State prevailing rates

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

Latest update: 03-13-2019
CPT code State Provider class Modifier Current pricing Effective date
01996 MO 01 00 $285.00 9/6/2016
01996 MO 04 00 $285.00 9/6/2016
0282T MO 01 00 $594.40 9/7/2016
0282T MO 04 00 $594.40 9/7/2016
0359T MO 01 00 $500.00 2/16/2016
0359T MO 04 00 $500.00 2/16/2016
0360T MO 01 00 $62.50 2/16/2016
0360T MO 04 00 $62.50 2/16/2016
0361T MO 01 00 $62.50 2/16/2016
0361T MO 04 00 $62.50 2/16/2016
0364T MO 01 00 $62.50 7/13/2018
0364T MO 04 00 $62.50 7/13/2018
0365T MO 01 00 $62.50 2/16/2016
0365T MO 04 00 $62.50 2/16/2016
0368T MO 01 00 $62.50 2/16/2016
0368T MO 04 00 $62.50 2/16/2016
0369T MO 01 00 $62.50 2/16/2016
0369T MO 04 00 $62.50 2/16/2016
0370T MO 01 00 $125.00 2/16/2016
0370T MO 04 00 $125.00 2/16/2016
1036F MO 01 00 $0.01 2/16/2016
1036F MO 04 00 $0.01 2/16/2016
2019F MO 01 00 $0.01 2/16/2016
2019F MO 04 00 $0.01 2/16/2016
21088 MO 01 00 $2,800.00 2/16/2016
21088 MO 04 00 $2,800.00 2/16/2016
21742 MO 01 00 $2,879.00 7/13/2018
21742 MO 04 00 $2,879.00 7/13/2018
3016F MO 01 00 $0.01 2/16/2016
3016F MO 04 00 $0.01 2/16/2016
37195 MO 01 00 $2,295.00 7/13/2018
37195 MO 04 00 $2,295.00 7/13/2018
4047F MO 01 00 $0.01 2/16/2016
4047F MO 04 00 $0.01 2/16/2016
4048F MO 01 00 $0.01 2/16/2016
4048F MO 04 00 $0.01 2/16/2016
4177F MO 01 00 $0.01 2/16/2016
4177F MO 04 00 $0.01 2/16/2016
58974 MO 01 00 $1,000.00 9/6/2016
58974 MO 04 00 $1,000.00 9/6/2016
59899 MO 01 00 $395.73 7/13/2018
59899 MO 04 00 $395.73 7/13/2018
73530 MO 04 00 $73.00 7/13/2018
74300 MO 01 00 $1,669.00 4/28/2017
74300 MO 01 00 $1,669.00 7/13/2018
74300 MO 04 00 $1,669.00 7/13/2018
74300 MO 01 TC $721.15 7/13/2018
74300 MO 04 TC $721.15 7/13/2018
74328 MO 04 00 $696.88 7/13/2018
74328 MO 01 00 $1,285.00 8/11/2018
74328 MO 01 00 $696.88 8/11/2018
74328 MO 01 TC $661.64 7/13/2018
74328 MO 04 TC $661.64 7/13/2018
74330 MO 01 00 $1,741.90 7/13/2018
74330 MO 04 00 $1,741.90 7/13/2018
74330 MO 01 TC $959.75 7/13/2018
74330 MO 04 TC $959.75 7/13/2018
74340 MO 01 00 $102.49 7/13/2018
74340 MO 04 00 $102.49 7/13/2018
74360 MO 01 00 $943.91 7/13/2018
74360 MO 04 00 $943.91 7/13/2018
74360 MO 01 TC $915.79 7/13/2018
74360 MO 04 TC $915.79 7/13/2018
75894 MO 01 00 $3,569.00 7/13/2018
75894 MO 04 00 $3,569.00 7/13/2018
75894 MO 01 TC $2,727.43 7/13/2018
75894 MO 04 TC $2,727.43 7/13/2018
75896 MO 04 00 $1,906.00 7/13/2018
75952 MO 01 00 $739.27 7/13/2018
75952 MO 04 00 $739.27 7/13/2018
75970 MO 01 00 $182.21 7/13/2018
75970 MO 04 00 $182.21 7/13/2018
75982 MO 04 00 $383.40 7/13/2018
76001 MO 01 00 $1,653.00 4/28/2017
76001 MO 01 00 $1,653.00 7/13/2018
76001 MO 04 00 $1,653.00 7/13/2018
76001 MO 01 TC $1,239.00 7/13/2018
76001 MO 04 TC $419.32 7/13/2018
76945 MO 01 00 $460.00 2/16/2016
76945 MO 04 00 $460.00 2/16/2016
76945 MO 01 TC $278.27 2/16/2016
76945 MO 04 TC $278.27 2/16/2016
76998 MO 01 00 $1,533.00 9/7/2016
76998 MO 04 00 $1,533.00 9/7/2016
76998 MO 01 TC $621.66 2/16/2016
76998 MO 04 TC $621.66 2/16/2016
77013 MO 01 00 $739.27 7/13/2018
77013 MO 04 00 $739.27 7/13/2018
77061 MO 01 00 $46.00 2/16/2016
77061 MO 04 00 $46.00 2/16/2016
77061 MO 01 00 $50.00 8/11/2018
77062 MO 01 00 $90.00 2/16/2016
77062 MO 04 00 $90.00 2/16/2016
77062 MO 01 26 $140.00 8/11/2018
77371 MO 01 00 $61,972.00 7/13/2018
77371 MO 04 00 $61,972.00 7/13/2018
77385 MO 01 00 $2,663.00 2/16/2016
77385 MO 04 00 $2,663.00 2/16/2016
77385 MO 01 00 $3,104.00 8/11/2018
77386 MO 01 00 $3,720.00 9/7/2016
77386 MO 04 00 $3,068.00 1/18/2017
77520 MO 01 00 $3,560.00 7/13/2018
77520 MO 04 00 $3,560.00 7/13/2018
80300 MO 01 00 $298.00 9/7/2016
80300 MO 04 00 $298.00 9/7/2016
80301 MO 01 00 $443.00 2/16/2016
80301 MO 04 00 $443.00 2/16/2016
80302 MO 01 00 $158.00 2/16/2016
80302 MO 04 00 $158.00 2/16/2016
80320 MO 01 00 $156.00 2/16/2016
80320 MO 04 00 $156.00 2/16/2016
80325 MO 01 00 $22.70 2/16/2016
80325 MO 04 00 $22.70 2/16/2016
80326 MO 01 00 $11.80 9/7/2016
80326 MO 04 00 $11.80 9/7/2016
80329 MO 01 00 $367.20 2/16/2016
80329 MO 04 00 $367.20 2/16/2016
80331 MO 01 00 $11.80 9/7/2016
80331 MO 04 00 $11.80 9/7/2016
80334 MO 01 00 $11.80 9/7/2016
80334 MO 04 00 $11.80 9/7/2016
80335 MO 01 00 $22.90 2/16/2016
80335 MO 04 00 $22.90 2/16/2016
80337 MO 01 00 $16.00 9/7/2016
80337 MO 04 00 $16.00 9/7/2016
80346 MO 01 00 $100.00 2/16/2016
80346 MO 04 00 $100.00 2/16/2016
80347 MO 01 00 $37.80 2/16/2016
80347 MO 04 00 $37.80 2/16/2016
80348 MO 01 00 $94.50 2/16/2016
80348 MO 04 00 $94.50 2/16/2016
80354 MO 01 00 $110.84 2/16/2016
80354 MO 04 00 $110.84 2/16/2016
80356 MO 01 00 $39.80 2/16/2016
80356 MO 04 00 $39.80 2/16/2016
80357 MO 01 00 $36.90 2/16/2016
80357 MO 04 00 $36.90 2/16/2016
80359 MO 01 00 $36.90 2/16/2016
80359 MO 04 00 $36.90 2/16/2016
80360 MO 01 00 $36.90 2/16/2016
80360 MO 04 00 $36.90 2/16/2016
80362 MO 01 00 $110.84 2/16/2016
80362 MO 04 00 $110.84 2/16/2016
80364 MO 01 00 $199.00 2/16/2016
80364 MO 04 00 $199.00 2/16/2016
80365 MO 01 00 $178.71 2/16/2016
80365 MO 04 00 $178.71 2/16/2016
80367 MO 01 00 $39.80 2/16/2016
80367 MO 04 00 $39.80 2/16/2016
80369 MO 01 00 $72.10 2/16/2016
80369 MO 04 00 $72.10 2/16/2016
80372 MO 01 00 $36.90 2/16/2016
80372 MO 04 00 $36.90 2/16/2016
80373 MO 01 00 $84.06 2/16/2016
80373 MO 04 00 $84.06 2/16/2016
81216 MO 01 00 $2,090.00 2/16/2016
81216 MO 04 00 $2,090.00 2/16/2016
81228 MO 01 00 $3,873.00 2/16/2016
81228 MO 04 00 $3,873.00 2/16/2016
81229 MO 01 00 $3,615.00 2/16/2016
81229 MO 04 00 $3,615.00 2/16/2016
81257 MO 01 00 $1,086.25 2/16/2016
81257 MO 04 00 $1,086.25 2/16/2016
81407 MO 01 00 $4,378.00 2/16/2016
81407 MO 04 00 $4,378.00 2/16/2016
86860 MO 01 00 $162.96 4/28/2017
86860 MO 01 00 $303.18 7/13/2018
86860 MO 04 00 $162.96 7/13/2018
86921 MO 01 00 $44.85 7/13/2018
86921 MO 04 00 $44.85 7/13/2018
86932 MO 01 00 $75.00 7/13/2018
86932 MO 04 00 $75.00 7/13/2018
86960 MO 01 00 $329.30 2/16/2016
86960 MO 04 00 $329.30 2/16/2016
86970 MO 01 00 $62.40 7/13/2018
86970 MO 04 00 $62.40 7/13/2018
86976 MO 01 00 $136.28 7/13/2018
86976 MO 04 00 $136.28 7/13/2018
86978 MO 01 00 $168.00 7/13/2018
86978 MO 04 00 $168.00 7/13/2018
88299 MO 01 00 $135.00 7/13/2018
88299 MO 04 00 $135.00 7/13/2018
90471 MO 01 00 $47.00 8/11/2018
90660 MO 01 00 $50.00 7/13/2018
90660 MO 04 00 $50.00 7/13/2018
90736 MO 01 00 $235.51 7/19/2017
90736 MO 04 00 $235.51 7/19/2017
90736 MO 01 00 $254.35 7/20/2017
90736 MO 04 00 $254.35 7/20/2017
90736 MO 01 NU $235.51 10/19/2016
90736 MO 04 NU $235.51 10/19/2016
90993 MO 01 00 $5,140.00 4/28/2017
90993 MO 04 00 $5,140.00 4/28/2017
90993 MO 01 00 $5,140.00 7/13/2018
90993 MO 04 00 $3,629.00 7/13/2018
92921 MO 01 00 $9,754.50 7/13/2018
92921 MO 04 00 $9,754.50 7/13/2018
92929 MO 01 00 $1,496.95 7/13/2018
92929 MO 04 00 $1,496.95 7/13/2018
92978 MO 01 00 $770.00 7/13/2018
92978 MO 04 00 $770.00 7/13/2018
92979 MO 01 00 $189.80 7/13/2018
92979 MO 04 00 $189.80 7/13/2018
93299 MO 01 00 $357.00 7/13/2018
93299 MO 04 00 $357.00 7/13/2018
93317 MO 01 00 $243.00 7/13/2018
93317 MO 04 00 $243.00 7/13/2018
93531 MO 04 00 $6,351.23 7/13/2018
93531 MO 01 00 $6,351.23 8/11/2018
93531 MO 01 00 $12,582.00 8/11/2018
93531 MO 01 TC $5,883.80 7/13/2018
93531 MO 04 TC $5,883.80 7/13/2018
93533 MO 01 00 $2,657.20 7/13/2018
93533 MO 04 00 $2,657.20 7/13/2018
93561 MO 01 00 $142.35 7/13/2018
93561 MO 04 00 $142.35 7/13/2018
93562 MO 01 00 $75.92 7/13/2018
93562 MO 04 00 $75.92 7/13/2018
93571 MO 01 00 $7,487.00 4/28/2017
93571 MO 04 00 $7,487.00 7/13/2018
93571 MO 01 00 $8,079.00 8/11/2018
93571 MO 01 TC $1,006.34 7/13/2018
93571 MO 04 TC $1,006.34 7/13/2018
93609 MO 01 00 $6,466.82 7/13/2018
93609 MO 04 00 $6,466.82 7/13/2018
93609 MO 01 TC $6,182.74 7/13/2018
93609 MO 04 TC $6,182.74 7/13/2018
93620 MO 01 00 $3,964.61 7/13/2018
93620 MO 04 00 $3,964.61 7/13/2018
93620 MO 01 TC $3,303.47 7/13/2018
93620 MO 04 TC $3,303.47 7/13/2018
93621 MO 01 00 $4,130.50 4/28/2017
93621 MO 01 00 $9,886.40 7/13/2018
93621 MO 04 00 $4,130.50 7/13/2018
93621 MO 01 TC $5,383.00 7/13/2018
93621 MO 04 TC $5,383.00 7/13/2018
93623 MO 01 00 $10,051.00 4/28/2017
93623 MO 04 00 $10,051.00 4/28/2017
93623 MO 01 00 $10,051.00 7/13/2018
93623 MO 04 00 $10,051.00 7/13/2018
93623 MO 01 TC $1,204.28 7/13/2018
93623 MO 04 TC $1,204.28 7/13/2018
93641 MO 01 00 $4,368.00 7/13/2018
93641 MO 04 00 $4,368.00 7/13/2018
93662 MO 01 00 $9,815.00 4/28/2017
93662 MO 01 00 $9,815.00 7/13/2018
93662 MO 04 00 $9,815.00 7/13/2018
93662 MO 01 TC $1,516.60 7/13/2018
93662 MO 04 TC $1,516.60 7/13/2018
94770 MO 01 26 $281.00 7/13/2018
94770 MO 04 26 $281.00 7/13/2018
94770 MO 01 TC $307.00 7/13/2018
94770 MO 04 TC $307.00 7/13/2018
94776 MO 01 00 $543.21 7/13/2018
94776 MO 04 00 $543.21 7/13/2018
96377 MO 01 00 $190.00 7/13/2018
96377 MO 04 00 $190.00 7/13/2018
99000 MO 01 00 $25.00 4/28/2017
99000 MO 04 00 $25.00 4/28/2017
99000 MO 01 00 $25.00 7/13/2018
99000 MO 04 00 $25.00 7/13/2018
99001 MO 01 00 $36.85 4/28/2017
99001 MO 04 00 $36.85 4/28/2017
99001 MO 04 00 $38.80 7/13/2018
99001 MO 01 00 $40.74 8/11/2018
99002 MO 01 00 $35.00 7/13/2018
99002 MO 04 00 $35.00 7/13/2018
99060 MO 01 00 $30.00 7/13/2018
99060 MO 04 00 $30.00 7/13/2018
99071 MO 01 00 $13.00 9/7/2016
99071 MO 04 00 $13.00 9/7/2016
99082 MO 01 00 $6.09 7/13/2018
99082 MO 04 00 $6.09 7/13/2018
99190 MO 01 00 $476.50 7/13/2018
99190 MO 04 00 $476.50 7/13/2018
99455 MO 01 00 $186.10 2/16/2016
99455 MO 04 00 $186.10 2/16/2016
A0225 MO 01 00 $407.11 7/13/2018
A0225 MO 04 00 $407.11 7/13/2018
A0430 MO 01 00 $3,950.63 12/6/2016
A0430 MO 04 00 $3,950.63 12/6/2016
A0430 MO 01 00 $2,854.33 4/9/2018
A0430 MO 04 00 $2,854.33 4/9/2018
A0431 MO 01 00 $9,050.21 12/6/2016
A0431 MO 04 00 $9,050.21 12/6/2016
A0431 MO 01 00 $6,538.78 4/9/2018
A0431 MO 04 00 $6,538.78 4/9/2018
A0435 MO 01 00 $61.97 12/6/2016
A0435 MO 04 00 $61.97 12/6/2016
A0435 MO 01 00 $44.77 4/9/2018
A0435 MO 04 00 $44.77 4/9/2018
A0436 MO 01 00 $84.03 12/6/2016
A0436 MO 04 00 $84.03 12/6/2016
A0436 MO 01 00 $60.72 4/9/2018
A0436 MO 04 00 $60.72 4/9/2018
A0513 MO 04 00 $68.40 7/13/2018
A4206 MO 01 00 $20.00 7/13/2018
A4206 MO 04 00 $20.00 7/13/2018
A4208 MO 01 00 $20.00 4/28/2017
A4208 MO 04 00 $20.00 4/28/2017
A4208 MO 01 00 $20.00 7/13/2018
A4208 MO 04 00 $20.00 7/13/2018
A4209 MO 01 00 $2.21 7/13/2018
A4209 MO 04 00 $2.21 7/13/2018
A4210 MO 01 00 $3.54 7/13/2018
A4210 MO 04 00 $3.54 7/13/2018
A4211 MO 01 00 $21.08 8/11/2018
A4211 MO 01 00 $40.00 8/11/2018
A4211 MO 04 00 $40.00 8/11/2018
A4211 MO 04 00 $21.08 8/11/2018
A4212 MO 01 00 $23.83 7/13/2018
A4212 MO 04 00 $23.83 7/13/2018
A4213 MO 01 00 $5.70 4/28/2017
A4213 MO 04 00 $5.70 4/28/2017
A4213 MO 01 00 $5.70 7/13/2018
A4213 MO 04 00 $5.70 7/13/2018
A4215 MO 01 00 $28.00 4/28/2017
A4215 MO 04 00 $28.00 4/28/2017
A4215 MO 01 00 $28.00 7/13/2018
A4215 MO 04 00 $28.00 7/13/2018
A4218 MO 01 00 $2.14 7/13/2018
A4218 MO 04 00 $2.14 7/13/2018
A4218 MO 01 NU $2.14 7/13/2018
A4218 MO 04 NU $2.14 7/13/2018
A4220 MO 01 00 $60.00 7/13/2018
A4220 MO 04 00 $60.00 7/13/2018
A4223 MO 01 00 $236.33 4/28/2017
A4223 MO 04 00 $236.33 4/28/2017
A4223 MO 01 00 $354.50 8/11/2018
A4223 MO 04 00 $354.50 8/11/2018
A4230 MO 01 00 $12.70 7/13/2018
A4230 MO 04 00 $12.70 7/13/2018
A4231 MO 01 00 $7.77 7/13/2018
A4231 MO 04 00 $7.77 7/13/2018
A4232 MO 01 00 $4.38 7/13/2018
A4232 MO 04 00 $4.38 7/13/2018
A4244 MO 01 00 $3.73 7/13/2018
A4244 MO 04 00 $3.73 7/13/2018
A4245 MO 01 00 $0.24 7/13/2018
A4245 MO 04 00 $0.24 7/13/2018
A4247 MO 01 00 $0.35 7/13/2018
A4247 MO 04 00 $0.35 7/13/2018
A4250 MO 01 00 $16.00 7/13/2018
A4250 MO 04 00 $16.00 7/13/2018
A4262 MO 01 00 $41.88 7/13/2018
A4262 MO 04 00 $41.88 7/13/2018
A4263 MO 01 00 $84.82 7/13/2018
A4263 MO 04 00 $84.82 7/13/2018
A4267 MO 01 00 $0.05 2/16/2016
A4267 MO 04 00 $0.05 2/16/2016
A4268 MO 01 00 $0.57 2/16/2016
A4268 MO 04 00 $0.57 2/16/2016
A4270 MO 01 00 $35.00 7/13/2018
A4270 MO 04 00 $35.00 7/13/2018
A4281 MO 01 00 $17.40 7/13/2018
A4281 MO 04 00 $17.40 7/13/2018
A4282 MO 01 00 $78.60 7/13/2018
A4282 MO 04 00 $78.60 7/13/2018
A4283 MO 01 00 $4.00 7/13/2018
A4283 MO 04 00 $4.00 7/13/2018
A4284 MO 01 00 $45.10 7/13/2018
A4284 MO 04 00 $45.10 7/13/2018
A4285 MO 01 00 $12.50 4/28/2017
A4285 MO 04 00 $12.50 4/28/2017
A4285 MO 01 00 $18.64 7/13/2018
A4285 MO 04 00 $18.64 7/13/2018
A4286 MO 01 00 $9.00 7/13/2018
A4286 MO 04 00 $9.00 7/13/2018
A4290 MO 01 00 $500.00 7/13/2018
A4290 MO 04 00 $500.00 7/13/2018
A4300 MO 01 00 $49.40 7/13/2018
A4300 MO 04 00 $49.40 7/13/2018
A4301 MO 01 00 $619.45 7/13/2018
A4301 MO 04 00 $619.45 7/13/2018
A4305 MO 01 00 $80.00 7/13/2018
A4305 MO 04 00 $80.00 7/13/2018
A4306 MO 01 00 $100.00 7/13/2018
A4306 MO 04 00 $100.00 7/13/2018
A4465 MO 01 00 $31.95 7/13/2018
A4465 MO 04 00 $31.95 7/13/2018
A4466 MO 01 00 $77.00 1/16/2018
A4466 MO 04 00 $77.00 1/16/2018
A4480 MO 01 00 $50.00 7/13/2018
A4480 MO 04 00 $50.00 7/13/2018
A4483 MO 01 00 $33.40 7/13/2018
A4483 MO 04 00 $33.40 7/13/2018
A4495 MO 01 00 $49.67 7/13/2018
A4495 MO 04 00 $49.67 7/13/2018
A4500 MO 01 00 $50.00 7/13/2018
A4500 MO 04 00 $50.00 7/13/2018
A4510 MO 01 00 $86.73 7/13/2018
A4510 MO 04 00 $86.73 7/13/2018
A4550 MO 01 00 $200.00 4/28/2017
A4550 MO 04 00 $200.00 4/28/2017
A4550 MO 01 00 $200.00 7/13/2018
A4550 MO 04 00 $200.00 7/13/2018
A4554 MO 01 00 $0.39 9/7/2016
A4554 MO 04 00 $0.39 9/7/2016
A4570 MO 01 00 $28.11 4/28/2017
A4570 MO 04 00 $28.11 4/28/2017
A4570 MO 01 00 $35.00 8/11/2018
A4570 MO 04 00 $35.00 8/11/2018
A4580 MO 01 00 $82.00 7/13/2018
A4580 MO 04 00 $82.00 7/13/2018
A4590 MO 01 00 $113.00 4/28/2017
A4590 MO 04 00 $113.00 4/28/2017
A4590 MO 01 00 $113.00 7/13/2018
A4590 MO 04 00 $113.00 7/13/2018
A4600 MO 01 00 $189.07 7/13/2018
A4600 MO 04 00 $189.07 7/13/2018
A4606 MO 01 00 $29.00 4/28/2017
A4606 MO 04 00 $29.00 4/28/2017
A4606 MO 01 00 $30.00 7/13/2018
A4606 MO 04 00 $30.00 7/13/2018
A4627 MO 01 00 $56.00 4/28/2017
A4627 MO 04 00 $56.00 4/28/2017
A4627 MO 01 00 $56.00 7/13/2018
A4627 MO 04 00 $56.00 7/13/2018
A4641 MO 01 00 $201.00 7/13/2018
A4641 MO 04 00 $201.00 7/13/2018
A4642 MO 01 00 $28.59 7/13/2018
A4642 MO 04 00 $28.59 7/13/2018
A4648 MO 01 00 $500.00 4/28/2017
A4648 MO 04 00 $500.00 4/28/2017
A4648 MO 01 00 $500.00 7/13/2018
A4648 MO 04 00 $500.00 7/13/2018
A4651 MO 01 00 $2.86 7/13/2018
A4651 MO 04 00 $2.86 7/13/2018
A4652 MO 01 00 $16.13 7/13/2018
A4652 MO 04 00 $16.13 7/13/2018
A4657 MO 01 00 $67.33 4/28/2017
A4657 MO 04 00 $67.33 4/28/2017
A4657 MO 01 00 $94.80 8/11/2018
A4657 MO 04 00 $94.80 8/11/2018
A4660 MO 01 00 $102.30 7/13/2018
A4660 MO 04 00 $102.30 7/13/2018
A4663 MO 01 00 $31.40 7/13/2018
A4663 MO 04 00 $31.40 7/13/2018
A4670 MO 01 00 $50.00 7/13/2018
A4670 MO 04 00 $50.00 7/13/2018
A4671 MO 01 00 $70.73 7/13/2018
A4671 MO 04 00 $70.73 7/13/2018
A4714 MO 01 00 $1.31 7/13/2018
A4714 MO 04 00 $1.31 7/13/2018
A4721 MO 01 00 $22.05 7/13/2018
A4721 MO 04 00 $22.05 7/13/2018
A4722 MO 01 00 $29.96 7/13/2018
A4722 MO 04 00 $29.96 7/13/2018
A4723 MO 01 00 $28.62 7/13/2018
A4723 MO 04 00 $28.62 7/13/2018
A4726 MO 01 00 $37.09 7/13/2018
A4726 MO 04 00 $37.09 7/13/2018
A4730 MO 01 00 $1.50 7/13/2018
A4730 MO 04 00 $1.50 7/13/2018
A4750 MO 01 00 $45.00 7/13/2018
A4750 MO 04 00 $45.00 7/13/2018
A4755 MO 01 00 $25.20 7/13/2018
A4755 MO 04 00 $25.20 7/13/2018
A4770 MO 01 00 $25.00 7/13/2018
A4770 MO 04 00 $25.00 7/13/2018
A4771 MO 01 00 $23.54 7/13/2018
A4771 MO 04 00 $23.54 7/13/2018
A4772 MO 01 00 $3.92 7/13/2018
A4772 MO 04 00 $3.92 7/13/2018
A4860 MO 01 00 $45.56 7/13/2018
A4860 MO 04 00 $45.56 7/13/2018
A4911 MO 01 00 $9.40 7/13/2018
A4911 MO 04 00 $9.40 7/13/2018
A4927 MO 01 00 $15.84 4/28/2017
A4927 MO 04 00 $15.84 4/28/2017
A4927 MO 01 00 $15.84 7/13/2018
A4927 MO 04 00 $15.84 7/13/2018
A4928 MO 01 00 $8.96 7/13/2018
A4928 MO 04 00 $8.96 7/13/2018
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G0410 MO 04 00 $125.00 4/28/2017
G0410 MO 01 00 $431.25 7/13/2018
G0410 MO 04 00 $175.00 7/13/2018
G0411 MO 01 00 $120.00 7/13/2018
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G0463 MO 04 00 $295.00 7/13/2018
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H0001 MO 01 00 $745.00 7/13/2018
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V5264 MO 01 00 $80.00 7/13/2018
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V5265 MO 01 00 $85.00 7/13/2018
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