2018 Workers' Compensation Part B Fee Schedule

33677-35011

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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
33677   1 90 2 0 3,403.04 0
33677   2 90 2 0 2,981.92 0
33677   3 90 2 0 2,981.92 0
33677   4 90 2 0 2,981.92 0
33681   1 90 2 0 6,408.01 0
33681   2 90 2 0 6,189.66 0
33681   3 90 2 0 5,728.63 0
33681   4 90 2 0 5,646.67 0
33684   1 90 2 0 6,586.43 0
33684   2 90 2 0 6,365.82 0
33684   3 90 2 0 5,900.77 0
33684   4 90 2 0 5,817.01 0
33688   1 90 2 0 6,675.21 0
33688   2 90 2 0 6,453.45 0
33688   3 90 2 0 5,986.39 0
33688   4 90 2 0 5,901.78 0
33690   1 90 2 0 4,243.52 0
33690   2 90 2 0 4,098.00 0
33690   3 90 2 0 3,793.50 0
33690   4 90 2 0 3,739.93 0
33692   1 90 2 0 7,163.95 0
33692   2 90 2 0 6,913.45 0
33692   3 90 2 0 6,388.32 0
33692   4 90 2 0 6,297.04 0
33694   1 90 2 0 7,253.61 0
33694   2 90 2 0 7,001.98 0
33694   3 90 2 0 6,474.79 0
33694   4 90 2 0 6,382.71 0
33697   1 90 2 0 7,432.07 0
33697   2 90 2 0 7,178.15 0
33697   3 90 2 0 6,646.92 0
33697   4 90 2 0 6,553.11 0
33702   1 90 2 0 5,791.46 0
33702   2 90 2 0 5,600.78 0
33702   3 90 2 0 5,197.88 0
33702   4 90 2 0 5,124.33 0
33710   1 90 2 0 6,590.14 0
33710   2 90 2 0 6,369.45 0
33710   3 90 2 0 5,904.30 0
33710   4 90 2 0 5,820.51 0
33720   1 90 2 0 5,791.46 0
33720   2 90 2 0 5,600.78 0
33720   3 90 2 0 5,197.88 0
33720   4 90 2 0 5,124.33 0
33722   1 90 2 0 3,854.59 0
33722   2 90 2 0 3,793.28 0
33722   3 90 2 0 3,540.51 0
33722   4 90 2 0 3,500.15 0
33724   1 90 2 0 2,263.11 0
33724   2 90 2 0 1,995.06 0
33724   3 90 2 0 1,995.06 0
33724   4 90 2 0 1,995.06 0
33726   1 90 2 0 2,973.34 0
33726   2 90 2 0 2,631.54 0
33726   3 90 2 0 2,631.54 0
33726   4 90 2 0 2,631.54 0
33730   1 90 2 0 7,219.82 0
33730   2 90 2 0 6,968.55 0
33730   3 90 2 0 6,442.12 0
33730   4 90 2 0 6,350.36 0
33732   1 90 2 0 6,031.92 0
33732   2 90 2 0 5,835.86 0
33732   3 90 2 0 5,421.79 0
33732   4 90 2 0 5,345.41 0
33735   1 90 2 0 4,798.11 0
33735   2 90 2 0 4,632.39 0
33735   3 90 2 0 4,284.73 0
33735   4 90 2 0 4,223.69 0
33736   1 90 2 0 4,489.85 0
33736   2 90 2 0 4,406.49 0
33736   3 90 2 0 4,062.28 0
33736   4 90 2 0 4,013.01 0
33737   1 90 2 0 4,846.60 0
33737   2 90 2 0 4,680.30 0
33737   3 90 2 0 4,331.53 0
33737   4 90 2 0 4,270.01 0
33750   1 90 2 0 4,411.84 0
33750   2 90 2 0 4,264.19 0
33750   3 90 2 0 3,955.98 0
33750   4 90 2 0 3,900.75 0
33755   1 90 2 0 4,443.92 0
33755   2 90 2 0 4,295.78 0
33755   3 90 2 0 3,986.83 0
33755   4 90 2 0 3,931.32 0
33762   1 90 2 0 4,443.92 0
33762   2 90 2 0 4,295.78 0
33762   3 90 2 0 3,986.83 0
33762   4 90 2 0 3,931.32 0
33764   1 90 2 0 5,581.88 0
33764   2 90 2 0 5,581.88 0
33764   3 90 2 0 5,581.88 0
33764   4 90 2 0 5,581.88 0
33766   1 90 2 0 4,532.68 0
33766   2 90 2 0 4,383.40 0
33766   3 90 2 0 4,072.47 0
33766   4 90 2 0 4,016.11 0
33767   1 90 2 0 5,114.69 0
33767   2 90 2 0 4,945.00 0
33767   3 90 2 0 4,590.11 0
33767   4 90 2 0 4,526.03 0
33768   1 ZZZ 0 0 715.74 0
33768   2 ZZZ 0 0 639.38 0
33768   3 ZZZ 0 0 639.38 0
33768   4 ZZZ 0 0 639.38 0
33770   1 90 2 0 7,409.14 0
33770   2 90 2 0 7,155.59 0
33770   3 90 2 0 6,624.83 0
33770   4 90 2 0 6,531.27 0
33771   1 90 2 0 7,521.74 0
33771   2 90 2 0 7,266.71 0
33771   3 90 2 0 6,733.49 0
33771   4 90 2 0 6,638.73 0
33774   1 90 2 0 6,232.30 0
33774   2 90 2 0 6,033.73 0
33774   3 90 2 0 5,615.09 0
33774   4 90 2 0 5,536.79 0
33775   1 90 2 0 6,343.95 0
33775   2 90 2 0 6,143.90 0
33775   3 90 2 0 5,722.75 0
33775   4 90 2 0 5,643.36 0
33776   1 90 2 0 6,943.34 0
33776   2 90 2 0 6,718.15 0
33776   3 90 2 0 6,245.01 0
33776   4 90 2 0 6,157.80 0
33777   1 90 2 0 6,456.50 0
33777   2 90 2 0 6,255.03 0
33777   3 90 2 0 5,831.36 0
33777   4 90 2 0 5,750.85 0
33778   1 90 2 0 11,876.40 0
33778   2 90 2 0 11,876.40 0
33778   3 90 2 0 11,876.40 0
33778   4 90 2 0 11,876.40 0
33779   1 90 2 0 11,876.40 0
33779   2 90 2 0 11,876.40 0
33779   3 90 2 0 11,876.40 0
33779   4 90 2 0 11,876.40 0
33780   1 90 2 0 11,876.40 0
33780   2 90 2 0 11,876.40 0
33780   3 90 2 0 11,876.40 0
33780   4 90 2 0 11,876.40 0
33781   1 90 2 0 11,876.40 0
33781   2 90 2 0 11,876.40 0
33781   3 90 2 0 11,876.40 0
33781   4 90 2 0 11,876.40 0
33782   1 90 2 0 4,141.66 0
33782   2 90 2 0 3,896.21 0
33782   3 90 2 0 3,896.21 0
33782   4 90 2 0 3,896.21 0
33783   1 90 2 0 4,541.75 0
33783   2 90 2 0 4,255.52 0
33783   3 90 2 0 4,255.52 0
33783   4 90 2 0 4,255.52 0
33786   1 90 2 0 10,451.25 0
33786   2 90 2 0 10,451.25 0
33786   3 90 2 0 10,451.25 0
33786   4 90 2 0 10,451.25 0
33788     90 2 0 * 0
33800   1 90 2 0 2,497.33 0
33800   2 90 2 0 2,457.60 0
33800   3 90 2 0 2,293.99 0
33800   4 90 2 0 2,267.81 0
33802   1 90 2 0 4,087.01 0
33802   2 90 2 0 3,943.47 0
33802   3 90 2 0 3,642.55 0
33802   4 90 2 0 3,590.54 0
33803   1 90 2 0 4,264.57 0
33803   2 90 2 0 4,118.68 0
33803   3 90 2 0 3,813.87 0
33803   4 90 2 0 3,760.02 0
33813   1 90 2 0 5,700.68 0
33813   2 90 2 0 5,700.68 0
33813   3 90 2 0 5,700.68 0
33813   4 90 2 0 5,700.68 0
33814   1 90 2 0 6,650.74 0
33814   2 90 2 0 6,650.74 0
33814   3 90 2 0 6,650.74 0
33814   4 90 2 0 6,650.74 0
33820   1 90 2 0 3,175.51 0
33820   2 90 2 0 3,175.51 0
33820   3 90 2 0 3,175.51 0
33820   4 90 2 0 3,175.51 0
33822   1 90 2 0 4,087.01 0
33822   2 90 2 0 3,943.47 0
33822   3 90 2 0 3,642.55 0
33822   4 90 2 0 3,590.54 0
33824   1 90 2 0 4,264.57 0
33824   2 90 2 0 4,118.68 0
33824   3 90 2 0 3,813.87 0
33824   4 90 2 0 3,760.02 0
33840   1 90 2 0 5,605.66 0
33840   2 90 2 0 5,605.66 0
33840   3 90 2 0 5,605.66 0
33840   4 90 2 0 5,605.66 0
33845   1 90 2 0 6,862.15 0
33845   2 90 2 0 6,862.15 0
33845   3 90 2 0 6,862.15 0
33845   4 90 2 0 6,862.15 0
33851   1 90 2 0 6,650.74 0
33851   2 90 2 0 6,650.74 0
33851   3 90 2 0 6,650.74 0
33851   4 90 2 0 6,650.74 0
33852   1 90 2 0 7,125.87 0
33852   2 90 2 0 7,125.87 0
33852   3 90 2 0 7,125.87 0
33852   4 90 2 0 7,125.87 0
33853   1 90 2 0 8,214.52 0
33853   2 90 2 0 8,214.52 0
33853   3 90 2 0 8,214.52 0
33853   4 90 2 0 8,214.52 0
33860   1 90 2 0 7,605.32 0
33860   2 90 2 0 7,408.99 0
33860   3 90 2 0 7,365.48 0
33860   4 90 2 0 7,323.34 0
33863   1 90 2 0 7,714.39 0
33863   2 90 2 0 7,517.43 0
33863   3 90 2 0 7,471.32 0
33863   4 90 2 0 7,428.16 0
33864   1 90 2 0 4,693.22 0
33864   2 90 2 0 4,236.71 0
33864   3 90 2 0 4,236.71 0
33864   4 90 2 0 4,236.71 0
33870   1 90 2 0 7,981.70 0
33870   2 90 2 0 8,153.54 0
33870   3 90 2 0 7,252.48 0
33870   4 90 2 0 7,165.04 0
33875   1 90 2 0 7,038.87 0
33875   2 90 2 0 7,218.30 0
33875   3 90 2 0 6,863.58 0
33875   4 90 2 0 6,763.88 0
33877   1 90 2 0 8,357.05 0
33877   2 90 2 0 8,266.83 0
33877   3 90 2 0 7,992.61 0
33877   4 90 2 0 8,000.78 0
33880   1 90 2 0 2,938.30 0
33880   2 90 2 0 2,665.72 0
33880   3 90 2 0 2,665.72 0
33880   4 90 2 0 2,665.72 0
33881   1 90 2 0 2,525.45 0
33881   2 90 2 0 2,288.35 0
33881   3 90 2 0 2,288.35 0
33881   4 90 2 0 2,288.35 0
33883   1 90 2 0 1,878.51 0
33883   2 90 2 0 1,687.36 0
33883   3 90 2 0 1,687.36 0
33883   4 90 2 0 1,687.36 0
33884   1 ZZZ 0 0 695.83 0
33884   2 ZZZ 0 0 631.08 0
33884   3 ZZZ 0 0 631.08 0
33884   4 ZZZ 0 0 631.08 0
33886   1 90 2 0 1,623.28 0
33886   2 90 2 0 1,455.87 0
33886   3 90 2 0 1,455.87 0
33886   4 90 2 0 1,455.87 0
33889   1 0 2 0 1,401.20 0
33889   2 0 2 0 1,257.10 0
33889   3 0 2 0 1,257.10 0
33889   4 0 2 0 1,257.10 0
33891   1 0 2 0 1,788.39 0
33891   2 0 2 0 1,602.32 0
33891   3 0 2 0 1,602.32 0
33891   4 0 2 0 1,602.32 0
33910   1 90 2 0 3,446.87 0
33910   2 90 2 0 4,769.58 0
33910   3 90 2 0 3,177.09 0
33910   4 90 2 0 3,141.12 0
33915   1 90 2 0 2,897.41 0
33915   2 90 2 0 3,480.38 0
33915   3 90 2 0 2,676.48 0
33915   4 90 2 0 2,646.27 0
33916   1 90 2 0 3,976.17 0
33916   2 90 2 0 3,912.93 0
33916   3 90 2 0 3,652.43 0
33916   4 90 2 0 3,610.79 0
33917   1 90 2 0 6,123.02 0
33917   2 90 2 0 5,908.23 0
33917   3 90 2 0 5,453.99 0
33917   4 90 2 0 5,374.95 0
33920   1 90 2 0 7,298.43 0
33920   2 90 2 0 7,046.24 0
33920   3 90 2 0 6,518.09 0
33920   4 90 2 0 6,425.50 0
33922   1 90 2 0 3,446.87 0
33922   2 90 2 0 3,394.16 0
33922   3 90 2 0 3,177.09 0
33922   4 90 2 0 3,141.12 0
33924   1 ZZZ 0 0 964.10 0
33924   2 ZZZ 0 0 920.78 0
33924   3 ZZZ 0 0 864.97 0
33924   4 ZZZ 0 0 852.43 0
33925   1 90 2 0 2,957.18 0
33925   2 90 2 0 2,613.57 0
33925   3 90 2 0 2,613.57 0
33925   4 90 2 0 2,613.57 0
33926   1 90 2 0 3,984.38 0
33926   2 90 2 0 3,542.89 0
33926   3 90 2 0 3,542.89 0
33926   4 90 2 0 3,542.89 0
33927   1 XXX 2 0 3,263.17 0
33927   2 XXX 2 0 2,983.63 0
33927   3 XXX 2 0 2,983.63 0
33927   4 XXX 2 0 2,983.63 0
33928         0 * 0
33929         0 * 0
33933     XXX 2 0 * 0
33935   1 90 2 0 12,544.23 0
33935   2 90 2 0 12,140.22 0
33935   3 90 2 0 11,286.01 0
33935   4 90 2 0 11,127.21 0
33944     XXX 2 0 * 0
33945   1 90 2 0 12,881.13 0
33945   2 90 2 0 12,881.13 0
33945   3 90 2 0 12,881.13 0
33945   4 90 2 0 12,881.13 0
33946   1 XXX 0 0 426.40 0
33946   2 XXX 0 0 392.50 0
33946   3 XXX 0 0 392.50 0
33946   4 XXX 0 0 392.50 0
33947   1 XXX 0 0 463.46 0
33947   2 XXX 0 0 427.69 0
33947   3 XXX 0 0 427.69 0
33947   4 XXX 0 0 427.69 0
33948   1 XXX 0 0 323.35 0
33948   2 XXX 0 0 299.65 0
33948   3 XXX 0 0 299.65 0
33948   4 XXX 0 0 299.65 0
33949   1 XXX 0 0 315.65 0
33949   2 XXX 0 0 292.39 0
33949   3 XXX 0 0 292.39 0
33949   4 XXX 0 0 292.39 0
33951   1 0 2 0 514.47 511.16
33951   2 0 2 0 483.50 480.66
33951   3 0 2 0 483.50 480.66
33951   4 0 2 0 483.50 480.66
33952   1 0 2 0 500.72 496.47
33952   2 0 2 0 471.76 468.10
33952   3 0 2 0 471.76 468.10
33952   4 0 2 0 471.76 468.10
33953   1 0 2 0 572.38 569.08
33953   2 0 2 0 538.33 535.50
33953   3 0 2 0 538.33 535.50
33953   4 0 2 0 538.33 535.50
33954   1 0 2 0 557.21 552.47
33954   2 0 2 0 525.36 521.32
33954   3 0 2 0 525.36 521.32
33954   4 0 2 0 525.36 521.32
33955   1 0 2 0 1,209.55 1205.29
33955   2 0 2 0 1,107.66 1104.01
33955   3 0 2 0 1,107.66 1104.01
33955   4 0 2 0 1,107.66 1104.01
33956   1 0 2 0 1,142.70 1137.99
33956   2 0 2 0 1,050.53 1046.49
33956   3 0 2 0 1,050.53 1046.49
33956   4 0 2 0 1,050.53 1046.49
33957   1 0 2 0 426.89 422.63
33957   2 0 2 0 369.37 365.74
33957   3 0 2 0 369.37 365.74
33957   4 0 2 0 369.37 365.74
33958   1 0 2 0 417.88 414.56
33958   2 0 2 0 361.67 358.83
33958   3 0 2 0 361.67 358.83
33958   4 0 2 0 361.67 358.83
33959   1 0 2 0 487.18 482.91
33959   2 0 2 0 426.22 422.58
33959   3 0 2 0 426.22 422.58
33959   4 0 2 0 426.22 422.58
33962   1 0 2 0 465.84 461.10
33962   2 0 2 0 408.00 403.95
33962   3 0 2 0 408.00 403.95
33962   4 0 2 0 408.00 403.95
33963   1 0 2 0 770.85 766.59
33963   2 0 2 0 693.84 690.20
33963   3 0 2 0 693.84 690.20
33963   4 0 2 0 693.84 690.20
33964   1 0 2 0 778.90 775.59
33964   2 0 2 0 703.51 700.66
33964   3 0 2 0 703.51 700.66
33964   4 0 2 0 703.51 700.66
33965   1 0 2 0 422.63 426.89
33965   2 0 2 0 365.74 369.37
33965   3 0 2 0 365.74 369.37
33965   4 0 2 0 365.74 369.37
33966   1 0 2 0 462.90 467.65
33966   2 0 2 0 405.66 409.70
33966   3 0 2 0 405.66 409.70
33966   4 0 2 0 405.66 409.70
33967   1 0 2 0 477.63 474.19
33967   2 0 2 0 435.49 432.55
33967   3 0 2 0 435.49 432.55
33967   4 0 2 0 435.49 432.55
33968   1 0 0 0 86.98 0
33968   2 0 0 0 72.01 0
33968   3 0 0 0 72.01 0
33968   4 0 0 0 72.01 0
33969   1 0 2 0 475.96 472.15
33969   2 0 2 0 425.09 421.84
33969   3 0 2 0 425.09 421.84
33969   4 0 2 0 425.09 421.84
33970   1 0 2 0 1,840.80 0
33970   2 0 2 0 1,728.49 0
33970   3 0 2 0 1,775.34 0
33970   4 0 2 0 1,774.66 0
33971   1 90 2 0 768.08 0
33971   2 90 2 0 751.33 0
33971   3 90 2 0 721.36 0
33971   4 90 2 0 715.48 0
33973   1 0 2 0 1,888.55 0
33973   2 0 2 0 1,776.01 0
33973   3 0 2 0 1,821.69 0
33973   4 0 2 0 1,820.62 0
33974   1 90 2 0 1,020.44 0
33974   2 90 2 0 1,002.17 0
33974   3 90 2 0 965.84 0
33974   4 90 2 0 957.67 0
33975     90 2 0 * 0
33976   1 90 2 0 4,375.79 0
33976   2 90 2 0 4,306.20 0
33976   3 90 2 0 4,019.46 0
33976   4 90 2 0 3,973.62 0
33977     90 2 0 * 0
33978   1 90 2 0 3,210.93 0
33978   2 90 2 0 3,159.92 0
33978   3 90 2 0 2,949.60 0
33978   4 90 2 0 2,916.02 0
33979     XXX 2 0 * 0
33980     90 2 0 * 0
33981     XXX 2 0 * 0
33982     XXX 2 0 * 0
33983     XXX 2 0 * 0
33984   1 0 2 0 465.31 460.57
33984   2 0 2 0 417.31 413.28
33984   3 0 2 0 417.31 413.28
33984   4 0 2 0 417.31 413.28
33985   1 0 2 0 877.86 873.59
33985   2 0 2 0 786.46 782.80
33985   3 0 2 0 786.46 782.80
33985   4 0 2 0 786.46 782.80
33986   1 0 2 0 836.77 832.03
33986   2 0 2 0 751.95 747.91
33986   3 0 2 0 751.95 747.91
33986   4 0 2 0 751.95 747.91
33987   1 ZZZ 0 0 354.70 0
33987   2 ZZZ 0 0 316.63 0
33987   3 ZZZ 0 0 316.63 0
33987   4 ZZZ 0 0 316.63 0
33988   1 0 2 0 992.90 987.70
33988   2 0 2 0 922.97 918.53
33988   3 0 2 0 922.97 918.53
33988   4 0 2 0 922.97 918.53
33989   1 0 2 0 669.53 664.79
33989   2 0 2 0 616.44 612.41
33989   3 0 2 0 616.44 612.41
33989   4 0 2 0 616.44 612.41
33990   1 XXX 2 0 616.46 0
33990   2 XXX 2 0 553.83 0
33990   3 XXX 2 0 553.83 0
33990   4 XXX 2 0 553.83 0
33991   1 XXX 2 0 898.16 0
33991   2 XXX 2 0 806.99 0
33991   3 XXX 2 0 806.99 0
33991   4 XXX 2 0 806.99 0
33992   1 XXX 2 0 293.55 0
33992   2 XXX 2 0 264.11 0
33992   3 XXX 2 0 264.11 0
33992   4 XXX 2 0 264.11 0
33993   1 XXX 2 0 257.72 0
33993   2 XXX 2 0 231.87 0
33993   3 XXX 2 0 231.87 0
33993   4 XXX 2 0 231.87 0
33999     YYY 2 0 * 0
34001   1 90 2 0 2,690.73 0
34001   2 90 2 0 2,639.84 0
34001   3 90 2 0 2,496.51 0
34001   4 90 2 0 2,500.02 0
34051   1 90 2 0 2,103.85 0
34051   2 90 2 0 2,072.57 0
34051   3 90 2 0 2,053.42 0
34051   4 90 2 0 1,921.83 0
34101   1 90 2 0 1,871.47 0
34101   2 90 2 0 1,771.39 0
34101   3 90 2 0 1,515.07 0
34101   4 90 2 0 1,800.85 0
34111   1 90 2 0 1,782.25 0
34111   2 90 2 0 1,771.06 0
34111   3 90 2 0 1,724.86 0
34111   4 90 2 0 1,718.30 0
34151   1 90 2 0 2,692.07 0
34151   2 90 2 0 2,659.71 0
34151   3 90 2 0 2,596.32 0
34151   4 90 2 0 2,576.72 0
34201   1 90 2 0 2,027.23 0
34201   2 90 2 0 1,777.09 0
34201   3 90 2 0 1,508.40 0
34201   4 90 2 0 1,902.02 0
34203   1 90 2 0 2,156.75 0
34203   2 90 2 0 2,142.34 0
34203   3 90 2 0 2,086.33 0
34203   4 90 2 0 2,074.27 0
34401   1 90 2 0 1,848.13 0
34401   2 90 2 0 1,845.66 0
34401   3 90 2 0 2,079.88 0
34401   4 90 2 0 1,687.16 0
34421   1 90 2 0 2,042.03 0
34421   2 90 2 0 1,981.73 0
34421   3 90 2 0 1,911.37 0
34421   4 90 2 0 1,878.15 0
34451   1 90 2 0 1,949.53 0
34451   2 90 2 0 1,927.08 0
34451   3 90 2 0 1,882.84 0
34451   4 90 2 0 2,072.84 0
34471   1 90 2 0 1,140.23 0
34471   2 90 2 0 1,126.67 0
34471   3 90 2 0 1,071.02 0
34471   4 90 2 0 1,059.47 0
34490   1 90 2 0 1,470.75 0
34490   2 90 2 0 1,509.51 0
34490   3 90 2 0 1,468.68 0
34490   4 90 2 0 1,399.14 0
34501   1 90 2 0 2,850.34 0
34501   2 90 2 0 2,850.34 0
34501   3 90 2 0 2,850.34 0
34501   4 90 2 0 2,850.34 0
34502   1 90 2 0 4,219.78 0
34502   2 90 2 0 4,152.72 0
34502   3 90 2 0 3,876.31 0
34502   4 90 2 0 3,832.14 0
34510   1 90 2 0 2,850.34 0
34510   2 90 2 0 2,850.34 0
34510   3 90 2 0 2,850.34 0
34510   4 90 2 0 2,850.34 0
34520   1 90 2 0 3,562.89 0
34520   2 90 2 0 3,562.89 0
34520   3 90 2 0 3,562.89 0
34520   4 90 2 0 3,562.89 0
34530   1 90 2 0 2,850.34 0
34530   2 90 2 0 2,850.34 0
34530   3 90 2 0 2,850.34 0
34530   4 90 2 0 2,850.34 0
34701   1 90 2 0 1,571.37 0
34701   2 90 2 0 1,441.18 0
34701   3 90 2 0 1,441.18 0
34701   4 90 2 0 1,441.18 0
34702   1 90 2 0 2,345.09 0
34702   2 90 2 0 2,154.07 0
34702   3 90 2 0 2,154.07 0
34702   4 90 2 0 2,154.07 0
34703   1 90 2 0 1,776.24 0
34703   2 90 2 0 1,625.09 0
34703   3 90 2 0 1,625.09 0
34703   4 90 2 0 1,625.09 0
34704   1 90 2 0 2,950.44 0
34704   2 90 2 0 2,704.70 0
34704   3 90 2 0 2,704.70 0
34704   4 90 2 0 2,704.70 0
34705   1 90 2 0 1,951.56 0
34705   2 90 2 0 1,789.77 0
34705   3 90 2 0 1,789.77 0
34705   4 90 2 0 1,789.77 0
34706   1 90 2 0 2,937.30 0
34706   2 90 2 0 2,695.45 0
34706   3 90 2 0 2,695.45 0
34706   4 90 2 0 2,695.45 0
34707   1 90 2 0 1,465.37 0
34707   2 90 2 0 1,344.51 0
34707   3 90 2 0 1,344.51 0
34707   4 90 2 0 1,344.51 0
34708   1 90 2 0 2,357.07 0
34708   2 90 2 0 2,165.57 0
34708   3 90 2 0 2,165.57 0
34708   4 90 2 0 2,165.57 0
34709   1 ZZZ 0 0 413.31 0
34709   2 ZZZ 0 0 379.56 0
34709   3 ZZZ 0 0 379.56 0
34709   4 ZZZ 0 0 379.56 0
34710   1 90 2 0 1,023.38 0
34710   2 90 2 0 936.83 0
34710   3 90 2 0 936.83 0
34710   4 90 2 0 936.83 0
34711   1 ZZZ 0 0 381.67 0
34711   2 ZZZ 0 0 350.45 0
34711   3 ZZZ 0 0 350.45 0
34711   4 ZZZ 0 0 350.45 0
34712   1 90 2 0 872.26 0
34712   2 90 2 0 797.20 0
34712   3 90 2 0 797.20 0
34712   4 90 2 0 797.20 0
34713   1 ZZZ 0 0 164.44 0
34713   2 ZZZ 0 0 150.92 0
34713   3 ZZZ 0 0 150.92 0
34713   4 ZZZ 0 0 150.92 0
34714   1 ZZZ 0 0 344.64 0
34714   2 ZZZ 0 0 316.63 0
34714   3 ZZZ 0 0 316.63 0
34714   4 ZZZ 0 0 316.63 0
34715   1 ZZZ 0 0 384.37 0
34715   2 ZZZ 0 0 353.97 0
34715   3 ZZZ 0 0 353.97 0
34715   4 ZZZ 0 0 353.97 0
34716   1 ZZZ 0 0 477.94 0
34716   2 ZZZ 0 0 438.89 0
34716   3 ZZZ 0 0 438.89 0
34716   4 ZZZ 0 0 438.89 0
34808   1 ZZZ 0 0 440.84 0
34808   2 ZZZ 0 0 400.92 0
34808   3 ZZZ 0 0 400.92 0
34808   4 ZZZ 0 0 400.92 0
34812   1 0 2 0 722.15 0
34812   2 0 2 0 656.23 0
34812   3 0 2 0 656.23 0
34812   4 0 2 0 656.23 0
34813   1 ZZZ 0 0 512.81 0
34813   2 ZZZ 0 0 466.22 0
34813   3 ZZZ 0 0 466.22 0
34813   4 ZZZ 0 0 466.22 0
34820   1 0 2 0 1,042.44 0
34820   2 0 2 0 947.52 0
34820   3 0 2 0 947.52 0
34820   4 0 2 0 947.52 0
34830   1 90 2 0 3,617.59 0
34830   2 90 2 0 3,280.71 0
34830   3 90 2 0 3,280.71 0
34830   4 90 2 0 3,280.71 0
34831   1 90 2 0 3,910.18 0
34831   2 90 2 0 3,546.96 0
34831   3 90 2 0 3,546.96 0
34831   4 90 2 0 3,546.96 0
34832   1 90 2 0 3,910.18 0
34832   2 90 2 0 3,546.96 0
34832   3 90 2 0 3,546.96 0
34832   4 90 2 0 3,546.96 0
34833   1 90 2 0 1,180.69 0
34833   2 90 2 0 1,075.45 0
34833   3 90 2 0 1,075.45 0
34833   4 90 2 0 1,075.45 0
34834   1 0 2 0 560.16 0
34834   2 0 2 0 503.39 0
34834   3 0 2 0 503.39 0
34834   4 0 2 0 503.39 0
34839     YYY 0 0 * 0
34841     YYY 0 0 * 0
34842     YYY 0 0 * 0
34843     YYY 0 0 * 0
34844     YYY 0 0 * 0
34845     YYY 0 0 * 0
34846     YYY 0 0 * 0
34847     YYY 0 0 * 0
34848     YYY 0 0 * 0
35001   1 90 2 0 3,292.34 0
35001   2 90 2 0 3,248.86 0
35001   3 90 2 0 3,004.98 0
35001   4 90 2 0 3,091.93 0
35002   1 90 2 0 3,986.11 0
35002   2 90 2 0 2,979.92 0
35002   3 90 2 0 2,790.56 0
35002   4 90 2 0 2,759.13 0
35005   1 90 2 0 2,558.03 0
35005   2 90 2 0 2,518.16 0
35005   3 90 2 0 2,354.11 0
35005   4 90 2 0 2,327.91 0
35011   1 90 2 0 2,702.61 0
35011   2 90 2 0 2,617.48 0
35011   3 90 2 0 2,511.83 0
35011   4 90 2 0 2,110.67 0