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Select Service Codes

--- service code 1 service code 2 service code 3 service code 4 service code 5 service code 6 service code 7 service code 8 service code 9 service code 10 service code 11 service code 12 service code 13 service code 14 service code 15 service code 16 service code 17 service code 18 service code 19 service code 20 service code 21 service code 22 service code 23 service code 24 service code 25 service code 26 service code 27 service code 28 service code 29 service code 30 service code 31 service code 32 service code 33 service code 34 service code 35 service code 36 service code 37 service code 38 service code 39 service code 40 service code 41 service code 42 service code 43 service code 44 service code 45 service code 46 service code 47 service code 48 service code 49 service code 50 --- service code 1 service code 2 service code 3 service code 4 service code 5 service code 6 service code 7 service code 8 service code 9 service code 10 service code 11 service code 12 service code 13 service code 14 service code 15 service code 16 service code 17 service code 18 service code 19 service code 20 service code 21 service code 22 service code 23 service code 24 service code 25 service code 26 service code 27 service code 28 service code 29 service code 30 service code 31 service code 32 service code 33 service code 34 service code 35 service code 36 service code 37 service code 38 service code 39 service code 40 service code 41 service code 42 service code 43 service code 44 service code 45 service code 46 service code 47 service code 48 service code 49 service code 50 --- service code 1 service code 2 service code 3 service code 4 service code 5 service code 6 service code 7 service code 8 service code 9 service code 10 service code 11 service code 12 service code 13 service code 14 service code 15 service code 16 service code 17 service code 18 service code 19 service code 20 service code 21 service code 22 service code 23 service code 24 service code 25 service code 26 service code 27 service code 28 service code 29 service code 30 service code 31 service code 32 service code 33 service code 34 service code 35 service code 36 service code 37 service code 38 service code 39 service code 40 service code 41 service code 42 service code 43 service code 44 service code 45 service code 46 service code 47 service code 48 service code 49 service code 50 --- service code 1 service code 2 service code 3 service code 4 service code 5 service code 6 service code 7 service code 8 service code 9 service code 10 service code 11 service code 12 service code 13 service code 14 service code 15 service code 16 service code 17 service code 18 service code 19 service code 20 service code 21 service code 22 service code 23 service code 24 service code 25 service code 26 service code 27 service code 28 service code 29 service code 30 service code 31 service code 32 service code 33 service code 34 service code 35 service code 36 service code 37 service code 38 service code 39 service code 40 service code 41 service code 42 service code 43 service code 44 service code 45 service code 46 service code 47 service code 48 service code 49 service code 50 --- service code 1 service code 2 service code 3 service code 4 service code 5 service code 6 service code 7 service code 8 service code 9 service code 10 service code 11 service code 12 service code 13 service code 14 service code 15 service code 16 service code 17 service code 18 service code 19 service code 20 service code 21 service code 22 service code 23 service code 24 service code 25 service code 26 service code 27 service code 28 service code 29 service code 30 service code 31 service code 32 service code 33 service code 34 service code 35 service code 36 service code 37 service code 38 service code 39 service code 40 service code 41 service code 42 service code 43 service code 44 service code 45 service code 46 service code 47 service code 48 service code 49 service code 50 --- service code 1 service code 2 service code 3 service code 4 service code 5 service code 6 service code 7 service code 8 service code 9 service code 10 service code 11 service code 12 service code 13 service code 14 service code 15 service code 16 service code 17 service code 18 service code 19 service code 20 service code 21 service code 22 service code 23 service code 24 service code 25 service code 26 service code 27 service code 28 service code 29 service code 30 service code 31 service code 32 service code 33 service code 34 service code 35 service code 36 service code 37 service code 38 service code 39 service code 40 service code 41 service code 42 service code 43 service code 44 service code 45 service code 46 service code 47 service code 48 service code 49 service code 50 --- service code 1 service code 2 service code 3 service code 4 service code 5 service code 6 service code 7 service code 8 service code 9 service code 10 service code 11 service code 12 service code 13 service code 14 service code 15 service code 16 service code 17 service code 18 service code 19 service code 20 service code 21 service code 22 service code 23 service code 24 service code 25 service code 26 service code 27 service code 28 service code 29 service code 30 service code 31 service code 32 service code 33 service code 34 service code 35 service code 36 service code 37 service code 38 service code 39 service code 40 service code 41 service code 42 service code 43 service code 44 service code 45 service code 46 service code 47 service code 48 service code 49 service code 50 --- service code 1 service code 2 service code 3 service code 4 service code 5 service code 6 service code 7 service code 8 service code 9 service code 10 service code 11 service code 12 service code 13 service code 14 service code 15 service code 16 service code 17 service code 18 service code 19 service code 20 service code 21 service code 22 service code 23 service code 24 service code 25 service code 26 service code 27 service code 28 service code 29 service code 30 service code 31 service code 32 service code 33 service code 34 service code 35 service code 36 service code 37 service code 38 service code 39 service code 40 service code 41 service code 42 service code 43 service code 44 service code 45 service code 46 service code 47 service code 48 service code 49 service code 50 --- service code 1 service code 2 service code 3 service code 4 service code 5 service code 6 service code 7 service code 8 service code 9 service code 10 service code 11 service code 12 service code 13 service code 14 service code 15 service code 16 service code 17 service code 18 service code 19 service code 20 service code 21 service code 22 service code 23 service code 24 service code 25 service code 26 service code 27 service code 28 service code 29 service code 30 service code 31 service code 32 service code 33 service code 34 service code 35 service code 36 service code 37 service code 38 service code 39 service code 40 service code 41 service code 42 service code 43 service code 44 service code 45 service code 46 service code 47 service code 48 service code 49 service code 50 --- service code 1 service code 2 service code 3 service code 4 service code 5 service code 6 service code 7 service code 8 service code 9 service code 10 service code 11 service code 12 service code 13 service code 14 service code 15 service code 16 service code 17 service code 18 service code 19 service code 20 service code 21 service code 22 service code 23 service code 24 service code 25 service code 26 service code 27 service code 28 service code 29 service code 30 service code 31 service code 32 service code 33 service code 34 service code 35 service code 36 service code 37 service code 38 service code 39 service code 40 service code 41 service code 42 service code 43 service code 44 service code 45 service code 46 service code 47 service code 48 service code 49 service code 50

Select Deduction Codes

--- deduct code 1 deduct code 2 deduct code 3 deduct code 4 deduct code 5 deduct code 6 deduct code 7 deduct code 8 deduct code 9 deduct code 10 deduct code 11 deduct code 12 deduct code 13 deduct code 14 deduct code 15 deduct code 16 deduct code 17 deduct code 18 deduct code 19 deduct code 20 deduct code 21 deduct code 22 deduct code 23 deduct code 24 deduct code 25 deduct code 26 deduct code 27 deduct code 28 deduct code 29 deduct code 30 deduct code 31 deduct code 32 deduct code 33 deduct code 34 deduct code 35 deduct code 36 deduct code 37 deduct code 38 deduct code 39 deduct code 40 deduct code 41 deduct code 42 deduct code 43 deduct code 44 deduct code 45 deduct code 46 deduct code 47 deduct code 48 deduct code 49 deduct code 50 --- deduct code 1 deduct code 2 deduct code 3 deduct code 4 deduct code 5 deduct code 6 deduct code 7 deduct code 8 deduct code 9 deduct code 10 deduct code 11 deduct code 12 deduct code 13 deduct code 14 deduct code 15 deduct code 16 deduct code 17 deduct code 18 deduct code 19 deduct code 20 deduct code 21 deduct code 22 deduct code 23 deduct code 24 deduct code 25 deduct code 26 deduct code 27 deduct code 28 deduct code 29 deduct code 30 deduct code 31 deduct code 32 deduct code 33 deduct code 34 deduct code 35 deduct code 36 deduct code 37 deduct code 38 deduct code 39 deduct code 40 deduct code 41 deduct code 42 deduct code 43 deduct code 44 deduct code 45 deduct code 46 deduct code 47 deduct code 48 deduct code 49 deduct code 50 --- deduct code 1 deduct code 2 deduct code 3 deduct code 4 deduct code 5 deduct code 6 deduct code 7 deduct code 8 deduct code 9 deduct code 10 deduct code 11 deduct code 12 deduct code 13 deduct code 14 deduct code 15 deduct code 16 deduct code 17 deduct code 18 deduct code 19 deduct code 20 deduct code 21 deduct code 22 deduct code 23 deduct code 24 deduct code 25 deduct code 26 deduct code 27 deduct code 28 deduct code 29 deduct code 30 deduct code 31 deduct code 32 deduct code 33 deduct code 34 deduct code 35 deduct code 36 deduct code 37 deduct code 38 deduct code 39 deduct code 40 deduct code 41 deduct code 42 deduct code 43 deduct code 44 deduct code 45 deduct code 46 deduct code 47 deduct code 48 deduct code 49 deduct code 50 --- deduct code 1 deduct code 2 deduct code 3 deduct code 4 deduct code 5 deduct code 6 deduct code 7 deduct code 8 deduct code 9 deduct code 10 deduct code 11 deduct code 12 deduct code 13 deduct code 14 deduct code 15 deduct code 16 deduct code 17 deduct code 18 deduct code 19 deduct code 20 deduct code 21 deduct code 22 deduct code 23 deduct code 24 deduct code 25 deduct code 26 deduct code 27 deduct code 28 deduct code 29 deduct code 30 deduct code 31 deduct code 32 deduct code 33 deduct code 34 deduct code 35 deduct code 36 deduct code 37 deduct code 38 deduct code 39 deduct code 40 deduct code 41 deduct code 42 deduct code 43 deduct code 44 deduct code 45 deduct code 46 deduct code 47 deduct code 48 deduct code 49 deduct code 50 --- deduct code 1 deduct code 2 deduct code 3 deduct code 4 deduct code 5 deduct code 6 deduct code 7 deduct code 8 deduct code 9 deduct code 10 deduct code 11 deduct code 12 deduct code 13 deduct code 14 deduct code 15 deduct code 16 deduct code 17 deduct code 18 deduct code 19 deduct code 20 deduct code 21 deduct code 22 deduct code 23 deduct code 24 deduct code 25 deduct code 26 deduct code 27 deduct code 28 deduct code 29 deduct code 30 deduct code 31 deduct code 32 deduct code 33 deduct code 34 deduct code 35 deduct code 36 deduct code 37 deduct code 38 deduct code 39 deduct code 40 deduct code 41 deduct code 42 deduct code 43 deduct code 44 deduct code 45 deduct code 46 deduct code 47 deduct code 48 deduct code 49 deduct code 50 --- deduct code 1 deduct code 2 deduct code 3 deduct code 4 deduct code 5 deduct code 6 deduct code 7 deduct code 8 deduct code 9 deduct code 10 deduct code 11 deduct code 12 deduct code 13 deduct code 14 deduct code 15 deduct code 16 deduct code 17 deduct code 18 deduct code 19 deduct code 20 deduct code 21 deduct code 22 deduct code 23 deduct code 24 deduct code 25 deduct code 26 deduct code 27 deduct code 28 deduct code 29 deduct code 30 deduct code 31 deduct code 32 deduct code 33 deduct code 34 deduct code 35 deduct code 36 deduct code 37 deduct code 38 deduct code 39 deduct code 40 deduct code 41 deduct code 42 deduct code 43 deduct code 44 deduct code 45 deduct code 46 deduct code 47 deduct code 48 deduct code 49 deduct code 50 --- deduct code 1 deduct code 2 deduct code 3 deduct code 4 deduct code 5 deduct code 6 deduct code 7 deduct code 8 deduct code 9 deduct code 10 deduct code 11 deduct code 12 deduct code 13 deduct code 14 deduct code 15 deduct code 16 deduct code 17 deduct code 18 deduct code 19 deduct code 20 deduct code 21 deduct code 22 deduct code 23 deduct code 24 deduct code 25 deduct code 26 deduct code 27 deduct code 28 deduct code 29 deduct code 30 deduct code 31 deduct code 32 deduct code 33 deduct code 34 deduct code 35 deduct code 36 deduct code 37 deduct code 38 deduct code 39 deduct code 40 deduct code 41 deduct code 42 deduct code 43 deduct code 44 deduct code 45 deduct code 46 deduct code 47 deduct code 48 deduct code 49 deduct code 50 --- deduct code 1 deduct code 2 deduct code 3 deduct code 4 deduct code 5 deduct code 6 deduct code 7 deduct code 8 deduct code 9 deduct code 10 deduct code 11 deduct code 12 deduct code 13 deduct code 14 deduct code 15 deduct code 16 deduct code 17 deduct code 18 deduct code 19 deduct code 20 deduct code 21 deduct code 22 deduct code 23 deduct code 24 deduct code 25 deduct code 26 deduct code 27 deduct code 28 deduct code 29 deduct code 30 deduct code 31 deduct code 32 deduct code 33 deduct code 34 deduct code 35 deduct code 36 deduct code 37 deduct code 38 deduct code 39 deduct code 40 deduct code 41 deduct code 42 deduct code 43 deduct code 44 deduct code 45 deduct code 46 deduct code 47 deduct code 48 deduct code 49 deduct code 50 --- deduct code 1 deduct code 2 deduct code 3 deduct code 4 deduct code 5 deduct code 6 deduct code 7 deduct code 8 deduct code 9 deduct code 10 deduct code 11 deduct code 12 deduct code 13 deduct code 14 deduct code 15 deduct code 16 deduct code 17 deduct code 18 deduct code 19 deduct code 20 deduct code 21 deduct code 22 deduct code 23 deduct code 24 deduct code 25 deduct code 26 deduct code 27 deduct code 28 deduct code 29 deduct code 30 deduct code 31 deduct code 32 deduct code 33 deduct code 34 deduct code 35 deduct code 36 deduct code 37 deduct code 38 deduct code 39 deduct code 40 deduct code 41 deduct code 42 deduct code 43 deduct code 44 deduct code 45 deduct code 46 deduct code 47 deduct code 48 deduct code 49 deduct code 50 --- deduct code 1 deduct code 2 deduct code 3 deduct code 4 deduct code 5 deduct code 6 deduct code 7 deduct code 8 deduct code 9 deduct code 10 deduct code 11 deduct code 12 deduct code 13 deduct code 14 deduct code 15 deduct code 16 deduct code 17 deduct code 18 deduct code 19 deduct code 20 deduct code 21 deduct code 22 deduct code 23 deduct code 24 deduct code 25 deduct code 26 deduct code 27 deduct code 28 deduct code 29 deduct code 30 deduct code 31 deduct code 32 deduct code 33 deduct code 34 deduct code 35 deduct code 36 deduct code 37 deduct code 38 deduct code 39 deduct code 40 deduct code 41 deduct code 42 deduct code 43 deduct code 44 deduct code 45 deduct code 46 deduct code 47 deduct code 48 deduct code 49 deduct code 50
Total

<script type="text/javascript" language="javascript">
<!--
function getTotal(oForm)
{
var field, i = 0, total = 0, els = oForm.elements;
var fieldnames = ['servicecode1' , 'servicecode2' , 'servicecode3' , 'servicecode4' , 'servicecode5' , 'servicecode6' , 'servicecode7' , 'servicecode8' , 'servicecode9' , 'servicecode10' , 'servicecode11' , 'servicecode12' , 'servicecode13' , 'servicecode14' , 'servicecode15' , 'servicecode16' , 'servicecode17' , 'servicecode18' , 'servicecode19' , 'servicecode20'];
for (i; i < fieldnames.length; ++i)
{
field = els[fieldnames[i]];
if (field.value != '' && isNaN(field.value))
{
alert('Please enter a valid number here.')
field.focus();
field.select();
return '';
}
else total += Number(field.value);
}
return ' ' + total.toFixed(2);
}
//-->
</script>

<style type="text/css">
<!--
#Form1
{
width:50em;
}

#Form1 fieldset
{
display: block;
background-color: #ffffff;
border:#CCC 1px solid;
font-size: 1.2em;
padding: 0px 0px 0px 10px; /* clockwise top-right-bottom-left */
color:#000;
}

#Form1 fieldset label
{
display:block;
margin:10px 5px 10px 5px;
font-size: 1.0em;
font-weight: normal;
color:#369;
}


#Form1 fieldset legend p
{
font-size: 0.8em;
font-weight: normal;
color:#0CF;
padding:0px 5px 0px 5px;
background-color: #FFF;
}

#Form1 fieldset .total
{
color:#FFF;
font-size: 0.8em;
font-weight: bold;
background-color: #369;
}

#Form1 fieldset select
{
color:#369;
font-size: 0.8em;
font-weight: normal;
background-color: #FFC;
margin-bottom:5px;
}
-->
</style>
<form id="Form1">
<fieldset>
<legend><p>Select Service Codes</p></legend>
<select name="servicecode1" id="servicecode1" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="1.50">service code 1</option>
<option value="2.00">service code 2</option>
<option value="2.50">service code 3</option>
<option value="3.00">service code 4</option>
<option value="3.50">service code 5</option>
<option value="4.00">service code 6</option>
<option value="4.50">service code 7</option>
<option value="5.00">service code 8</option>
<option value="5.50">service code 9</option>
<option value="6.50">service code 10</option>
<option value="1.50">service code 11</option>
<option value="2.00">service code 12</option>
<option value="2.50">service code 13</option>
<option value="3.00">service code 14</option>
<option value="3.50">service code 15</option>
<option value="4.00">service code 16</option>
<option value="4.50">service code 17</option>
<option value="5.00">service code 18</option>
<option value="5.50">service code 19</option>
<option value="6.50">service code 20</option>
<option value="1.50">service code 21</option>
<option value="2.00">service code 22</option>
<option value="2.50">service code 23</option>
<option value="3.00">service code 24</option>
<option value="3.50">service code 25</option>
<option value="4.00">service code 26</option>
<option value="4.50">service code 27</option>
<option value="5.00">service code 28</option>
<option value="5.50">service code 29</option>
<option value="6.50">service code 30</option>
<option value="11.50">service code 31</option>
<option value="23.00">service code 32</option>
<option value="21.50">service code 33</option>
<option value="32.00">service code 34</option>
<option value="33.50">service code 35</option>
<option value="4.00">service code 36</option>
<option value="46.50">service code 37</option>
<option value="35.00">service code 38</option>
<option value="51.50">service code 39</option>
<option value="61.53">service code 40</option>
<option value="15.59">service code 41</option>
<option value="24.00">service code 42</option>
<option value="2.88">service code 43</option>
<option value="3.25">service code 44</option>
<option value="3.55">service code 45</option>
<option value="4.95">service code 46</option>
<option value="14.95">service code 47</option>
<option value="45.21">service code 48</option>
<option value="45.99">service code 49</option>
<option value="16.52">service code 50</option>
</select>

<select name="servicecode2" id="servicecode2" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="1.50">service code 1</option>
<option value="2.00">service code 2</option>
<option value="2.50">service code 3</option>
<option value="3.00">service code 4</option>
<option value="3.50">service code 5</option>
<option value="4.00">service code 6</option>
<option value="4.50">service code 7</option>
<option value="5.00">service code 8</option>
<option value="5.50">service code 9</option>
<option value="6.50">service code 10</option>
<option value="1.50">service code 11</option>
<option value="2.00">service code 12</option>
<option value="2.50">service code 13</option>
<option value="3.00">service code 14</option>
<option value="3.50">service code 15</option>
<option value="4.00">service code 16</option>
<option value="4.50">service code 17</option>
<option value="5.00">service code 18</option>
<option value="5.50">service code 19</option>
<option value="6.50">service code 20</option>
<option value="1.50">service code 21</option>
<option value="2.00">service code 22</option>
<option value="2.50">service code 23</option>
<option value="3.00">service code 24</option>
<option value="3.50">service code 25</option>
<option value="4.00">service code 26</option>
<option value="4.50">service code 27</option>
<option value="5.00">service code 28</option>
<option value="5.50">service code 29</option>
<option value="6.50">service code 30</option>
<option value="11.50">service code 31</option>
<option value="23.00">service code 32</option>
<option value="21.50">service code 33</option>
<option value="32.00">service code 34</option>
<option value="33.50">service code 35</option>
<option value="4.00">service code 36</option>
<option value="46.50">service code 37</option>
<option value="35.00">service code 38</option>
<option value="51.50">service code 39</option>
<option value="61.53">service code 40</option>
<option value="15.59">service code 41</option>
<option value="24.00">service code 42</option>
<option value="2.88">service code 43</option>
<option value="3.25">service code 44</option>
<option value="3.55">service code 45</option>
<option value="4.95">service code 46</option>
<option value="14.95">service code 47</option>
<option value="45.21">service code 48</option>
<option value="45.99">service code 49</option>
<option value="16.52">service code 50</option>
</select>

<select name="servicecode3" id="servicecode3" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="1.50">service code 1</option>
<option value="2.00">service code 2</option>
<option value="2.50">service code 3</option>
<option value="3.00">service code 4</option>
<option value="3.50">service code 5</option>
<option value="4.00">service code 6</option>
<option value="4.50">service code 7</option>
<option value="5.00">service code 8</option>
<option value="5.50">service code 9</option>
<option value="6.50">service code 10</option>
<option value="1.50">service code 11</option>
<option value="2.00">service code 12</option>
<option value="2.50">service code 13</option>
<option value="3.00">service code 14</option>
<option value="3.50">service code 15</option>
<option value="4.00">service code 16</option>
<option value="4.50">service code 17</option>
<option value="5.00">service code 18</option>
<option value="5.50">service code 19</option>
<option value="6.50">service code 20</option>
<option value="1.50">service code 21</option>
<option value="2.00">service code 22</option>
<option value="2.50">service code 23</option>
<option value="3.00">service code 24</option>
<option value="3.50">service code 25</option>
<option value="4.00">service code 26</option>
<option value="4.50">service code 27</option>
<option value="5.00">service code 28</option>
<option value="5.50">service code 29</option>
<option value="6.50">service code 30</option>
<option value="11.50">service code 31</option>
<option value="23.00">service code 32</option>
<option value="21.50">service code 33</option>
<option value="32.00">service code 34</option>
<option value="33.50">service code 35</option>
<option value="4.00">service code 36</option>
<option value="46.50">service code 37</option>
<option value="35.00">service code 38</option>
<option value="51.50">service code 39</option>
<option value="61.53">service code 40</option>
<option value="15.59">service code 41</option>
<option value="24.00">service code 42</option>
<option value="2.88">service code 43</option>
<option value="3.25">service code 44</option>
<option value="3.55">service code 45</option>
<option value="4.95">service code 46</option>
<option value="14.95">service code 47</option>
<option value="45.21">service code 48</option>
<option value="45.99">service code 49</option>
<option value="16.52">service code 50</option>
</select>

<select name="servicecode4" id="servicecode4" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="1.50">service code 1</option>
<option value="2.00">service code 2</option>
<option value="2.50">service code 3</option>
<option value="3.00">service code 4</option>
<option value="3.50">service code 5</option>
<option value="4.00">service code 6</option>
<option value="4.50">service code 7</option>
<option value="5.00">service code 8</option>
<option value="5.50">service code 9</option>
<option value="6.50">service code 10</option>
<option value="1.50">service code 11</option>
<option value="2.00">service code 12</option>
<option value="2.50">service code 13</option>
<option value="3.00">service code 14</option>
<option value="3.50">service code 15</option>
<option value="4.00">service code 16</option>
<option value="4.50">service code 17</option>
<option value="5.00">service code 18</option>
<option value="5.50">service code 19</option>
<option value="6.50">service code 20</option>
<option value="1.50">service code 21</option>
<option value="2.00">service code 22</option>
<option value="2.50">service code 23</option>
<option value="3.00">service code 24</option>
<option value="3.50">service code 25</option>
<option value="4.00">service code 26</option>
<option value="4.50">service code 27</option>
<option value="5.00">service code 28</option>
<option value="5.50">service code 29</option>
<option value="6.50">service code 30</option>
<option value="11.50">service code 31</option>
<option value="23.00">service code 32</option>
<option value="21.50">service code 33</option>
<option value="32.00">service code 34</option>
<option value="33.50">service code 35</option>
<option value="4.00">service code 36</option>
<option value="46.50">service code 37</option>
<option value="35.00">service code 38</option>
<option value="51.50">service code 39</option>
<option value="61.53">service code 40</option>
<option value="15.59">service code 41</option>
<option value="24.00">service code 42</option>
<option value="2.88">service code 43</option>
<option value="3.25">service code 44</option>
<option value="3.55">service code 45</option>
<option value="4.95">service code 46</option>
<option value="14.95">service code 47</option>
<option value="45.21">service code 48</option>
<option value="45.99">service code 49</option>
<option value="16.52">service code 50</option>
</select>

<select name="servicecode5" id="servicecode5" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="1.50">service code 1</option>
<option value="2.00">service code 2</option>
<option value="2.50">service code 3</option>
<option value="3.00">service code 4</option>
<option value="3.50">service code 5</option>
<option value="4.00">service code 6</option>
<option value="4.50">service code 7</option>
<option value="5.00">service code 8</option>
<option value="5.50">service code 9</option>
<option value="6.50">service code 10</option>
<option value="1.50">service code 11</option>
<option value="2.00">service code 12</option>
<option value="2.50">service code 13</option>
<option value="3.00">service code 14</option>
<option value="3.50">service code 15</option>
<option value="4.00">service code 16</option>
<option value="4.50">service code 17</option>
<option value="5.00">service code 18</option>
<option value="5.50">service code 19</option>
<option value="6.50">service code 20</option>
<option value="1.50">service code 21</option>
<option value="2.00">service code 22</option>
<option value="2.50">service code 23</option>
<option value="3.00">service code 24</option>
<option value="3.50">service code 25</option>
<option value="4.00">service code 26</option>
<option value="4.50">service code 27</option>
<option value="5.00">service code 28</option>
<option value="5.50">service code 29</option>
<option value="6.50">service code 30</option>
<option value="11.50">service code 31</option>
<option value="23.00">service code 32</option>
<option value="21.50">service code 33</option>
<option value="32.00">service code 34</option>
<option value="33.50">service code 35</option>
<option value="4.00">service code 36</option>
<option value="46.50">service code 37</option>
<option value="35.00">service code 38</option>
<option value="51.50">service code 39</option>
<option value="61.53">service code 40</option>
<option value="15.59">service code 41</option>
<option value="24.00">service code 42</option>
<option value="2.88">service code 43</option>
<option value="3.25">service code 44</option>
<option value="3.55">service code 45</option>
<option value="4.95">service code 46</option>
<option value="14.95">service code 47</option>
<option value="45.21">service code 48</option>
<option value="45.99">service code 49</option>
<option value="16.52">service code 50</option>
</select>

<select name="servicecode6" id="servicecode6" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="1.50">service code 1</option>
<option value="2.00">service code 2</option>
<option value="2.50">service code 3</option>
<option value="3.00">service code 4</option>
<option value="3.50">service code 5</option>
<option value="4.00">service code 6</option>
<option value="4.50">service code 7</option>
<option value="5.00">service code 8</option>
<option value="5.50">service code 9</option>
<option value="6.50">service code 10</option>
<option value="1.50">service code 11</option>
<option value="2.00">service code 12</option>
<option value="2.50">service code 13</option>
<option value="3.00">service code 14</option>
<option value="3.50">service code 15</option>
<option value="4.00">service code 16</option>
<option value="4.50">service code 17</option>
<option value="5.00">service code 18</option>
<option value="5.50">service code 19</option>
<option value="6.50">service code 20</option>
<option value="1.50">service code 21</option>
<option value="2.00">service code 22</option>
<option value="2.50">service code 23</option>
<option value="3.00">service code 24</option>
<option value="3.50">service code 25</option>
<option value="4.00">service code 26</option>
<option value="4.50">service code 27</option>
<option value="5.00">service code 28</option>
<option value="5.50">service code 29</option>
<option value="6.50">service code 30</option>
<option value="11.50">service code 31</option>
<option value="23.00">service code 32</option>
<option value="21.50">service code 33</option>
<option value="32.00">service code 34</option>
<option value="33.50">service code 35</option>
<option value="4.00">service code 36</option>
<option value="46.50">service code 37</option>
<option value="35.00">service code 38</option>
<option value="51.50">service code 39</option>
<option value="61.53">service code 40</option>
<option value="15.59">service code 41</option>
<option value="24.00">service code 42</option>
<option value="2.88">service code 43</option>
<option value="3.25">service code 44</option>
<option value="3.55">service code 45</option>
<option value="4.95">service code 46</option>
<option value="14.95">service code 47</option>
<option value="45.21">service code 48</option>
<option value="45.99">service code 49</option>
<option value="16.52">service code 50</option>
</select>

<select name="servicecode7" id="servicecode7" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="1.50">service code 1</option>
<option value="2.00">service code 2</option>
<option value="2.50">service code 3</option>
<option value="3.00">service code 4</option>
<option value="3.50">service code 5</option>
<option value="4.00">service code 6</option>
<option value="4.50">service code 7</option>
<option value="5.00">service code 8</option>
<option value="5.50">service code 9</option>
<option value="6.50">service code 10</option>
<option value="1.50">service code 11</option>
<option value="2.00">service code 12</option>
<option value="2.50">service code 13</option>
<option value="3.00">service code 14</option>
<option value="3.50">service code 15</option>
<option value="4.00">service code 16</option>
<option value="4.50">service code 17</option>
<option value="5.00">service code 18</option>
<option value="5.50">service code 19</option>
<option value="6.50">service code 20</option>
<option value="1.50">service code 21</option>
<option value="2.00">service code 22</option>
<option value="2.50">service code 23</option>
<option value="3.00">service code 24</option>
<option value="3.50">service code 25</option>
<option value="4.00">service code 26</option>
<option value="4.50">service code 27</option>
<option value="5.00">service code 28</option>
<option value="5.50">service code 29</option>
<option value="6.50">service code 30</option>
<option value="11.50">service code 31</option>
<option value="23.00">service code 32</option>
<option value="21.50">service code 33</option>
<option value="32.00">service code 34</option>
<option value="33.50">service code 35</option>
<option value="4.00">service code 36</option>
<option value="46.50">service code 37</option>
<option value="35.00">service code 38</option>
<option value="51.50">service code 39</option>
<option value="61.53">service code 40</option>
<option value="15.59">service code 41</option>
<option value="24.00">service code 42</option>
<option value="2.88">service code 43</option>
<option value="3.25">service code 44</option>
<option value="3.55">service code 45</option>
<option value="4.95">service code 46</option>
<option value="14.95">service code 47</option>
<option value="45.21">service code 48</option>
<option value="45.99">service code 49</option>
<option value="16.52">service code 50</option>
</select>

<select name="servicecode8" id="servicecode8" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="1.50">service code 1</option>
<option value="2.00">service code 2</option>
<option value="2.50">service code 3</option>
<option value="3.00">service code 4</option>
<option value="3.50">service code 5</option>
<option value="4.00">service code 6</option>
<option value="4.50">service code 7</option>
<option value="5.00">service code 8</option>
<option value="5.50">service code 9</option>
<option value="6.50">service code 10</option>
<option value="1.50">service code 11</option>
<option value="2.00">service code 12</option>
<option value="2.50">service code 13</option>
<option value="3.00">service code 14</option>
<option value="3.50">service code 15</option>
<option value="4.00">service code 16</option>
<option value="4.50">service code 17</option>
<option value="5.00">service code 18</option>
<option value="5.50">service code 19</option>
<option value="6.50">service code 20</option>
<option value="1.50">service code 21</option>
<option value="2.00">service code 22</option>
<option value="2.50">service code 23</option>
<option value="3.00">service code 24</option>
<option value="3.50">service code 25</option>
<option value="4.00">service code 26</option>
<option value="4.50">service code 27</option>
<option value="5.00">service code 28</option>
<option value="5.50">service code 29</option>
<option value="6.50">service code 30</option>
<option value="11.50">service code 31</option>
<option value="23.00">service code 32</option>
<option value="21.50">service code 33</option>
<option value="32.00">service code 34</option>
<option value="33.50">service code 35</option>
<option value="4.00">service code 36</option>
<option value="46.50">service code 37</option>
<option value="35.00">service code 38</option>
<option value="51.50">service code 39</option>
<option value="61.53">service code 40</option>
<option value="15.59">service code 41</option>
<option value="24.00">service code 42</option>
<option value="2.88">service code 43</option>
<option value="3.25">service code 44</option>
<option value="3.55">service code 45</option>
<option value="4.95">service code 46</option>
<option value="14.95">service code 47</option>
<option value="45.21">service code 48</option>
<option value="45.99">service code 49</option>
<option value="16.52">service code 50</option>
</select>

<select name="servicecode9" id="servicecode9" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="1.50">service code 1</option>
<option value="2.00">service code 2</option>
<option value="2.50">service code 3</option>
<option value="3.00">service code 4</option>
<option value="3.50">service code 5</option>
<option value="4.00">service code 6</option>
<option value="4.50">service code 7</option>
<option value="5.00">service code 8</option>
<option value="5.50">service code 9</option>
<option value="6.50">service code 10</option>
<option value="1.50">service code 11</option>
<option value="2.00">service code 12</option>
<option value="2.50">service code 13</option>
<option value="3.00">service code 14</option>
<option value="3.50">service code 15</option>
<option value="4.00">service code 16</option>
<option value="4.50">service code 17</option>
<option value="5.00">service code 18</option>
<option value="5.50">service code 19</option>
<option value="6.50">service code 20</option>
<option value="1.50">service code 21</option>
<option value="2.00">service code 22</option>
<option value="2.50">service code 23</option>
<option value="3.00">service code 24</option>
<option value="3.50">service code 25</option>
<option value="4.00">service code 26</option>
<option value="4.50">service code 27</option>
<option value="5.00">service code 28</option>
<option value="5.50">service code 29</option>
<option value="6.50">service code 30</option>
<option value="11.50">service code 31</option>
<option value="23.00">service code 32</option>
<option value="21.50">service code 33</option>
<option value="32.00">service code 34</option>
<option value="33.50">service code 35</option>
<option value="4.00">service code 36</option>
<option value="46.50">service code 37</option>
<option value="35.00">service code 38</option>
<option value="51.50">service code 39</option>
<option value="61.53">service code 40</option>
<option value="15.59">service code 41</option>
<option value="24.00">service code 42</option>
<option value="2.88">service code 43</option>
<option value="3.25">service code 44</option>
<option value="3.55">service code 45</option>
<option value="4.95">service code 46</option>
<option value="14.95">service code 47</option>
<option value="45.21">service code 48</option>
<option value="45.99">service code 49</option>
<option value="16.52">service code 50</option>
</select>

<select name="servicecode10" id="servicecode10" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="1.50">service code 1</option>
<option value="2.00">service code 2</option>
<option value="2.50">service code 3</option>
<option value="3.00">service code 4</option>
<option value="3.50">service code 5</option>
<option value="4.00">service code 6</option>
<option value="4.50">service code 7</option>
<option value="5.00">service code 8</option>
<option value="5.50">service code 9</option>
<option value="6.50">service code 10</option>
<option value="1.50">service code 11</option>
<option value="2.00">service code 12</option>
<option value="2.50">service code 13</option>
<option value="3.00">service code 14</option>
<option value="3.50">service code 15</option>
<option value="4.00">service code 16</option>
<option value="4.50">service code 17</option>
<option value="5.00">service code 18</option>
<option value="5.50">service code 19</option>
<option value="6.50">service code 20</option>
<option value="1.50">service code 21</option>
<option value="2.00">service code 22</option>
<option value="2.50">service code 23</option>
<option value="3.00">service code 24</option>
<option value="3.50">service code 25</option>
<option value="4.00">service code 26</option>
<option value="4.50">service code 27</option>
<option value="5.00">service code 28</option>
<option value="5.50">service code 29</option>
<option value="6.50">service code 30</option>
<option value="11.50">service code 31</option>
<option value="23.00">service code 32</option>
<option value="21.50">service code 33</option>
<option value="32.00">service code 34</option>
<option value="33.50">service code 35</option>
<option value="4.00">service code 36</option>
<option value="46.50">service code 37</option>
<option value="35.00">service code 38</option>
<option value="51.50">service code 39</option>
<option value="61.53">service code 40</option>
<option value="15.59">service code 41</option>
<option value="24.00">service code 42</option>
<option value="2.88">service code 43</option>
<option value="3.25">service code 44</option>
<option value="3.55">service code 45</option>
<option value="4.95">service code 46</option>
<option value="14.95">service code 47</option>
<option value="45.21">service code 48</option>
<option value="45.99">service code 49</option>
<option value="16.52">service code 50</option>
</select>
<legend><p>Select Deduction Codes</p></legend>
<select name="servicecode11" id="servicecode11" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="-1.50">deduct code 1</option>
<option value="-2.00">deduct code 2</option>
<option value="-2.50">deduct code 3</option>
<option value="-3.00">deduct code 4</option>
<option value="-3.50">deduct code 5</option>
<option value="-4.00">deduct code 6</option>
<option value="-4.50">deduct code 7</option>
<option value="-5.00">deduct code 8</option>
<option value="-5.50">deduct code 9</option>
<option value="-6.50">deduct code 10</option>
<option value="-1.50">deduct code 11</option>
<option value="-2.00">deduct code 12</option>
<option value="-2.50">deduct code 13</option>
<option value="-3.00">deduct code 14</option>
<option value="-3.50">deduct code 15</option>
<option value="-4.00">deduct code 16</option>
<option value="-4.50">deduct code 17</option>
<option value="-5.00">deduct code 18</option>
<option value="-5.50">deduct code 19</option>
<option value="-6.50">deduct code 20</option>
<option value="-1.50">deduct code 21</option>
<option value="-2.00">deduct code 22</option>
<option value="-2.50">deduct code 23</option>
<option value="-3.00">deduct code 24</option>
<option value="-3.50">deduct code 25</option>
<option value="-4.00">deduct code 26</option>
<option value="-4.50">deduct code 27</option>
<option value="-5.00">deduct code 28</option>
<option value="-5.50">deduct code 29</option>
<option value="-6.50">deduct code 30</option>
<option value="-11.50">deduct code 31</option>
<option value="-23.00">deduct code 32</option>
<option value="-21.50">deduct code 33</option>
<option value="-32.00">deduct code 34</option>
<option value="-33.50">deduct code 35</option>
<option value="-4.00">deduct code 36</option>
<option value="-46.50">deduct code 37</option>
<option value="-35.00">deduct code 38</option>
<option value="-51.50">deduct code 39</option>
<option value="-61.53">deduct code 40</option>
<option value="-15.59">deduct code 41</option>
<option value="-24.00">deduct code 42</option>
<option value="-2.88">deduct code 43</option>
<option value="-3.25">deduct code 44</option>
<option value="-3.55">deduct code 45</option>
<option value="-4.95">deduct code 46</option>
<option value="-14.95">deduct code 47</option>
<option value="-45.21">deduct code 48</option>
<option value="-45.99">deduct code 49</option>
<option value="-16.52">deduct code 50</option>
</select>

<select name="servicecode12" id="servicecode12" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="-1.50">deduct code 1</option>
<option value="-2.00">deduct code 2</option>
<option value="-2.50">deduct code 3</option>
<option value="-3.00">deduct code 4</option>
<option value="-3.50">deduct code 5</option>
<option value="-4.00">deduct code 6</option>
<option value="-4.50">deduct code 7</option>
<option value="-5.00">deduct code 8</option>
<option value="-5.50">deduct code 9</option>
<option value="-6.50">deduct code 10</option>
<option value="-1.50">deduct code 11</option>
<option value="-2.00">deduct code 12</option>
<option value="-2.50">deduct code 13</option>
<option value="-3.00">deduct code 14</option>
<option value="-3.50">deduct code 15</option>
<option value="-4.00">deduct code 16</option>
<option value="-4.50">deduct code 17</option>
<option value="-5.00">deduct code 18</option>
<option value="-5.50">deduct code 19</option>
<option value="-6.50">deduct code 20</option>
<option value="-1.50">deduct code 21</option>
<option value="-2.00">deduct code 22</option>
<option value="-2.50">deduct code 23</option>
<option value="-3.00">deduct code 24</option>
<option value="-3.50">deduct code 25</option>
<option value="-4.00">deduct code 26</option>
<option value="-4.50">deduct code 27</option>
<option value="-5.00">deduct code 28</option>
<option value="-5.50">deduct code 29</option>
<option value="-6.50">deduct code 30</option>
<option value="-11.50">deduct code 31</option>
<option value="-23.00">deduct code 32</option>
<option value="-21.50">deduct code 33</option>
<option value="-32.00">deduct code 34</option>
<option value="-33.50">deduct code 35</option>
<option value="-4.00">deduct code 36</option>
<option value="-46.50">deduct code 37</option>
<option value="-35.00">deduct code 38</option>
<option value="-51.50">deduct code 39</option>
<option value="-61.53">deduct code 40</option>
<option value="-15.59">deduct code 41</option>
<option value="-24.00">deduct code 42</option>
<option value="-2.88">deduct code 43</option>
<option value="-3.25">deduct code 44</option>
<option value="-3.55">deduct code 45</option>
<option value="-4.95">deduct code 46</option>
<option value="-14.95">deduct code 47</option>
<option value="-45.21">deduct code 48</option>
<option value="-45.99">deduct code 49</option>
<option value="-16.52">deduct code 50</option>
</select>

<select name="servicecode13" id="servicecode13" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="-1.50">deduct code 1</option>
<option value="-2.00">deduct code 2</option>
<option value="-2.50">deduct code 3</option>
<option value="-3.00">deduct code 4</option>
<option value="-3.50">deduct code 5</option>
<option value="-4.00">deduct code 6</option>
<option value="-4.50">deduct code 7</option>
<option value="-5.00">deduct code 8</option>
<option value="-5.50">deduct code 9</option>
<option value="-6.50">deduct code 10</option>
<option value="-1.50">deduct code 11</option>
<option value="-2.00">deduct code 12</option>
<option value="-2.50">deduct code 13</option>
<option value="-3.00">deduct code 14</option>
<option value="-3.50">deduct code 15</option>
<option value="-4.00">deduct code 16</option>
<option value="-4.50">deduct code 17</option>
<option value="-5.00">deduct code 18</option>
<option value="-5.50">deduct code 19</option>
<option value="-6.50">deduct code 20</option>
<option value="-1.50">deduct code 21</option>
<option value="-2.00">deduct code 22</option>
<option value="-2.50">deduct code 23</option>
<option value="-3.00">deduct code 24</option>
<option value="-3.50">deduct code 25</option>
<option value="-4.00">deduct code 26</option>
<option value="-4.50">deduct code 27</option>
<option value="-5.00">deduct code 28</option>
<option value="-5.50">deduct code 29</option>
<option value="-6.50">deduct code 30</option>
<option value="-11.50">deduct code 31</option>
<option value="-23.00">deduct code 32</option>
<option value="-21.50">deduct code 33</option>
<option value="-32.00">deduct code 34</option>
<option value="-33.50">deduct code 35</option>
<option value="-4.00">deduct code 36</option>
<option value="-46.50">deduct code 37</option>
<option value="-35.00">deduct code 38</option>
<option value="-51.50">deduct code 39</option>
<option value="-61.53">deduct code 40</option>
<option value="-15.59">deduct code 41</option>
<option value="-24.00">deduct code 42</option>
<option value="-2.88">deduct code 43</option>
<option value="-3.25">deduct code 44</option>
<option value="-3.55">deduct code 45</option>
<option value="-4.95">deduct code 46</option>
<option value="-14.95">deduct code 47</option>
<option value="-45.21">deduct code 48</option>
<option value="-45.99">deduct code 49</option>
<option value="-16.52">deduct code 50</option>
</select>

<select name="servicecode14" id="servicecode14" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="-1.50">deduct code 1</option>
<option value="-2.00">deduct code 2</option>
<option value="-2.50">deduct code 3</option>
<option value="-3.00">deduct code 4</option>
<option value="-3.50">deduct code 5</option>
<option value="-4.00">deduct code 6</option>
<option value="-4.50">deduct code 7</option>
<option value="-5.00">deduct code 8</option>
<option value="-5.50">deduct code 9</option>
<option value="-6.50">deduct code 10</option>
<option value="-1.50">deduct code 11</option>
<option value="-2.00">deduct code 12</option>
<option value="-2.50">deduct code 13</option>
<option value="-3.00">deduct code 14</option>
<option value="-3.50">deduct code 15</option>
<option value="-4.00">deduct code 16</option>
<option value="-4.50">deduct code 17</option>
<option value="-5.00">deduct code 18</option>
<option value="-5.50">deduct code 19</option>
<option value="-6.50">deduct code 20</option>
<option value="-1.50">deduct code 21</option>
<option value="-2.00">deduct code 22</option>
<option value="-2.50">deduct code 23</option>
<option value="-3.00">deduct code 24</option>
<option value="-3.50">deduct code 25</option>
<option value="-4.00">deduct code 26</option>
<option value="-4.50">deduct code 27</option>
<option value="-5.00">deduct code 28</option>
<option value="-5.50">deduct code 29</option>
<option value="-6.50">deduct code 30</option>
<option value="-11.50">deduct code 31</option>
<option value="-23.00">deduct code 32</option>
<option value="-21.50">deduct code 33</option>
<option value="-32.00">deduct code 34</option>
<option value="-33.50">deduct code 35</option>
<option value="-4.00">deduct code 36</option>
<option value="-46.50">deduct code 37</option>
<option value="-35.00">deduct code 38</option>
<option value="-51.50">deduct code 39</option>
<option value="-61.53">deduct code 40</option>
<option value="-15.59">deduct code 41</option>
<option value="-24.00">deduct code 42</option>
<option value="-2.88">deduct code 43</option>
<option value="-3.25">deduct code 44</option>
<option value="-3.55">deduct code 45</option>
<option value="-4.95">deduct code 46</option>
<option value="-14.95">deduct code 47</option>
<option value="-45.21">deduct code 48</option>
<option value="-45.99">deduct code 49</option>
<option value="-16.52">deduct code 50</option>
</select>

<select name="servicecode15" id="servicecode15" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="-1.50">deduct code 1</option>
<option value="-2.00">deduct code 2</option>
<option value="-2.50">deduct code 3</option>
<option value="-3.00">deduct code 4</option>
<option value="-3.50">deduct code 5</option>
<option value="-4.00">deduct code 6</option>
<option value="-4.50">deduct code 7</option>
<option value="-5.00">deduct code 8</option>
<option value="-5.50">deduct code 9</option>
<option value="-6.50">deduct code 10</option>
<option value="-1.50">deduct code 11</option>
<option value="-2.00">deduct code 12</option>
<option value="-2.50">deduct code 13</option>
<option value="-3.00">deduct code 14</option>
<option value="-3.50">deduct code 15</option>
<option value="-4.00">deduct code 16</option>
<option value="-4.50">deduct code 17</option>
<option value="-5.00">deduct code 18</option>
<option value="-5.50">deduct code 19</option>
<option value="-6.50">deduct code 20</option>
<option value="-1.50">deduct code 21</option>
<option value="-2.00">deduct code 22</option>
<option value="-2.50">deduct code 23</option>
<option value="-3.00">deduct code 24</option>
<option value="-3.50">deduct code 25</option>
<option value="-4.00">deduct code 26</option>
<option value="-4.50">deduct code 27</option>
<option value="-5.00">deduct code 28</option>
<option value="-5.50">deduct code 29</option>
<option value="-6.50">deduct code 30</option>
<option value="-11.50">deduct code 31</option>
<option value="-23.00">deduct code 32</option>
<option value="-21.50">deduct code 33</option>
<option value="-32.00">deduct code 34</option>
<option value="-33.50">deduct code 35</option>
<option value="-4.00">deduct code 36</option>
<option value="-46.50">deduct code 37</option>
<option value="-35.00">deduct code 38</option>
<option value="-51.50">deduct code 39</option>
<option value="-61.53">deduct code 40</option>
<option value="-15.59">deduct code 41</option>
<option value="-24.00">deduct code 42</option>
<option value="-2.88">deduct code 43</option>
<option value="-3.25">deduct code 44</option>
<option value="-3.55">deduct code 45</option>
<option value="-4.95">deduct code 46</option>
<option value="-14.95">deduct code 47</option>
<option value="-45.21">deduct code 48</option>
<option value="-45.99">deduct code 49</option>
<option value="-16.52">deduct code 50</option>
</select>

<select name="servicecode16" id="servicecode16" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="-1.50">deduct code 1</option>
<option value="-2.00">deduct code 2</option>
<option value="-2.50">deduct code 3</option>
<option value="-3.00">deduct code 4</option>
<option value="-3.50">deduct code 5</option>
<option value="-4.00">deduct code 6</option>
<option value="-4.50">deduct code 7</option>
<option value="-5.00">deduct code 8</option>
<option value="-5.50">deduct code 9</option>
<option value="-6.50">deduct code 10</option>
<option value="-1.50">deduct code 11</option>
<option value="-2.00">deduct code 12</option>
<option value="-2.50">deduct code 13</option>
<option value="-3.00">deduct code 14</option>
<option value="-3.50">deduct code 15</option>
<option value="-4.00">deduct code 16</option>
<option value="-4.50">deduct code 17</option>
<option value="-5.00">deduct code 18</option>
<option value="-5.50">deduct code 19</option>
<option value="-6.50">deduct code 20</option>
<option value="-1.50">deduct code 21</option>
<option value="-2.00">deduct code 22</option>
<option value="-2.50">deduct code 23</option>
<option value="-3.00">deduct code 24</option>
<option value="-3.50">deduct code 25</option>
<option value="-4.00">deduct code 26</option>
<option value="-4.50">deduct code 27</option>
<option value="-5.00">deduct code 28</option>
<option value="-5.50">deduct code 29</option>
<option value="-6.50">deduct code 30</option>
<option value="-11.50">deduct code 31</option>
<option value="-23.00">deduct code 32</option>
<option value="-21.50">deduct code 33</option>
<option value="-32.00">deduct code 34</option>
<option value="-33.50">deduct code 35</option>
<option value="-4.00">deduct code 36</option>
<option value="-46.50">deduct code 37</option>
<option value="-35.00">deduct code 38</option>
<option value="-51.50">deduct code 39</option>
<option value="-61.53">deduct code 40</option>
<option value="-15.59">deduct code 41</option>
<option value="-24.00">deduct code 42</option>
<option value="-2.88">deduct code 43</option>
<option value="-3.25">deduct code 44</option>
<option value="-3.55">deduct code 45</option>
<option value="-4.95">deduct code 46</option>
<option value="-14.95">deduct code 47</option>
<option value="-45.21">deduct code 48</option>
<option value="-45.99">deduct code 49</option>
<option value="-16.52">deduct code 50</option>
</select>

<select name="servicecode17" id="servicecode17" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="-1.50">deduct code 1</option>
<option value="-2.00">deduct code 2</option>
<option value="-2.50">deduct code 3</option>
<option value="-3.00">deduct code 4</option>
<option value="-3.50">deduct code 5</option>
<option value="-4.00">deduct code 6</option>
<option value="-4.50">deduct code 7</option>
<option value="-5.00">deduct code 8</option>
<option value="-5.50">deduct code 9</option>
<option value="-6.50">deduct code 10</option>
<option value="-1.50">deduct code 11</option>
<option value="-2.00">deduct code 12</option>
<option value="-2.50">deduct code 13</option>
<option value="-3.00">deduct code 14</option>
<option value="-3.50">deduct code 15</option>
<option value="-4.00">deduct code 16</option>
<option value="-4.50">deduct code 17</option>
<option value="-5.00">deduct code 18</option>
<option value="-5.50">deduct code 19</option>
<option value="-6.50">deduct code 20</option>
<option value="-1.50">deduct code 21</option>
<option value="-2.00">deduct code 22</option>
<option value="-2.50">deduct code 23</option>
<option value="-3.00">deduct code 24</option>
<option value="-3.50">deduct code 25</option>
<option value="-4.00">deduct code 26</option>
<option value="-4.50">deduct code 27</option>
<option value="-5.00">deduct code 28</option>
<option value="-5.50">deduct code 29</option>
<option value="-6.50">deduct code 30</option>
<option value="-11.50">deduct code 31</option>
<option value="-23.00">deduct code 32</option>
<option value="-21.50">deduct code 33</option>
<option value="-32.00">deduct code 34</option>
<option value="-33.50">deduct code 35</option>
<option value="-4.00">deduct code 36</option>
<option value="-46.50">deduct code 37</option>
<option value="-35.00">deduct code 38</option>
<option value="-51.50">deduct code 39</option>
<option value="-61.53">deduct code 40</option>
<option value="-15.59">deduct code 41</option>
<option value="-24.00">deduct code 42</option>
<option value="-2.88">deduct code 43</option>
<option value="-3.25">deduct code 44</option>
<option value="-3.55">deduct code 45</option>
<option value="-4.95">deduct code 46</option>
<option value="-14.95">deduct code 47</option>
<option value="-45.21">deduct code 48</option>
<option value="-45.99">deduct code 49</option>
<option value="-16.52">deduct code 50</option>
</select>

<select name="servicecode18" id="servicecode18" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="-1.50">deduct code 1</option>
<option value="-2.00">deduct code 2</option>
<option value="-2.50">deduct code 3</option>
<option value="-3.00">deduct code 4</option>
<option value="-3.50">deduct code 5</option>
<option value="-4.00">deduct code 6</option>
<option value="-4.50">deduct code 7</option>
<option value="-5.00">deduct code 8</option>
<option value="-5.50">deduct code 9</option>
<option value="-6.50">deduct code 10</option>
<option value="-1.50">deduct code 11</option>
<option value="-2.00">deduct code 12</option>
<option value="-2.50">deduct code 13</option>
<option value="-3.00">deduct code 14</option>
<option value="-3.50">deduct code 15</option>
<option value="-4.00">deduct code 16</option>
<option value="-4.50">deduct code 17</option>
<option value="-5.00">deduct code 18</option>
<option value="-5.50">deduct code 19</option>
<option value="-6.50">deduct code 20</option>
<option value="-1.50">deduct code 21</option>
<option value="-2.00">deduct code 22</option>
<option value="-2.50">deduct code 23</option>
<option value="-3.00">deduct code 24</option>
<option value="-3.50">deduct code 25</option>
<option value="-4.00">deduct code 26</option>
<option value="-4.50">deduct code 27</option>
<option value="-5.00">deduct code 28</option>
<option value="-5.50">deduct code 29</option>
<option value="-6.50">deduct code 30</option>
<option value="-11.50">deduct code 31</option>
<option value="-23.00">deduct code 32</option>
<option value="-21.50">deduct code 33</option>
<option value="-32.00">deduct code 34</option>
<option value="-33.50">deduct code 35</option>
<option value="-4.00">deduct code 36</option>
<option value="-46.50">deduct code 37</option>
<option value="-35.00">deduct code 38</option>
<option value="-51.50">deduct code 39</option>
<option value="-61.53">deduct code 40</option>
<option value="-15.59">deduct code 41</option>
<option value="-24.00">deduct code 42</option>
<option value="-2.88">deduct code 43</option>
<option value="-3.25">deduct code 44</option>
<option value="-3.55">deduct code 45</option>
<option value="-4.95">deduct code 46</option>
<option value="-14.95">deduct code 47</option>
<option value="-45.21">deduct code 48</option>
<option value="-45.99">deduct code 49</option>
<option value="-16.52">deduct code 50</option>
</select>

<select name="servicecode19" id="servicecode19" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="-1.50">deduct code 1</option>
<option value="-2.00">deduct code 2</option>
<option value="-2.50">deduct code 3</option>
<option value="-3.00">deduct code 4</option>
<option value="-3.50">deduct code 5</option>
<option value="-4.00">deduct code 6</option>
<option value="-4.50">deduct code 7</option>
<option value="-5.00">deduct code 8</option>
<option value="-5.50">deduct code 9</option>
<option value="-6.50">deduct code 10</option>
<option value="-1.50">deduct code 11</option>
<option value="-2.00">deduct code 12</option>
<option value="-2.50">deduct code 13</option>
<option value="-3.00">deduct code 14</option>
<option value="-3.50">deduct code 15</option>
<option value="-4.00">deduct code 16</option>
<option value="-4.50">deduct code 17</option>
<option value="-5.00">deduct code 18</option>
<option value="-5.50">deduct code 19</option>
<option value="-6.50">deduct code 20</option>
<option value="-1.50">deduct code 21</option>
<option value="-2.00">deduct code 22</option>
<option value="-2.50">deduct code 23</option>
<option value="-3.00">deduct code 24</option>
<option value="-3.50">deduct code 25</option>
<option value="-4.00">deduct code 26</option>
<option value="-4.50">deduct code 27</option>
<option value="-5.00">deduct code 28</option>
<option value="-5.50">deduct code 29</option>
<option value="-6.50">deduct code 30</option>
<option value="-11.50">deduct code 31</option>
<option value="-23.00">deduct code 32</option>
<option value="-21.50">deduct code 33</option>
<option value="-32.00">deduct code 34</option>
<option value="-33.50">deduct code 35</option>
<option value="-4.00">deduct code 36</option>
<option value="-46.50">deduct code 37</option>
<option value="-35.00">deduct code 38</option>
<option value="-51.50">deduct code 39</option>
<option value="-61.53">deduct code 40</option>
<option value="-15.59">deduct code 41</option>
<option value="-24.00">deduct code 42</option>
<option value="-2.88">deduct code 43</option>
<option value="-3.25">deduct code 44</option>
<option value="-3.55">deduct code 45</option>
<option value="-4.95">deduct code 46</option>
<option value="-14.95">deduct code 47</option>
<option value="-45.21">deduct code 48</option>
<option value="-45.99">deduct code 49</option>
<option value="-16.52">deduct code 50</option>
</select>

<select name="servicecode20" id="servicecode20" onChange="total.value=getTotal(this.form)">
<option value="0" selected="selected">---</option>
<option value="-1.50">deduct code 1</option>
<option value="-2.00">deduct code 2</option>
<option value="-2.50">deduct code 3</option>
<option value="-3.00">deduct code 4</option>
<option value="-3.50">deduct code 5</option>
<option value="-4.00">deduct code 6</option>
<option value="-4.50">deduct code 7</option>
<option value="-5.00">deduct code 8</option>
<option value="-5.50">deduct code 9</option>
<option value="-6.50">deduct code 10</option>
<option value="-1.50">deduct code 11</option>
<option value="-2.00">deduct code 12</option>
<option value="-2.50">deduct code 13</option>
<option value="-3.00">deduct code 14</option>
<option value="-3.50">deduct code 15</option>
<option value="-4.00">deduct code 16</option>
<option value="-4.50">deduct code 17</option>
<option value="-5.00">deduct code 18</option>
<option value="-5.50">deduct code 19</option>
<option value="-6.50">deduct code 20</option>
<option value="-1.50">deduct code 21</option>
<option value="-2.00">deduct code 22</option>
<option value="-2.50">deduct code 23</option>
<option value="-3.00">deduct code 24</option>
<option value="-3.50">deduct code 25</option>
<option value="-4.00">deduct code 26</option>
<option value="-4.50">deduct code 27</option>
<option value="-5.00">deduct code 28</option>
<option value="-5.50">deduct code 29</option>
<option value="-6.50">deduct code 30</option>
<option value="-11.50">deduct code 31</option>
<option value="-23.00">deduct code 32</option>
<option value="-21.50">deduct code 33</option>
<option value="-32.00">deduct code 34</option>
<option value="-33.50">deduct code 35</option>
<option value="-4.00">deduct code 36</option>
<option value="-46.50">deduct code 37</option>
<option value="-35.00">deduct code 38</option>
<option value="-51.50">deduct code 39</option>
<option value="-61.53">deduct code 40</option>
<option value="-15.59">deduct code 41</option>
<option value="-24.00">deduct code 42</option>
<option value="-2.88">deduct code 43</option>
<option value="-3.25">deduct code 44</option>
<option value="-3.55">deduct code 45</option>
<option value="-4.95">deduct code 46</option>
<option value="-14.95">deduct code 47</option>
<option value="-45.21">deduct code 48</option>
<option value="-45.99">deduct code 49</option>
<option value="-16.52">deduct code 50</option>
</select>
<br />
<label for="total">Total
<input id="total" type="text" name="total" value="" readonly="readonly" class="total" size="10"/>
</label>
</fieldset>
</form>

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