2018 Workers' Compensation Part B Fee Schedule

94010-95806

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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
94010   1 XXX 0 0 85.19 0
94010 26 1 XXX 0 0 37.99 0
94010 TC 1 XXX 0 0 34.93 0
94010   2 XXX 0 0 79.93 0
94010 26 2 XXX 0 0 37.21 0
94010 TC 2 XXX 0 0 34.27 0
94010   3 XXX 0 0 81.82 0
94010 26 3 XXX 0 0 36.39 0
94010 TC 3 XXX 0 0 31.45 0
94010   4 XXX 0 0 81.56 0
94010 26 4 XXX 0 0 34.78 0
94010 TC 4 XXX 0 0 30.98 0
94011   1 XXX 0 0 138.86 0
94011   2 XXX 0 0 129.73 0
94011   3 XXX 0 0 129.73 0
94011   4 XXX 0 0 129.73 0
94012   1 XXX 0 0 213.30 0
94012   2 XXX 0 0 199.50 0
94012   3 XXX 0 0 199.50 0
94012   4 XXX 0 0 199.50 0
94013   1 XXX 0 0 45.31 0
94013   2 XXX 0 0 42.24 0
94013   3 XXX 0 0 42.24 0
94013   4 XXX 0 0 42.24 0
94014   1 XXX 0 0 86.71 0
94014 26 1 XXX 0 0 53.02 0
94014 TC 1 XXX 0 0 33.67 0
94014   2 XXX 0 0 77.11 0
94014 26 2 XXX 0 0 48.81 0
94014 TC 2 XXX 0 0 28.28 0
94014   3 XXX 0 0 77.11 0
94014 26 3 XXX 0 0 48.81 0
94014 TC 3 XXX 0 0 28.28 0
94014   4 XXX 0 0 77.11 0
94014 26 4 XXX 0 0 48.81 0
94014 TC 4 XXX 0 0 28.28 0
94015   1 XXX 0 0 36.13 0
94015   2 XXX 0 0 33.29 0
94015   3 XXX 0 0 33.29 0
94015   4 XXX 0 0 33.29 0
94016   1 XXX 0 0 54.67 0
94016   2 XXX 0 0 49.69 0
94016   3 XXX 0 0 49.69 0
94016   4 XXX 0 0 49.69 0
94060   1 XXX 0 0 145.41 0
94060 26 1 XXX 0 0 59.72 0
94060 TC 1 XXX 0 0 77.30 0
94060   2 XXX 0 0 143.43 0
94060 26 2 XXX 0 0 56.84 0
94060 TC 2 XXX 0 0 76.23 0
94060   3 XXX 0 0 126.50 0
94060 26 3 XXX 0 0 55.64 0
94060 TC 3 XXX 0 0 68.08 0
94060   4 XXX 0 0 134.53 0
94060 26 4 XXX 0 0 52.87 0
94060 TC 4 XXX 0 0 69.17 0
94070   1 XXX 0 0 201.33 0
94070 26 1 XXX 0 0 76.96 0
94070 TC 1 XXX 0 0 124.37 0
94070   2 XXX 0 0 172.49 0
94070 26 2 XXX 0 0 69.58 0
94070 TC 2 XXX 0 0 102.91 0
94070   3 XXX 0 0 172.49 0
94070 26 3 XXX 0 0 69.58 0
94070 TC 3 XXX 0 0 102.91 0
94070   4 XXX 0 0 172.49 0
94070 26 4 XXX 0 0 69.58 0
94070 TC 4 XXX 0 0 102.91 0
94150   1 XXX 9 0 33.72 0
94150 26 1 XXX 9 0 16.69 0
94150 TC 1 XXX 9 0 31.66 0
94150   2 XXX 9 0 34.14 0
94150 26 2 XXX 9 0 17.01 0
94150 TC 2 XXX 9 0 30.15 0
94150   3 XXX 9 0 31.82 0
94150 26 3 XXX 9 0 15.57 0
94150 TC 3 XXX 9 0 6.60 0
94150   4 XXX 9 0 30.62 0
94150 26 4 XXX 9 0 17.64 0
94150 TC 4 XXX 9 0 6.49 0
94200   1 XXX 0 0 62.79 0
94200 26 1 XXX 0 0 22.33 0
94200 TC 1 XXX 0 0 69.35 0
94200   2 XXX 0 0 59.89 0
94200 26 2 XXX 0 0 22.04 0
94200 TC 2 XXX 0 0 68.11 0
94200   3 XXX 0 0 59.67 0
94200 26 3 XXX 0 0 20.83 0
94200 TC 3 XXX 0 0 19.03 0
94200   4 XXX 0 0 67.65 0
94200 26 4 XXX 0 0 16.43 0
94200 TC 4 XXX 0 0 18.75 0
94250   1 XXX 0 0 32.19 0
94250 26 1 XXX 0 0 20.81 0
94250 TC 1 XXX 0 0 11.38 0
94250   2 XXX 0 0 31.68 0
94250 26 2 XXX 0 0 20.49 0
94250 TC 2 XXX 0 0 11.18 0
94250   3 XXX 0 0 29.63 0
94250 26 3 XXX 0 0 19.34 0
94250 TC 3 XXX 0 0 10.27 0
94250   4 XXX 0 0 29.21 0
94250 26 4 XXX 0 0 19.09 0
94250 TC 4 XXX 0 0 10.15 0
94375   1 XXX 0 0 93.70 0
94375 26 1 XXX 0 0 38.02 0
94375 TC 1 XXX 0 0 88.15 0
94375   2 XXX 0 0 92.94 0
94375 26 2 XXX 0 0 37.76 0
94375 TC 2 XXX 0 0 87.35 0
94375   3 XXX 0 0 90.64 0
94375 26 3 XXX 0 0 36.84 0
94375 TC 3 XXX 0 0 86.59 0
94375   4 XXX 0 0 87.56 0
94375 26 4 XXX 0 0 34.27 0
94375 TC 4 XXX 0 0 36.03 0
94400   1 XXX 0 0 115.12 0
94400 26 1 XXX 0 0 95.37 0
94400 TC 1 XXX 0 0 30.69 0
94400   2 XXX 0 0 185.98 0
94400 26 2 XXX 0 0 82.65 0
94400 TC 2 XXX 0 0 29.82 0
94400   3 XXX 0 0 181.50 0
94400 26 3 XXX 0 0 92.45 0
94400 TC 3 XXX 0 0 26.51 0
94400   4 XXX 0 0 100.57 0
94400 26 4 XXX 0 0 74.45 0
94400 TC 4 XXX 0 0 26.11 0
94450   1 XXX 0 0 174.39 0
94450 26 1 XXX 0 0 52.52 0
94450 TC 1 XXX 0 0 32.56 0
94450   2 XXX 0 0 83.82 0
94450 26 2 XXX 0 0 51.90 0
94450 TC 2 XXX 0 0 31.95 0
94450   3 XXX 0 0 78.72 0
94450 26 3 XXX 0 0 49.41 0
94450 TC 3 XXX 0 0 29.28 0
94450   4 XXX 0 0 77.70 0
94450 26 4 XXX 0 0 48.83 0
94450 TC 4 XXX 0 0 28.82 0
94452   1 XXX 0 0 91.44 0
94452 26 1 XXX 0 0 27.15 0
94452 TC 1 XXX 0 0 64.30 0
94452   2 XXX 0 0 78.26 0
94452 26 2 XXX 0 0 25.05 0
94452 TC 2 XXX 0 0 53.23 0
94452   3 XXX 0 0 78.26 0
94452 26 3 XXX 0 0 25.05 0
94452 TC 3 XXX 0 0 53.23 0
94452   4 XXX 0 0 78.26 0
94452 26 4 XXX 0 0 25.05 0
94452 TC 4 XXX 0 0 53.23 0
94453   1 XXX 0 0 130.07 0
94453 26 1 XXX 0 0 34.78 0
94453 TC 1 XXX 0 0 95.29 0
94453   2 XXX 0 0 111.29 0
94453 26 2 XXX 0 0 32.24 0
94453 TC 2 XXX 0 0 79.04 0
94453   3 XXX 0 0 111.29 0
94453 26 3 XXX 0 0 32.24 0
94453 TC 3 XXX 0 0 79.04 0
94453   4 XXX 0 0 111.29 0
94453 26 4 XXX 0 0 32.24 0
94453 TC 4 XXX 0 0 79.04 0
94610   1 XXX 0 0 96.18 0
94610   2 XXX 0 0 83.15 0
94610   3 XXX 0 0 83.15 0
94610   4 XXX 0 0 83.15 0
94617   1 XXX 0 0 117.10 0
94617 26 1 XXX 0 0 40.40 0
94617 TC 1 XXX 0 0 76.70 0
94617   2 XXX 0 0 104.83 0
94617 26 2 XXX 0 0 38.11 0
94617 TC 2 XXX 0 0 66.72 0
94617   3 XXX 0 0 104.83 0
94617 26 3 XXX 0 0 38.11 0
94617 TC 3 XXX 0 0 66.72 0
94617   4 XXX 0 0 104.83 0
94617 26 4 XXX 0 0 38.11 0
94617 TC 4 XXX 0 0 66.72 0
94618   1 XXX 0 0 41.73 0
94618 26 1 XXX 0 0 27.63 0
94618 TC 1 XXX 0 0 14.10 0
94618   2 XXX 0 0 38.31 0
94618 26 2 XXX 0 0 26.08 0
94618 TC 2 XXX 0 0 12.23 0
94618   3 XXX 0 0 38.31 0
94618 26 3 XXX 0 0 26.08 0
94618 TC 3 XXX 0 0 12.23 0
94618   4 XXX 0 0 38.31 0
94618 26 4 XXX 0 0 26.08 0
94618 TC 4 XXX 0 0 12.23 0
94621   1 XXX 0 0 201.30 0
94621 26 1 XXX 0 0 85.10 0
94621 TC 1 XXX 0 0 116.12 0
94621   2 XXX 0 0 175.68 0
94621 26 2 XXX 0 0 78.49 0
94621 TC 2 XXX 0 0 97.15 0
94621   3 XXX 0 0 175.68 0
94621 26 3 XXX 0 0 78.49 0
94621 TC 3 XXX 0 0 97.15 0
94621   4 XXX 0 0 175.68 0
94621 26 4 XXX 0 0 78.49 0
94621 TC 4 XXX 0 0 97.15 0
94640   1 XXX 0 0 34.12 0
94640   2 XXX 0 0 33.51 0
94640   3 XXX 0 0 30.75 0
94640   4 XXX 0 0 40.50 0
94642     XXX 0 0 65.89 0
94644   1 XXX 0 0 55.89 0
94644   2 XXX 0 0 45.34 0
94644   3 XXX 0 0 45.34 0
94644   4 XXX 0 0 45.34 0
94645   1 XXX 0 0 21.57 0
94645   2 XXX 0 0 17.27 0
94645   3 XXX 0 0 17.27 0
94645   4 XXX 0 0 17.27 0
94660   1 XXX 0 0 123.83 0
94660   2 XXX 0 0 122.26 0
94660   3 XXX 0 0 143.24 0
94660   4 XXX 0 0 148.98 0
94662   1 XXX 0 0 86.17 0
94662   2 XXX 0 0 146.67 0
94662   3 XXX 0 0 145.33 0
94662   4 XXX 0 0 81.02 0
94664   1 XXX 0 0 39.22 0
94664   2 XXX 0 0 41.18 0
94664   3 XXX 0 0 37.20 0
94664   4 XXX 0 0 33.93 0
94667   1 XXX 0 0 51.97 0
94667   2 XXX 0 0 51.57 0
94667   3 XXX 0 0 49.84 0
94667   4 XXX 0 0 43.98 0
94668   1 XXX 0 0 30.23 0
94668   2 XXX 0 0 29.65 0
94668   3 XXX 0 0 27.11 0
94668   4 XXX 0 0 26.65 0
94669   1 XXX 0 0 47.44 0
94669   2 XXX 0 0 40.63 0
94669   3 XXX 0 0 40.63 0
94669   4 XXX 0 0 40.63 0
94680   1 XXX 0 0 97.31 0
94680 26 1 XXX 0 0 60.38 0
94680 TC 1 XXX 0 0 47.56 0
94680   2 XXX 0 0 130.96 0
94680 26 2 XXX 0 0 56.66 0
94680 TC 2 XXX 0 0 46.46 0
94680   3 XXX 0 0 87.97 0
94680 26 3 XXX 0 0 45.37 0
94680 TC 3 XXX 0 0 41.85 0
94680   4 XXX 0 0 86.75 0
94680 26 4 XXX 0 0 45.52 0
94680 TC 4 XXX 0 0 41.19 0
94681   1 XXX 0 0 187.22 0
94681 26 1 XXX 0 0 107.20 0
94681 TC 1 XXX 0 0 119.71 0
94681   2 XXX 0 0 215.85 0
94681 26 2 XXX 0 0 105.40 0
94681 TC 2 XXX 0 0 169.01 0
94681   3 XXX 0 0 153.67 0
94681 26 3 XXX 0 0 105.49 0
94681 TC 3 XXX 0 0 106.96 0
94681   4 XXX 0 0 207.92 0
94681 26 4 XXX 0 0 100.15 0
94681 TC 4 XXX 0 0 105.33 0
94690   1 XXX 0 0 54.95 0
94690 26 1 XXX 0 0 13.18 0
94690 TC 1 XXX 0 0 45.51 0
94690   2 XXX 0 0 51.16 0
94690 26 2 XXX 0 0 13.16 0
94690 TC 2 XXX 0 0 44.63 0
94690   3 XXX 0 0 49.98 0
94690 26 3 XXX 0 0 13.04 0
94690 TC 3 XXX 0 0 41.00 0
94690   4 XXX 0 0 49.26 0
94690 26 4 XXX 0 0 13.01 0
94690 TC 4 XXX 0 0 40.31 0
94726   1 XXX 0 0 74.50 0
94726 26 1 XXX 0 0 16.66 0
94726 TC 1 XXX 0 0 57.84 0
94726   2 XXX 0 0 65.31 0
94726 26 2 XXX 0 0 15.68 0
94726 TC 2 XXX 0 0 49.64 0
94726   3 XXX 0 0 65.31 0
94726 26 3 XXX 0 0 15.68 0
94726 TC 3 XXX 0 0 49.64 0
94726   4 XXX 0 0 65.31 0
94726 26 4 XXX 0 0 15.68 0
94726 TC 4 XXX 0 0 49.64 0
94727   1 XXX 0 0 58.27 0
94727 26 1 XXX 0 0 16.66 0
94727 TC 1 XXX 0 0 41.62 0
94727   2 XXX 0 0 51.44 0
94727 26 2 XXX 0 0 15.68 0
94727 TC 2 XXX 0 0 35.74 0
94727   3 XXX 0 0 51.44 0
94727 26 3 XXX 0 0 15.68 0
94727 TC 3 XXX 0 0 35.74 0
94727   4 XXX 0 0 51.44 0
94727 26 4 XXX 0 0 15.68 0
94727 TC 4 XXX 0 0 35.74 0
94728   1 XXX 0 0 58.27 0
94728 26 1 XXX 0 0 16.66 0
94728 TC 1 XXX 0 0 41.62 0
94728   2 XXX 0 0 51.44 0
94728 26 2 XXX 0 0 15.68 0
94728 TC 2 XXX 0 0 35.74 0
94728   3 XXX 0 0 51.44 0
94728 26 3 XXX 0 0 15.68 0
94728 TC 3 XXX 0 0 35.74 0
94728   4 XXX 0 0 51.44 0
94728 26 4 XXX 0 0 15.68 0
94728 TC 4 XXX 0 0 35.74 0
94729   1 ZZZ 0 0 73.95 0
94729 26 1 ZZZ 0 0 11.19 0
94729 TC 1 ZZZ 0 0 62.76 0
94729   2 ZZZ 0 0 64.46 0
94729 26 2 ZZZ 0 0 10.46 0
94729 TC 2 ZZZ 0 0 53.97 0
94729   3 ZZZ 0 0 64.46 0
94729 26 3 ZZZ 0 0 10.46 0
94729 TC 3 ZZZ 0 0 53.97 0
94729   4 ZZZ 0 0 64.46 0
94729 26 4 ZZZ 0 0 10.46 0
94729 TC 4 ZZZ 0 0 53.97 0
94750   1 XXX 0 0 91.00 0
94750 26 1 XXX 0 0 42.34 0
94750 TC 1 XXX 0 0 48.69 0
94750   2 XXX 0 0 92.41 0
94750 26 2 XXX 0 0 42.50 0
94750 TC 2 XXX 0 0 47.73 0
94750   3 XXX 0 0 88.62 0
94750 26 3 XXX 0 0 39.46 0
94750 TC 3 XXX 0 0 43.90 0
94750   4 XXX 0 0 82.15 0
94750 26 4 XXX 0 0 38.92 0
94750 TC 4 XXX 0 0 43.26 0
94760   1 XXX 0 0 18.35 0
94760   2 XXX 0 0 18.12 0
94760   3 XXX 0 0 17.13 0
94760   4 XXX 0 0 16.92 0
94761   1 XXX 0 0 39.16 0
94761   2 XXX 0 0 38.50 0
94761   3 XXX 0 0 35.70 0
94761   4 XXX 0 0 35.21 0
94762   1 XXX 0 0 84.35 0
94762   2 XXX 0 0 83.21 0
94762   3 XXX 0 0 78.52 0
94762   4 XXX 0 0 77.75 0
94770   1 XXX 0 0 46.95 0
94770 26 1 XXX 0 0 21.84 0
94770 TC 1 XXX 0 0 32.31 0
94770   2 XXX 0 0 45.30 0
94770 26 2 XXX 0 0 21.59 0
94770 TC 2 XXX 0 0 24.85 0
94770   3 XXX 0 0 52.77 0
94770 26 3 XXX 0 0 20.29 0
94770 TC 3 XXX 0 0 27.23 0
94770   4 XXX 0 0 52.16 0
94770 26 4 XXX 0 0 20.34 0
94770 TC 4 XXX 0 0 26.91 0
94772   1 XXX 0 0 568.49 0
94772 26 1 XXX 0 0 215.96 0
94772 TC 1 XXX 0 0 352.50 0
94772   2 XXX 0 0 568.49 0
94772 26 2 XXX 0 0 215.96 0
94772 TC 2 XXX 0 0 352.50 0
94772   3 XXX 0 0 568.49 0
94772 26 3 XXX 0 0 215.96 0
94772 TC 3 XXX 0 0 352.50 0
94772   4 XXX 0 0 568.49 0
94772 26 4 XXX 0 0 215.96 0
94772 TC 4 XXX 0 0 352.50 0
94774     YYY 0 0 * 0
94775     YYY 0 0 * 0
94776     YYY 0 0 * 0
94777     YYY 0 0 * 0
94780   1 XXX 0 0 69.82 32.22
94780   2 XXX 0 0 62.51 30.10
94780   3 XXX 0 0 62.51 30.10
94780   4 XXX 0 0 62.51 30.10
94781   1 ZZZ 0 0 27.17 11.19
94781   2 ZZZ 0 0 24.25 10.46
94781   3 ZZZ 0 0 24.25 10.46
94781   4 ZZZ 0 0 24.25 10.46
94799     XXX 0 0 * 0
95004   1 XXX 0 0 7.41 0
95004   2 XXX 0 0 7.65 0
95004   3 XXX 0 0 6.72 0
95004   4 XXX 0 0 6.90 0
95012   1 XXX 0 0 29.12 0
95012   2 XXX 0 0 23.64 0
95012   3 XXX 0 0 23.64 0
95012   4 XXX 0 0 23.64 0
95017   1 XXX 0 0 11.93 5.11
95017   2 XXX 0 0 10.55 4.69
95017   3 XXX 0 0 10.55 4.69
95017   4 XXX 0 0 10.55 4.69
95018   1 XXX 0 0 29.09 9.52
95018   2 XXX 0 0 25.72 8.85
95018   3 XXX 0 0 25.72 8.85
95018   4 XXX 0 0 25.72 8.85
95024   1 XXX 0 0 10.45 0
95024   2 XXX 0 0 11.18 0
95024   3 XXX 0 0 10.50 0
95024   4 XXX 0 0 10.58 0
95027   1 XXX 0 0 15.46 0
95027   2 XXX 0 0 13.99 0
95027   3 XXX 0 0 14.92 0
95027   4 XXX 0 0 14.82 0
95028   1 XXX 0 0 17.49 0
95028   2 XXX 0 0 18.12 0
95028   3 XXX 0 0 15.85 0
95028   4 XXX 0 0 16.56 0
95044   1 XXX 0 0 15.31 0
95044   2 XXX 0 0 15.06 0
95044   3 XXX 0 0 11.73 0
95044   4 XXX 0 0 13.76 0
95052   1 XXX 0 0 15.68 0
95052   2 XXX 0 0 15.58 0
95052   3 XXX 0 0 14.39 0
95052   4 XXX 0 0 17.97 0
95056   1 XXX 0 0 12.28 0
95056   2 XXX 0 0 12.57 0
95056   3 XXX 0 0 13.16 0
95056   4 XXX 0 0 13.00 0
95060   1 XXX 0 0 20.88 0
95060   2 XXX 0 0 20.56 0
95060   3 XXX 0 0 19.36 0
95060   4 XXX 0 0 19.12 0
95065   1 XXX 0 0 16.07 0
95065   2 XXX 0 0 15.78 0
95065   3 XXX 0 0 16.29 0
95065   4 XXX 0 0 14.41 0
95070   1 XXX 0 0 173.89 0
95070   2 XXX 0 0 171.47 0
95070   3 XXX 0 0 161.41 0
95070   4 XXX 0 0 158.64 0
95071   1 XXX 0 0 222.46 0
95071   2 XXX 0 0 172.06 0
95071   3 XXX 0 0 206.58 0
95071   4 XXX 0 0 203.10 0
95076   1 XXX 0 0 154.77 94.29
95076   2 XXX 0 0 140.92 88.79
95076   3 XXX 0 0 140.92 88.79
95076   4 XXX 0 0 140.92 88.79
95079   1 ZZZ 0 0 108.61 86.78
95079   2 ZZZ 0 0 100.49 81.68
95079   3 ZZZ 0 0 100.49 81.68
95079   4 ZZZ 0 0 100.49 81.68
95115   1 0 0 0 29.21 0
95115   2 0 0 0 27.51 0
95115   3 0 0 0 26.87 0
95115   4 0 0 0 25.31 0
95117   1 0 0 0 38.67 0
95117   2 0 0 0 38.02 0
95117   3 0 0 0 35.98 0
95117   4 0 0 0 37.92 0
95120     XXX 9 0 203.58 0
95125     XXX 9 0 251.17 0
95130     XXX 9 0 101.75 0
95131     XXX 9 0 158.32 0
95132     XXX 9 0 214.63 0
95133     XXX 9 0 271.24 0
95134     XXX 9 0 327.80 0
95144     0 0 0 17.62 0
95145     0 0 0 84.61 0
95146     0 0 0 145.01 0
95147     0 0 0 192.23 0
95148     0 0 0 248.73 0
95149     0 0 0 305.10 0
95165     0 0 0 87.74 0
95170     0 0 0 * 0
95180   1 0 0 0 116.09 0
95180   2 0 0 0 119.88 0
95180   3 0 0 0 117.13 0
95180   4 0 0 0 163.65 0
95199     0 0 0 * 0
95249   1 XXX 0 0 68.52 0
95249   2 XXX 0 0 59.52 0
95249   3 XXX 0 0 59.52 0
95249   4 XXX 0 0 59.52 0
95250   1 XXX 0 0 100.52 0
95250   2 XXX 0 0 85.26 0
95250   3 XXX 0 0 85.26 0
95250   4 XXX 0 0 85.26 0
95251   1 XXX 0 0 43.06 0
95251   2 XXX 0 0 39.81 0
95251   3 XXX 0 0 39.81 0
95251   4 XXX 0 0 39.81 0
95782   1 XXX 0 0 1,399.14 0
95782 26 1 XXX 0 0 167.97 0
95782 TC 1 XXX 0 0 1,231.19 0
95782   2 XXX 0 0 1,216.84 0
95782 26 2 XXX 0 0 157.66 0
95782 TC 2 XXX 0 0 1,059.20 0
95782   3 XXX 0 0 1,216.84 0
95782 26 3 XXX 0 0 157.66 0
95782 TC 3 XXX 0 0 1,059.20 0
95782   4 XXX 0 0 1,216.84 0
95782 26 4 XXX 0 0 157.66 0
95782 TC 4 XXX 0 0 1,059.20 0
95783   1 XXX 0 0 1,493.81 0
95783 26 1 XXX 0 0 183.91 0
95783 TC 1 XXX 0 0 1,309.90 0
95783   2 XXX 0 0 1,299.21 0
95783 26 2 XXX 0 0 172.42 0
95783 TC 2 XXX 0 0 1,126.82 0
95783   3 XXX 0 0 1,299.21 0
95783 26 3 XXX 0 0 172.42 0
95783 TC 3 XXX 0 0 1,126.82 0
95783   4 XXX 0 0 1,299.21 0
95783 26 4 XXX 0 0 172.42 0
95783 TC 4 XXX 0 0 1,126.82 0
95800   1 XXX 0 0 298.62 0
95800 26 1 XXX 0 0 82.64 0
95800 TC 1 XXX 0 0 215.96 0
95800   2 XXX 0 0 268.12 0
95800 26 2 XXX 0 0 77.40 0
95800 TC 2 XXX 0 0 190.69 0
95800   3 XXX 0 0 268.12 0
95800 26 3 XXX 0 0 77.40 0
95800 TC 3 XXX 0 0 190.69 0
95800   4 XXX 0 0 268.12 0
95800 26 4 XXX 0 0 77.40 0
95800 TC 4 XXX 0 0 190.69 0
95801   1 XXX 0 0 139.72 0
95801 26 1 XXX 0 0 72.87 0
95801 TC 1 XXX 0 0 66.85 0
95801   2 XXX 0 0 127.47 0
95801 26 2 XXX 0 0 68.52 0
95801 TC 2 XXX 0 0 58.94 0
95801   3 XXX 0 0 127.47 0
95801 26 3 XXX 0 0 68.52 0
95801 TC 3 XXX 0 0 58.94 0
95801   4 XXX 0 0 127.47 0
95801 26 4 XXX 0 0 68.52 0
95801 TC 4 XXX 0 0 58.94 0
95803     XXX 0 0 * 0
95805   1 XXX 0 0 631.94 0
95805 26 1 XXX 0 0 186.86 0
95805 TC 1 XXX 0 0 445.12 0
95805   2 XXX 0 0 540.15 0
95805 26 2 XXX 0 0 172.37 0
95805 TC 2 XXX 0 0 367.84 0
95805   3 XXX 0 0 540.15 0
95805 26 3 XXX 0 0 172.37 0
95805 TC 3 XXX 0 0 367.84 0
95805   4 XXX 0 0 540.15 0
95805 26 4 XXX 0 0 172.37 0
95805 TC 4 XXX 0 0 367.84 0
95806   1 XXX 0 0 763.70 0
95806 26 1 XXX 0 0 338.71 0
95806 TC 1 XXX 0 0 425.01 0
95806   2 XXX 0 0 647.61 0
95806 26 2 XXX 0 0 296.32 0
95806 TC 2 XXX 0 0 351.30 0
95806   3 XXX 0 0 647.61 0
95806 26 3 XXX 0 0 296.32 0
95806 TC 3 XXX 0 0 351.30 0
95806   4 XXX 0 0 647.61 0
95806 26 4 XXX 0 0 296.32 0
95806 TC 4 XXX 0 0 351.30 0