2018 Workers' Compensation Part B Fee Schedule

19105-21014

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CPT/HCPC Code
Modifier
Medicare Location
Global Surgery Indicator
Multiple Surgery Indicator
Prevailing Charge Amount
Fee Schedule Amount
Site of Service Amount
19105   1 0 2 0 2,919.33 261.49
19105   2 0 2 0 2,409.66 237.23
19105   3 0 2 0 2,409.66 237.23
19105   4 0 2 0 2,409.66 237.23
19110   1 90 2 0 673.02 0
19110   2 90 2 0 616.76 0
19110   3 90 2 0 577.55 0
19110   4 90 2 0 571.08 0
19112   1 90 2 0 541.04 0
19112   2 90 2 0 580.36 0
19112   3 90 2 0 539.80 0
19112   4 90 2 0 496.54 0
19120   1 90 2 0 692.76 0
19120   2 90 2 0 617.58 0
19120   3 90 2 0 617.58 0
19120   4 90 2 0 617.58 0
19125   1 90 2 0 818.61 0
19125   2 90 2 0 806.90 0
19125   3 90 2 0 689.18 0
19125   4 90 2 0 684.24 0
19126   1 ZZZ 0 0 410.38 0
19126   2 ZZZ 0 0 404.42 0
19126   3 ZZZ 0 0 564.20 0
19126   4 ZZZ 0 0 560.63 0
19260   1 90 2 0 1,895.73 0
19260   2 90 2 0 1,767.98 0
19260   3 90 2 0 1,848.21 0
19260   4 90 2 0 1,840.80 0
19271   1 90 2 0 2,983.36 0
19271   2 90 2 0 2,933.75 0
19271   3 90 2 0 2,729.52 0
19271   4 90 2 0 2,698.11 0
19272   1 90 2 0 3,045.16 0
19272   2 90 2 0 2,997.84 0
19272   3 90 2 0 2,802.88 0
19272   4 90 2 0 2,771.48 0
19281   1 0 2 0 325.85 138.16
19281   2 0 2 0 289.35 128.26
19281   3 0 2 0 289.35 128.26
19281   4 0 2 0 289.35 128.26
19282   1 ZZZ 0 0 225.35 64.90
19282   2 ZZZ 0 0 198.81 61.07
19282   3 ZZZ 0 0 198.81 61.07
19282   4 ZZZ 0 0 198.81 61.07
19283   1 0 2 0 370.25 139.61
19283   2 0 2 0 327.48 129.49
19283   3 0 2 0 327.48 129.49
19283   4 0 2 0 327.48 129.49
19284   1 ZZZ 0 0 270.71 65.38
19284   2 ZZZ 0 0 237.74 61.48
19284   3 ZZZ 0 0 237.74 61.48
19284   4 ZZZ 0 0 237.74 61.48
19285   1 0 2 0 627.88 118.34
19285   2 0 2 0 547.16 109.81
19285   3 0 2 0 547.16 109.81
19285   4 0 2 0 547.16 109.81
19286   1 ZZZ 0 0 526.09 56.19
19286   2 ZZZ 0 0 456.10 52.77
19286   3 ZZZ 0 0 456.10 52.77
19286   4 ZZZ 0 0 456.10 52.77
19287   1 0 2 0 1,169.00 197.68
19287   2 0 2 0 1,013.20 179.49
19287   3 0 2 0 1,013.20 179.49
19287   4 0 2 0 1,013.20 179.49
19288   1 ZZZ 0 0 925.87 83.97
19288   2 ZZZ 0 0 801.57 78.93
19288   3 ZZZ 0 0 801.57 78.93
19288   4 ZZZ 0 0 801.57 78.93
19294   1 ZZZ 0 0 206.81 0
19294   2 ZZZ 0 0 189.74 0
19294   3 ZZZ 0 0 189.74 0
19294   4 ZZZ 0 0 189.74 0
19296   1 0 2 0 8,698.17 360.57
19296   2 0 2 0 7,281.85 326.26
19296   3 0 2 0 7,281.85 326.26
19296   4 0 2 0 7,281.85 326.26
19297   1 ZZZ 0 0 165.08 0
19297   2 ZZZ 0 0 149.78 0
19297   3 ZZZ 0 0 149.78 0
19297   4 ZZZ 0 0 149.78 0
19298   1 0 2 0 3,249.73 573.94
19298   2 0 2 0 2,756.69 524.42
19298   3 0 2 0 2,756.69 524.42
19298   4 0 2 0 2,756.69 524.42
19300   1 90 2 0 738.85 511.71
19300   2 90 2 0 632.49 446.81
19300   3 90 2 0 632.49 446.81
19300   4 90 2 0 632.49 446.81
19301   1 90 2 0 557.46 0
19301   2 90 2 0 488.86 0
19301   3 90 2 0 488.86 0
19301   4 90 2 0 488.86 0
19302   1 90 2 0 1,181.59 0
19302   2 90 2 0 1,042.65 0
19302   3 90 2 0 1,042.65 0
19302   4 90 2 0 1,042.65 0
19303   1 90 2 0 1,178.31 0
19303   2 90 2 0 1,064.56 0
19303   3 90 2 0 1,064.56 0
19303   4 90 2 0 1,064.56 0
19304   1 90 2 0 741.30 0
19304   2 90 2 0 648.66 0
19304   3 90 2 0 648.66 0
19304   4 90 2 0 648.66 0
19305   1 90 2 0 1,456.96 0
19305   2 90 2 0 1,291.55 0
19305   3 90 2 0 1,291.55 0
19305   4 90 2 0 1,291.55 0
19306   1 90 2 0 1,516.70 0
19306   2 90 2 0 1,342.59 0
19306   3 90 2 0 1,342.59 0
19306   4 90 2 0 1,342.59 0
19307   1 90 2 0 1,525.84 0
19307   2 90 2 0 1,349.97 0
19307   3 90 2 0 1,349.97 0
19307   4 90 2 0 1,349.97 0
19316     90 2 0 * 0
19318   1 90 2 0 3,178.21 0
19318   2 90 2 0 3,156.03 0
19318   3 90 2 0 3,037.00 0
19318   4 90 2 0 3,052.17 0
19324   1 90 2 0 835.12 0
19324   2 90 2 0 1,859.72 0
19324   3 90 2 0 770.51 0
19324   4 90 2 0 761.93 0
19325   1 90 2 0 1,324.10 0
19325   2 90 2 0 1,303.18 0
19325   3 90 2 0 1,705.37 0
19325   4 90 2 0 1,202.94 0
19328   1 90 2 0 862.88 0
19328   2 90 2 0 737.38 0
19328   3 90 2 0 689.84 0
19328   4 90 2 0 784.33 0
19330   1 90 2 0 1,032.78 0
19330   2 90 2 0 1,017.93 0
19330   3 90 2 0 956.99 0
19330   4 90 2 0 946.42 0
19340   1 ZZZ 0 0 2,565.69 0
19340   2 ZZZ 0 0 2,551.75 0
19340   3 ZZZ 0 0 2,494.11 0
19340   4 ZZZ 0 0 1,439.96 0
19342   1 90 2 0 2,277.56 0
19342   2 90 2 0 2,262.42 0
19342   3 90 2 0 1,892.74 0
19342   4 90 2 0 1,870.34 0
19350   1 90 2 0 1,472.84 0
19350   2 90 2 0 1,496.56 0
19350   3 90 2 0 1,453.74 0
19350   4 90 2 0 1,330.58 0
19355   1 90 2 0 1,161.04 0
19355   2 90 2 0 1,142.67 0
19355   3 90 2 0 1,067.29 0
19355   4 90 2 0 1,055.33 0
19357   1 90 2 0 2,750.56 0
19357   2 90 2 0 2,706.83 0
19357   3 90 2 0 2,526.62 0
19357   4 90 2 0 2,497.83 0
19361   1 90 2 0 3,712.47 0
19361   2 90 2 0 2,933.42 0
19361   3 90 2 0 2,756.69 0
19361   4 90 2 0 3,328.69 0
19364   1 90 2 0 4,210.38 0
19364   2 90 2 0 4,145.00 0
19364   3 90 2 0 3,876.19 0
19364   4 90 2 0 3,833.21 0
19366   1 90 2 0 3,478.12 0
19366   2 90 2 0 3,420.62 0
19366   3 90 2 0 3,183.66 0
19366   4 90 2 0 3,146.84 0
19367   1 90 2 0 3,839.99 0
19367   2 90 2 0 3,799.16 0
19367   3 90 2 0 3,580.49 0
19367   4 90 2 0 4,042.34 0
19368   1 90 2 0 3,839.99 0
19368   2 90 2 0 3,799.16 0
19368   3 90 2 0 3,580.49 0
19368   4 90 2 0 4,042.34 0
19369   1 90 2 0 3,839.99 0
19369   2 90 2 0 3,799.16 0
19369   3 90 2 0 3,580.49 0
19369   4 90 2 0 4,042.34 0
19370   1 90 2 0 1,619.51 0
19370   2 90 2 0 1,610.47 0
19370   3 90 2 0 1,573.10 0
19370   4 90 2 0 1,193.05 0
19371   1 90 2 0 1,745.27 0
19371   2 90 2 0 1,733.80 0
19371   3 90 2 0 1,686.32 0
19371   4 90 2 0 1,459.45 0
19380   1 90 2 0 1,620.19 0
19380   2 90 2 0 1,592.36 0
19380   3 90 2 0 1,477.65 0
19380   4 90 2 0 1,460.32 0
19396     0 2 0 * 0
19499     YYY 2 0 * 0
20005   1 10 2 0 445.86 0
20005   2 10 2 0 433.50 0
20005   3 10 2 0 414.67 0
20005   4 10 2 0 409.96 0
20100   1 10 2 0 1,464.11 0
20100   2 10 2 0 1,400.51 0
20100   3 10 2 0 1,322.28 0
20100   4 10 2 0 1,304.01 0
20101   1 10 2 0 462.82 0
20101   2 10 2 0 442.61 0
20101   3 10 2 0 417.83 0
20101   4 10 2 0 412.07 0
20102   1 10 2 0 566.77 0
20102   2 10 2 0 542.09 0
20102   3 10 2 0 511.82 0
20102   4 10 2 0 504.77 0
20103   1 10 2 0 762.47 0
20103   2 10 2 0 729.46 0
20103   3 10 2 0 688.72 0
20103   4 10 2 0 679.19 0
20150   1 90 2 0 2,448.89 0
20150   2 90 2 0 2,190.79 0
20150   3 90 2 0 2,131.94 0
20150   4 90 2 0 2,131.94 0
20200   1 0 2 0 310.50 0
20200   2 0 2 0 304.81 0
20200   3 0 2 0 295.11 0
20200   4 0 2 0 291.65 0
20205   1 0 2 0 510.72 0
20205   2 0 2 0 501.47 0
20205   3 0 2 0 492.99 0
20205   4 0 2 0 463.87 0
20206   1 0 2 0 290.12 0
20206   2 0 2 0 280.34 0
20206   3 0 2 0 277.72 0
20206   4 0 2 0 273.80 0
20220   1 0 2 0 240.08 0
20220   2 0 2 0 238.49 0
20220   3 0 2 0 213.78 0
20220   4 0 2 0 241.89 0
20225   1 0 2 0 371.09 0
20225   2 0 2 0 365.35 0
20225   3 0 2 0 428.98 0
20225   4 0 2 0 386.04 0
20240   1 10 2 0 434.48 0
20240   2 10 2 0 436.35 0
20240   3 10 2 0 414.52 0
20240   4 10 2 0 409.69 0
20245   1 10 2 0 855.52 0
20245   2 10 2 0 936.87 0
20245   3 10 2 0 866.39 0
20245   4 10 2 0 920.93 0
20250   1 10 2 0 1,025.48 0
20250   2 10 2 0 942.31 0
20250   3 10 2 0 1,037.02 0
20250   4 10 2 0 832.43 0
20251   1 10 2 0 1,123.86 0
20251   2 10 2 0 1,063.54 0
20251   3 10 2 0 961.27 0
20251   4 10 2 0 1,026.54 0
20500   1 10 2 0 126.18 112.09
20500   2 10 2 0 121.52 108.20
20500   3 10 2 0 119.71 106.65
20500   4 10 2 0 118.48 105.58
20501   1 0 2 0 86.17 0
20501   2 0 2 0 85.38 0
20501   3 0 2 0 81.93 0
20501   4 0 2 0 81.02 0
20520   1 10 2 0 162.46 140.11
20520   2 10 2 0 186.86 161.10
20520   3 10 2 0 184.19 159.80
20520   4 10 2 0 164.79 143.39
20525   1 10 2 0 467.09 0
20525   2 10 2 0 497.04 0
20525   3 10 2 0 438.51 0
20525   4 10 2 0 436.88 0
20526   1 0 2 0 115.09 88.10
20526   2 0 2 0 102.75 79.81
20526   3 0 2 0 102.75 79.81
20526   4 0 2 0 102.75 79.81
20527   1 0 2 0 106.59 84.01
20527   2 0 2 0 95.60 76.18
20527   3 0 2 0 95.60 76.18
20527   4 0 2 0 95.60 76.18
20550   1 0 2 0 87.27 75.79
20550   2 0 2 0 91.46 79.54
20550   3 0 2 0 88.33 76.75
20550   4 0 2 0 86.43 74.93
20551   1 0 2 0 115.09 88.10
20551   2 0 2 0 102.75 79.81
20551   3 0 2 0 102.75 79.81
20551   4 0 2 0 102.75 79.81
20552   1 0 2 0 115.09 88.10
20552   2 0 2 0 102.75 79.81
20552   3 0 2 0 102.75 79.81
20552   4 0 2 0 102.75 79.81
20553   1 0 2 0 115.09 88.10
20553   2 0 2 0 102.75 79.81
20553   3 0 2 0 102.75 79.81
20553   4 0 2 0 102.75 79.81
20555   1 0 2 0 459.47 0
20555   2 0 2 0 419.44 0
20555   3 0 2 0 419.44 0
20555   4 0 2 0 419.44 0
20600   1 0 2 0 92.43 74.17
20600   2 0 2 0 93.22 74.95
20600   3 0 2 0 89.02 71.82
20600   4 0 2 0 88.21 71.07
20604   1 0 2 0 93.72 59.12
20604   2 0 2 0 84.77 55.19
20604   3 0 2 0 84.77 55.19
20604   4 0 2 0 84.77 55.19
20605   1 0 2 0 102.61 83.37
20605   2 0 2 0 101.30 82.32
20605   3 0 2 0 95.98 78.05
20605   4 0 2 0 94.84 77.21
20606   1 0 2 0 102.89 66.88
20606   2 0 2 0 93.20 62.42
20606   3 0 2 0 93.20 62.42
20606   4 0 2 0 93.20 62.42
20610   1 0 2 0 104.34 86.13
20610   2 0 2 0 103.42 85.62
20610   3 0 2 0 98.18 81.41
20610   4 0 2 0 97.11 80.57
20611   1 0 2 0 118.54 79.21
20611   2 0 2 0 107.00 73.36
20611   3 0 2 0 107.00 73.36
20611   4 0 2 0 107.00 73.36
20612   1 0 2 0 103.63 69.86
20612   2 0 2 0 91.79 63.06
20612   3 0 2 0 91.79 63.06
20612   4 0 2 0 91.79 63.06
20615   1 10 2 0 188.81 172.02
20615   2 10 2 0 187.22 170.54
20615   3 10 2 0 182.77 167.28
20615   4 10 2 0 181.55 165.70
20650   1 10 2 0 466.87 0
20650   2 10 2 0 305.86 0
20650   3 10 2 0 287.70 0
20650   4 10 2 0 296.89 0
20660   1 0 0 0 449.15 0
20660   2 0 0 0 448.03 0
20660   3 0 0 0 443.92 0
20660   4 0 0 0 418.96 0
20661   1 90 2 0 816.02 0
20661   2 90 2 0 806.47 0
20661   3 90 2 0 789.39 0
20661   4 90 2 0 785.93 0
20662   1 90 2 0 1,153.14 0
20662   2 90 2 0 1,133.66 0
20662   3 90 2 0 1,053.12 0
20662   4 90 2 0 1,040.26 0
20663   1 90 2 0 903.55 0
20663   2 90 2 0 888.96 0
20663   3 90 2 0 828.64 0
20663   4 90 2 0 818.82 0
20664   1 90 2 0 951.54 0
20664   2 90 2 0 856.78 0
20664   3 90 2 0 856.78 0
20664   4 90 2 0 856.78 0
20665   1 10 2 0 220.12 0
20665   2 10 2 0 236.11 0
20665   3 10 2 0 148.58 0
20665   4 10 2 0 146.98 0
20670   1 10 2 0 386.25 0
20670   2 10 2 0 350.24 0
20670   3 10 2 0 345.71 0
20670   4 10 2 0 383.53 0
20680   1 90 2 0 623.82 0
20680   2 90 2 0 613.79 0
20680   3 90 2 0 572.27 0
20680   4 90 2 0 565.33 0
20690   1 ZZZ 0 0 669.84 0
20690   2 ZZZ 0 0 663.46 0
20690   3 ZZZ 0 0 625.59 0
20690   4 ZZZ 0 0 618.01 0
20692   1 ZZZ 0 0 927.85 0
20692   2 ZZZ 0 0 917.66 0
20692   3 ZZZ 0 0 875.64 0
20692   4 ZZZ 0 0 868.54 0
20693   1 90 2 0 723.19 0
20693   2 90 2 0 713.86 0
20693   3 90 2 0 675.62 0
20693   4 90 2 0 668.23 0
20694   1 90 2 0 594.70 0
20694   2 90 2 0 586.18 0
20694   3 90 2 0 551.03 0
20694   4 90 2 0 544.69 0
20696   1 90 2 0 1,546.06 0
20696   2 90 2 0 1,387.27 0
20696   3 90 2 0 1,387.27 0
20696   4 90 2 0 1,387.27 0
20697   1 0 2 0 1,813.34 0
20697   2 0 2 0 1,528.86 0
20697   3 0 2 0 1,528.86 0
20697   4 0 2 0 1,528.86 0
20802   1 90 2 0 7,860.23 0
20802   2 90 2 0 7,622.11 0
20802   3 90 2 0 7,119.23 0
20802   4 90 2 0 7,021.21 0
20805   1 90 2 0 9,620.92 0
20805   2 90 2 0 9,329.35 0
20805   3 90 2 0 8,713.58 0
20805   4 90 2 0 8,593.66 0
20808   1 90 2 0 11,961.67 0
20808   2 90 2 0 11,599.14 0
20808   3 90 2 0 10,833.57 0
20808   4 90 2 0 10,684.49 0
20816   1 90 2 0 5,896.40 0
20816   2 90 2 0 5,717.75 0
20816   3 90 2 0 5,340.42 0
20816   4 90 2 0 5,266.92 0
20822   1 90 2 0 4,874.50 0
20822   2 90 2 0 4,726.74 0
20822   3 90 2 0 4,414.85 0
20822   4 90 2 0 4,354.06 0
20824   1 90 2 0 5,896.40 0
20824   2 90 2 0 5,717.75 0
20824   3 90 2 0 5,340.42 0
20824   4 90 2 0 5,266.92 0
20827   1 90 2 0 5,012.10 0
20827   2 90 2 0 4,860.21 0
20827   3 90 2 0 4,539.36 0
20827   4 90 2 0 4,476.90 0
20838   1 90 2 0 7,860.23 0
20838   2 90 2 0 7,622.11 0
20838   3 90 2 0 7,119.23 0
20838   4 90 2 0 7,021.21 0
20900   1 90 2 0 720.31 0
20900   2 90 2 0 916.24 0
20900   3 90 2 0 880.69 0
20900   4 90 2 0 1,000.33 0
20902   1 90 2 0 1,093.55 0
20902   2 90 2 0 1,077.32 0
20902   3 90 2 0 1,010.31 0
20902   4 90 2 0 998.69 0
20910   1 90 2 0 351.16 0
20910   2 90 2 0 348.66 0
20910   3 90 2 0 337.59 0
20910   4 90 2 0 478.20 0
20912   1 90 2 0 985.21 0
20912   2 90 2 0 971.21 0
20912   3 90 2 0 913.17 0
20912   4 90 2 0 902.46 0
20920   1 90 2 0 1,202.76 0
20920   2 90 2 0 797.75 0
20920   3 90 2 0 750.53 0
20920   4 90 2 0 741.67 0
20922   1 90 2 0 974.92 0
20922   2 90 2 0 1,195.29 0
20922   3 90 2 0 900.89 0
20922   4 90 2 0 1,422.52 0
20924   1 90 2 0 1,520.72 0
20924   2 90 2 0 1,513.64 0
20924   3 90 2 0 995.72 0
20924   4 90 2 0 983.94 0
20926     90 2 0 * 0
20930     XXX 0 0 * 0
20931   1 ZZZ 0 0 358.37 0
20931   2 ZZZ 0 0 342.12 0
20931   3 ZZZ 0 0 320.17 0
20931   4 ZZZ 0 0 315.36 0
20936     ZZZ 0 0 * 0
20937   1 ZZZ 0 0 552.75 0
20937   2 ZZZ 0 0 527.49 0
20937   3 ZZZ 0 0 493.55 0
20937   4 ZZZ 0 0 486.10 0
20938   1 ZZZ 0 0 597.69 0
20938   2 ZZZ 0 0 570.50 0
20938   3 ZZZ 0 0 533.90 0
20938   4 ZZZ 0 0 525.85 0
20939   1 ZZZ 0 0 84.66 0
20939   2 ZZZ 0 0 77.64 0
20939   3 ZZZ 0 0 77.64 0
20939   4 ZZZ 0 0 77.64 0
20950   1 0 2 0 220.08 0
20950   2 0 2 0 253.32 0
20950   3 0 2 0 215.56 0
20950   4 0 2 0 200.34 0
20955   1 90 2 0 7,600.89 0
20955   2 90 2 0 7,600.89 0
20955   3 90 2 0 7,600.89 0
20955   4 90 2 0 7,600.89 0
20956   1 90 2 0 6,122.20 0
20956   2 90 2 0 5,515.37 0
20956   3 90 2 0 5,367.10 0
20956   4 90 2 0 5,367.10 0
20957   1 90 2 0 6,342.59 0
20957   2 90 2 0 5,713.94 0
20957   3 90 2 0 5,560.31 0
20957   4 90 2 0 5,560.31 0
20962   1 90 2 0 6,122.20 0
20962   2 90 2 0 5,515.37 0
20962   3 90 2 0 5,367.10 0
20962   4 90 2 0 5,367.10 0
20969   1 90 2 0 7,926.01 0
20969   2 90 2 0 7,090.74 0
20969   3 90 2 0 6,900.18 0
20969   4 90 2 0 6,900.18 0
20970   1 90 2 0 7,600.89 0
20970   2 90 2 0 7,600.89 0
20970   3 90 2 0 7,600.89 0
20970   4 90 2 0 7,600.89 0
20972   1 90 2 0 7,600.89 0
20972   2 90 2 0 7,600.89 0
20972   3 90 2 0 7,600.89 0
20972   4 90 2 0 7,600.89 0
20973   1 90 2 0 7,600.89 0
20973   2 90 2 0 7,600.89 0
20973   3 90 2 0 7,600.89 0
20973   4 90 2 0 7,600.89 0
20974   1 ZZZ 0 0 411.35 0
20974   2 ZZZ 0 0 402.34 0
20974   3 ZZZ 0 0 364.91 0
20974   4 ZZZ 0 0 359.84 0
20975   1 ZZZ 0 0 575.00 0
20975   2 ZZZ 0 0 564.80 0
20975   3 ZZZ 0 0 522.71 0
20975   4 ZZZ 0 0 516.30 0
20979   1 0 9 0 31.80 18.23
20979   2 0 9 0 28.23 16.66
20979   3 0 9 0 28.23 16.66
20979   4 0 9 0 28.23 16.66
20982   1 0 2 0 7,739.52 731.56
20982   2 0 2 0 6,626.01 664.12
20982   3 0 2 0 6,626.01 664.12
20982   4 0 2 0 6,626.01 664.12
20983   1 0 2 0 9,294.19 526.09
20983   2 0 2 0 7,979.56 485.93
20983   3 0 2 0 7,979.56 485.93
20983   4 0 2 0 7,979.56 485.93
20985   1 ZZZ 0 0 220.86 0
20985   2 ZZZ 0 0 194.25 0
20985   3 ZZZ 0 0 194.25 0
20985   4 ZZZ 0 0 194.25 0
20999     YYY 2 0 * 0
21010   1 90 2 0 1,752.82 0
21010   2 90 2 0 1,728.48 0
21010   3 90 2 0 1,627.31 0
21010   4 90 2 0 1,606.84 0
21011   1 90 2 0 456.60 356.29
21011   2 90 2 0 400.69 316.10
21011   3 90 2 0 400.69 316.10
21011   4 90 2 0 400.69 316.10
21012   1 90 2 0 488.45 0
21012   2 90 2 0 434.57 0
21012   3 90 2 0 434.57 0
21012   4 90 2 0 434.57 0
21013   1 90 2 0 707.86 572.86
21013   2 90 2 0 625.28 511.46
21013   3 90 2 0 625.28 511.46
21013   4 90 2 0 625.28 511.46
21014   1 90 2 0 753.02 0
21014   2 90 2 0 671.67 0
21014   3 90 2 0 671.67 0
21014   4 90 2 0 671.67 0