01 26 $7,686.82 05/25/17
C8914 FL 04 26 $7,686.82 05/25/17
C8920 FL 01 26 $6,079.00 05/25/17
C8920 FL 04 26 $6,079.00 05/25/17
C8923 FL 01 26 $1,454.00 05/25/17
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C8929 FL 04 26 $1,933.50 05/25/17
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C8930 FL 04 26 $2,742.00 05/25/17
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C8957 FL 01 TC $610.50 05/25/17
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C9113 FL 04 00 $277.58 05/25/17
C9254 FL 01 00 $1.19 05/25/17
C9254 FL 04 00 $1.19 05/25/17
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C9257 FL 04 00 $20.00 05/25/17
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C9898 FL 01 00 $1.00 05/25/17
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D0210 FL 01 00 $97.63 03/06/18
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D0272 FL 04 00 $31.87 04/09/18
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D0330 FL 04 00 $82.72 03/06/18
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D0350 FL 04 00 $46.53 03/06/18
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D7310 FL 04 00 $216.11 03/06/18
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E0181 FL 04 00 $306.25 05/25/17
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E0295 FL 04 00 $1,426.80 05/25/17
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G9088 FL 04 00 $7.67 02/04/16
G9091 FL 01 00 $24.00 02/04/16
G9091 FL 04 00 $24.00 02/04/16
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G9092 FL 04 00 $15.34 02/04/16
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G9095 FL 04 00 $24.00 02/04/16
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G9110 FL 04 00 $15.34 02/04/16
G9129 FL 01 00 $10.00 02/04/16
G9129 FL 04 00 $10.00 02/04/16
H0001 FL 01 00 $150.00 05/25/17
H0001 FL 04 00 $150.00 05/25/17
H0004 FL 01 00 $90.00 05/25/17
H0004 FL 04 00 $90.00 05/25/17
H0015 FL 01 00 $282.00 09/18/17 $268.00 02/24/16
H0015 FL 01 00 $268.00 02/24/16
H0015 FL 04 00 $282.00 09/18/17 $268.00 02/24/16
H0015 FL 04 00 $268.00 02/24/16
H0019 FL 01 00 $180.00 05/25/17
H0019 FL 04 00 $180.00 05/25/17
H0020 FL 01 00 $67.48 05/25/17
H0020 FL 04 00 $67.48 05/25/17
H0031 FL 01 00 $48.00 05/25/17
H0031 FL 04 00 $48.00 05/25/17
H0032 FL 01 00 $100.00 02/04/16
H0032 FL 04 00 $100.00 02/04/16
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H0035 FL 01 00 $282.00 09/18/17 $268.00 09/22/15
H0035 FL 04 00 $268.00 09/22/15 $254.00 01/03/14
H0035 FL 04 00 $282.00 09/18/17 $268.00 09/22/15
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H0037 FL 01 00 $377.00 09/18/17 $357.00 09/22/15
H0037 FL 04 00 $357.00 09/22/15 $339.00 01/03/14
H0037 FL 04 00 $377.00 09/18/17 $357.00 09/22/15
H1001 FL 01 00 $300.00 05/08/17
H1001 FL 04 00 $150.00 05/25/17
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H2000 FL 04 00 $225.00 05/25/17
H2019 FL 01 00 $18.75 05/25/17
H2019 FL 04 00 $12.50 05/25/17
J7300 FL 01 00 $299.00 05/25/17
J7300 FL 04 00 $299.00 05/25/17
K0001 FL 01 00 $3,545.80 05/08/17
K0001 FL 01 NU $3,545.80 05/25/17
K0001 FL 04 00 $3,545.80 05/08/17
K0001 FL 04 NU $3,545.80 05/25/17
K0002 FL 01 00 $540.00 05/25/17
K0002 FL 01 NU $540.00 05/25/17
K0002 FL 04 00 $540.00 05/25/17
K0002 FL 04 NU $540.00 05/25/17
K0003 FL 01 00 $1,080.00 05/25/17
K0003 FL 01 NU $1,080.00 05/25/17
K0003 FL 04 00 $1,080.00 05/25/17
K0003 FL 04 NU $1,080.00 05/25/17
K0004 FL 01 00 $1,800.00 05/25/17
K0004 FL 04 00 $1,800.00 05/25/17
K0006 FL 01 00 $1,560.00 05/25/17
K0006 FL 01 NU $1,560.00 05/25/17
K0006 FL 04 00 $1,560.00 05/25/17
K0006 FL 04 NU $1,560.00 05/25/17
K0007 FL 01 00 $2,280.00 05/25/17
K0007 FL 01 NU $2,280.00 05/25/17
K0007 FL 04 00 $2,280.00 05/25/17
K0007 FL 04 NU $2,280.00 05/25/17
K0010 FL 01 00 $4,438.80 05/25/17
K0010 FL 01 NU $4,438.80 05/25/17
K0010 FL 04 00 $4,438.80 05/25/17
K0010 FL 04 NU $4,438.80 05/25/17
K0011 FL 01 00 $5,423.00 05/25/17
K0011 FL 01 NU $5,423.00 05/25/17
K0011 FL 04 00 $5,423.00 05/25/17
K0011 FL 04 NU $5,423.00 05/25/17
K0053 FL 01 RR $60.00 05/08/17
K0053 FL 04 RR $14.72 05/08/17
K0195 FL 01 00 $54.17 05/08/17 $23.00 11/18/15
K0195 FL 04 00 $54.17 05/08/17 $23.00 11/18/15
K0669 FL 01 00 $154.00 05/25/17
K0669 FL 04 00 $154.00 05/25/17
K0739 FL 01 00 $14.87 12/01/15 $14.55 12/19/13
K0739 FL 01 00 $15.26 01/24/18 $15.02 12/29/16
K0739 FL 04 00 $14.87 12/01/15 $14.55 12/19/13
K0739 FL 04 00 $15.26 01/24/18 $15.02 12/29/16
L3201 FL 01 00 $100.89 05/25/17
L3201 FL 04 00 $100.89 05/25/17
L3202 FL 01 00 $50.50 05/25/17
L3202 FL 04 00 $50.50 05/25/17
L3204 FL 01 00 $50.70 05/25/17
L3204 FL 04 00 $50.70 05/25/17
L3206 FL 01 00 $50.70 05/25/17
L3206 FL 04 00 $50.70 05/25/17
L3207 FL 01 00 $50.70 05/25/17
L3207 FL 04 00 $50.70 05/25/17
L3209 FL 01 00 $20.00 05/25/17
L3209 FL 04 00 $20.00 05/25/17
L3211 FL 01 00 $20.00 05/25/17
L3211 FL 04 00 $20.00 05/25/17
L3215 FL 01 00 $76.60 02/04/16
L3215 FL 04 00 $76.60 02/04/16
L3216 FL 01 00 $150.00 02/04/16
L3216 FL 04 00 $150.00 02/04/16
L3219 FL 01 00 $88.20 02/04/16
L3219 FL 04 00 $88.20 02/04/16
L3222 FL 01 00 $59.00 02/04/16
L3222 FL 04 00 $59.00 02/04/16
L3230 FL 01 00 $350.00 02/04/16
L3230 FL 04 00 $350.00 02/04/16
L3250 FL 01 00 $350.00 02/04/16
L3250 FL 04 00 $350.00 02/04/16
L3251 FL 01 00 $26.30 02/04/16
L3251 FL 04 00 $26.30 02/04/16
L3252 FL 01 00 $90.00 02/04/16
L3252 FL 04 00 $90.00 02/04/16
L3253 FL 01 00 $90.00 02/04/16
L3253 FL 04 00 $90.00 02/04/16
L3260 FL 01 00 $100.00 05/08/17
L3260 FL 04 00 $100.00 05/08/17
L3265 FL 01 00 $51.48 02/04/16
L3320 FL 01 00 $80.21 05/25/17
L3320 FL 04 00 $80.21 05/25/17
L3485 FL 01 00 $67.00 05/25/17
L3485 FL 04 00 $67.00 05/25/17
L4205 FL 01 00 $22.16 12/01/15 $21.68 12/19/13
L4205 FL 01 00 $22.74 01/24/18 $22.38 12/29/16
L4205 FL 04 00 $22.16 12/01/15 $21.68 12/19/13
L4205 FL 04 00 $22.74 01/24/18 $22.38 12/29/16
L7520 FL 01 00 $30.08 12/01/15 $29.43 12/19/13
L7520 FL 01 00 $30.87 01/24/18 $30.38 12/29/16
L7520 FL 04 00 $30.08 12/01/15 $29.43 12/19/13
L7520 FL 04 00 $30.87 01/24/18 $30.38 12/29/16
L8010 FL 01 00 $373.50 05/08/17
L8010 FL 04 00 $373.50 05/08/17
L8680 FL 01 00 $1,838.00 05/08/17 $1,090.00 09/16/15
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L8680 FL 01 RT $1,200.00 02/04/16
L8680 FL 04 00 $1,838.00 05/08/17 $1,090.00 09/16/15
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L8680 FL 04 RT $1,200.00 02/04/16
L8687 FL 01 00 $58,481.00 05/25/17
L8687 FL 04 00 $58,481.00 05/25/17
M0076 FL 01 00 $125.00 02/04/16
M0076 FL 04 00 $125.00 02/04/16
M0300 FL 01 00 $90.00 02/04/16
M0300 FL 04 00 $90.00 02/04/16
P9016 FL 01 00 $564.00 05/08/17 $357.00 11/18/15
P9016 FL 04 00 $357.00 05/25/17
P9017 FL 01 00 $176.18 05/25/17
P9017 FL 04 00 $176.18 05/25/17
P9021 FL 01 00 $170.00 05/25/17
P9021 FL 04 00 $170.00 05/25/17
P9031 FL 01 00 $246.00 05/25/17 $237.00 11/18/15
P9031 FL 04 00 $237.00 05/25/17
P9032 FL 01 00 $297.00 05/25/17
P9032 FL 04 00 $297.00 05/25/17
P9033 FL 01 00 $1,380.00 05/08/17
P9033 FL 04 00 $1,380.00 05/08/17
P9034 FL 01 00 $1,005.00 05/25/17
P9034 FL 04 00 $1,005.00 05/25/17
P9035 FL 01 00 $1,253.00 05/25/17 $1,205.00 11/18/15
P9035 FL 04 00 $104.80 05/25/17
P9037 FL 01 00 $3,314.00 05/08/17
P9037 FL 04 00 $1,229.06 05/25/17
P9038 FL 01 00 $565.16 05/25/17
P9038 FL 04 00 $565.16 05/25/17
P9040 FL 01 00 $1,319.00 05/08/17
P9040 FL 04 00 $504.00 05/25/17
P9059 FL 01 00 $236.00 05/25/17
P9059 FL 04 00 $236.00 05/25/17
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P9603 FL 04 00 $1.14 05/25/17
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Q0508 FL 04 00 $1,991.96 05/08/17
Q0513 FL 01 00 $132.00 05/25/17
Q0513 FL 04 00 $132.00 05/25/17
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Q0514 FL 04 00 $84.48 05/08/17
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Q2034 FL 04 00 $25.00 05/25/17
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Q2039 FL 04 00 $73.27 05/25/17
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Q4124 FL 04 JC $15.00 02/04/16
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Q4133 FL 04 00 $106.00 05/25/17
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Q5001 FL 04 00 $195.09 05/08/17
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Q5005 FL 04 00 $870.06 05/25/17
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Q9962 FL 04 00 $25.00 05/25/17
Q9969 FL 01 00 $25.00 05/08/17
Q9969 FL 04 00 $20.00 05/25/17
R0070 FL 01 00 $300.00 05/08/17
R0070 FL 04 00 $67.30 05/25/17
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R0076 FL 01 00 $66.60 05/25/17
R0076 FL 04 00 $48.00 05/25/17
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S0017 FL 04 00 $8.53 02/04/16
S0020 FL 01 00 $16.00 02/04/16
S0020 FL 04 00 $16.00 02/04/16
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S0023 FL 04 00 $27.43 02/04/16
S0028 FL 01 00 $25.00 02/04/16 $20.00 07/24/14
S0028 FL 04 00 $20.00 02/04/16
S0030 FL 01 00 $133.50 02/04/16 $30.00 07/24/14
S0030 FL 04 00 $30.00 02/04/16
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S0073 FL 01 00 $9.41 02/04/16
S0073 FL 04 00 $9.41 02/04/16
S0074 FL 01 00 $6.33 02/04/16
S0074 FL 04 00 $6.33 02/04/16
S0077 FL 01 00 $40.00 02/04/16
S0077 FL 04 00 $13.72 02/04/16
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S0078 FL 04 00 $150.79 02/04/16
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S0081 FL 04 00 $3.53 02/04/16
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S0144 FL 04 00 $.90 05/25/17
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S0164 FL 04 00 $146.40 02/04/16
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S0395 FL 04 00 $75.00 02/04/16
S0610 FL 01 00 $75.00 02/04/16
S0610 FL 04 00 $75.00 02/04/16
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S0612 FL 04 00 $125.00 02/04/16 $142.00 07/24/14
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S0621 FL 04 00 $78.00 02/04/16
S0622 FL 01 00 $30.00 02/04/16
S0622 FL 04 00 $30.00 02/04/16
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S0630 FL 04 00 $75.00 02/04/16
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S1015 FL 04 00 $57.75 02/04/16
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S1030 FL 04 00 $190.21 05/25/17
S1031 FL 01 00 $80.00 05/25/17
S1031 FL 04 00 $80.00 05/25/17
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S3650 FL 04 00 $150.00 02/04/16
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S5108 FL 04 00 $31.25 05/25/17
S5145 FL 01 00 $87.30 02/04/16
S5145 FL 04 00 $87.30 02/04/16
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S5498 FL 04 00 $25.00 02/04/16
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S5501 FL 04 00 $50.00 02/04/16
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S8037 FL 04 00 $1,495.00 02/04/16
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S8085 FL 04 00 $475.00 02/04/16
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S8120 FL 04 00 $57.00 02/04/16
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S8121 FL 04 00 $1.05 02/04/16
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S8186 FL 04 00 $33.50 02/04/16
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S8189 FL 04 00 $13.30 02/04/16
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S8424 FL 04 00 $355.00 02/04/16
S8431 FL 01 00 $10.00 02/04/16
S8431 FL 04 00 $10.00 02/04/16
S8450 FL 01 00 $25.00 02/04/16
S8450 FL 04 00 $25.00 02/04/16
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S8452 FL 04 00 $20.00 02/04/16
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S9129 FL 04 00 $35.00 02/04/16
S9131 FL 04 00 $150.00 02/04/16
S9140 FL 01 00 $150.00 02/04/16
S9140 FL 04 00 $150.00 02/04/16
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S9330 FL 04 00 $80.00 02/04/16
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S9366 FL 01 00 $4,334.24 02/04/16
S9366 FL 04 00 $4,334.24 02/04/16
S9376 FL 01 00 $365.00 02/04/16
S9376 FL 04 00 $365.00 02/04/16
S9430 FL 01 00 $393.25 05/08/17
S9430 FL 04 00 $201.25 05/08/17
S9460 FL 01 00 $60.00 02/04/16
S9460 FL 04 00 $60.00 02/04/16
S9470 FL 04 00 $104.00 02/04/16
S9480 FL 01 00 $282.00 09/18/17 $268.00 02/24/16
S9480 FL 01 00 $268.00 02/24/16
S9480 FL 04 00 $282.00 09/18/17 $268.00 02/24/16
S9480 FL 04 00 $268.00 02/24/16
S9500 FL 01 00 $195.00 02/04/16
S9500 FL 04 00 $195.00 02/04/16
S9501 FL 01 00 $210.00 02/04/16
S9501 FL 04 00 $210.00 02/04/16
S9502 FL 04 00 $220.00 02/04/16
S9562 FL 01 00 $25.00 02/04/16
S9562 FL 04 00 $25.00 02/04/16
T1015 FL 01 00 $150.00 05/08/17
T1015 FL 04 00 $125.00 05/25/17
T1017 FL 01 00 $25.00 02/04/16
T1017 FL 04 00 $25.00 02/04/16
T1019 FL 01 00 $62.56 02/04/16
T1019 FL 04 00 $62.56 02/04/16
T1021 FL 01 00 $90.00 02/04/16
T1021 FL 04 00 $90.00 02/04/16
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T1024 FL 04 GP $37.50 02/04/16
T1025 FL 01 00 $160.05 05/25/17
T1025 FL 04 00 $160.05 05/25/17
T1026 FL 01 00 $41.22 05/25/17
T1026 FL 04 00 $41.22 05/25/17
T1030 FL 01 00 $150.00 05/08/17
T1030 FL 04 00 $150.00 05/25/17
T1031 FL 01 00 $150.00 05/08/17
T1031 FL 04 00 $96.00 05/25/17
T1502 FL 01 00 $15.00 05/08/17
T1502 FL 04 00 $15.00 05/25/17
T2042 FL 01 00 $161.16 05/08/17
T2042 FL 04 00 $141.74 05/25/17
T2045 FL 01 00 $675.00 05/08/17
T2045 FL 04 00 $670.66 05/25/17
V2025 FL 01 00 $90.00 02/04/16
V2025 FL 04 00 $90.00 02/04/16
V2781 FL 01 00 $269.00 05/08/17
V2781 FL 04 00 $251.00 05/08/17 $155.00 11/18/15
V2785 FL 01 00 $8,050.00 05/08/17
V2785 FL 04 00 $8,050.00 05/08/17
V2787 FL 01 00 $1,000.00 05/08/17
V2787 FL 04 00 $1,000.00 05/08/17
V2788 FL 01 00 $2,280.00 05/08/17 $2,250.00 11/18/15
V2788 FL 04 00 $2,280.00 05/08/17 $2,250.00 11/18/15
V2790 FL 01 00 $2,500.00 05/08/17 $2,056.00 11/18/15
V2790 FL 04 00 $2,500.00 05/08/17 $2,056.00 11/18/15
V5050 FL 01 00 $3,000.00 05/25/17 $1,407.00 11/18/15
V5050 FL 04 00 $3,000.00 05/25/17 $1,407.00 11/18/15
V5060 FL 01 00 $710.00 05/25/17
V5060 FL 04 00 $710.00 05/25/17
V5090 FL 01 00 $500.00 05/08/17
V5090 FL 04 00 $500.00 05/08/17
V5110 FL 01 00 $200.00 05/25/17
V5110 FL 04 00 $200.00 05/25/17
V5130 FL 01 00 $645.00 05/25/17
V5130 FL 04 00 $645.00 05/25/17
V5140 FL 01 00 $6,000.00 05/08/17
V5140 FL 04 00 $6,000.00 05/08/17
V5160 FL 01 00 $900.00 05/08/17
V5160 FL 04 00 $900.00 05/08/17
V5170 FL 01 00 $645.00 05/25/17
V5170 FL 04 00 $645.00 05/25/17
V5180 FL 01 00 $710.00 05/25/17
V5180 FL 04 00 $710.00 05/25/17
V5210 FL 01 00 $645.00 05/25/17
V5210 FL 04 00 $645.00 05/25/17
V5220 FL 01 00 $710.00 05/25/17
V5220 FL 04 00 $710.00 05/25/17
V5240 FL 01 00 $680.00 05/25/17
V5240 FL 04 00 $680.00 05/25/17
V5241 FL 01 00 $1,000.00 05/08/17
V5241 FL 04 00 $1,000.00 05/08/17
V5247 FL 01 00 $2,800.00 05/08/17
V5247 FL 04 00 $2,800.00 05/08/17
V5257 FL 01 00 $4,000.00 05/08/17 $3,800.00 11/18/15
V5257 FL 04 00 $4,000.00 05/08/17 $3,800.00 11/18/15
V5258 FL 01 00 $7,270.00 05/25/17
V5258 FL 04 00 $7,270.00 05/25/17
V5261 FL 01 00 $8,000.00 05/08/17
V5261 FL 04 00 $8,000.00 05/08/17
V5263 FL 01 00 $30.00 05/08/17
V5263 FL 04 00 $30.00 05/08/17
V5264 FL 01 00 $100.00 05/08/17
V5264 FL 04 00 $100.00 05/08/17
V5265 FL 01 00 $80.00 05/05/17
V5265 FL 04 00 $80.00 05/05/17
V5266 FL 01 00 $100.00 05/05/17
V5266 FL 04 00 $100.00 05/05/17
V5267 FL 01 00 $521.00 05/08/17
V5267 FL 04 00 $521.00 05/08/17
V5275 FL 01 00 $80.00 05/08/17
V5275 FL 04 00 $80.00 05/08/17