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Health Care Services Review
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Fee Schedule
>
Fee Schedule 99348-A4708
Begin Main Content Area
Page Content
Content Editor
2024 Workers' Compensation Part B Fee Schedule
99348-A4708
View the PDF
CPT/HCPC Code
Modifier
Medicare Location
Global Surgery Indicator
Multiple Surgery Indicator
Prevailing Charge Amount
Fee Schedule Amount
Site of Service Amount
99348
001
XXX
0
X
177.51
X
99348
002
XXX
0
X
162.90
X
99348
003
XXX
0
X
162.90
X
99348
004
XXX
0
X
162.90
X
99349
001
XXX
0
X
257.26
X
99349
004
XXX
0
X
238.47
X
99349
003
XXX
0
X
238.47
X
99349
002
XXX
0
X
238.47
X
99350
XXX
0
X
*
X
99358
XXX
0
X
*
X
99359
ZZZ
0
X
*
X
99360
XXX
9
X
*
X
99366
XXX
9
X
*
X
99367
XXX
9
X
*
X
99368
XXX
9
X
*
X
99374
XXX
9
X
*
X
99375
004
XXX
9
X
163.99
X
99375
002
XXX
9
X
173.98
X
99375
003
XXX
9
X
166.03
X
99375
001
XXX
9
X
177.59
X
99377
XXX
9
X
*
X
99378
001
XXX
9
X
218.70
X
99378
002
XXX
9
X
202.89
X
99378
003
XXX
9
X
202.89
X
99378
004
XXX
9
X
202.89
X
99379
XXX
9
X
*
X
99380
003
XXX
9
X
166.03
X
99380
004
XXX
9
X
163.99
X
99380
001
XXX
9
X
177.59
X
99380
002
XXX
9
X
173.98
X
99381
XXX
9
X
*
X
99382
XXX
9
X
*
X
99383
XXX
9
X
*
X
99384
XXX
9
X
*
X
99385
XXX
9
X
*
X
99386
XXX
9
X
*
X
99387
XXX
9
X
*
X
99391
XXX
9
X
*
X
99392
XXX
9
X
*
X
99394
XXX
9
X
*
X
99395
XXX
9
X
*
X
99396
XXX
9
X
*
X
99397
XXX
9
X
*
X
99401
XXX
9
X
*
X
99402
XXX
9
X
*
X
99403
XXX
9
X
*
X
99404
XXX
9
X
*
X
99406
003
XXX
0
X
21.98
20.68
99406
004
XXX
0
X
21.98
20.68
99406
002
XXX
0
X
21.98
20.68
99406
001
XXX
0
X
23.93
22.36
99407
004
XXX
0
X
43.36
41.44
99407
002
XXX
0
X
43.36
41.44
99407
003
XXX
0
X
43.36
41.44
99407
001
XXX
0
X
46.65
44.31
99408
XXX
9
X
*
X
99409
XXX
9
X
*
X
99411
XXX
9
X
*
X
99412
XXX
9
X
*
X
99415
002
ZZZ
0
X
12.76
X
99415
003
ZZZ
0
X
12.76
X
99415
004
ZZZ
0
X
12.76
X
99415
001
ZZZ
0
X
14.99
X
99416
003
ZZZ
0
X
7.17
X
99416
004
ZZZ
0
X
7.17
X
99416
001
ZZZ
0
X
8.46
X
99416
002
ZZZ
0
X
7.17
X
99417
XXX
9
X
*
X
99418
X
*
X
99421
001
XXX
0
X
22.69
19.47
99421
004
XXX
0
X
20.85
18.05
99421
003
XXX
0
X
20.85
18.05
99421
002
XXX
0
X
20.85
18.05
99422
001
XXX
0
X
45.49
40.09
99422
003
XXX
0
X
41.74
37.06
99422
002
XXX
0
X
41.74
37.06
99422
004
XXX
0
X
41.74
37.06
99423
001
XXX
0
X
73.53
63.84
99423
002
XXX
0
X
67.44
59.00
99423
003
XXX
0
X
67.44
59.00
99423
004
XXX
0
X
67.44
59.00
99424
002
XXX
0
X
97.93
88.92
99424
003
XXX
0
X
97.93
88.92
99424
004
XXX
0
X
97.93
88.92
99424
001
XXX
0
X
105.72
95.33
99425
004
ZZZ
0
X
70.57
61.94
99425
002
ZZZ
0
X
70.57
61.94
99425
003
ZZZ
0
X
70.57
61.94
99425
001
ZZZ
0
X
76.50
66.54
99426
002
XXX
0
X
76.33
61.37
99426
003
XXX
0
X
76.33
61.37
99426
004
XXX
0
X
76.33
61.37
99426
001
XXX
0
X
82.97
65.75
99427
001
ZZZ
0
X
61.71
44.99
99427
003
ZZZ
0
X
56.57
42.06
99427
002
ZZZ
0
X
56.57
42.06
99427
004
ZZZ
0
X
56.57
42.06
99429
XXX
9
X
#
X
99437
003
ZZZ
0
X
71.74
61.55
99437
002
ZZZ
0
X
71.74
61.55
99437
004
ZZZ
0
X
71.74
61.55
99437
001
ZZZ
0
X
77.85
66.10
99439
004
ZZZ
0
X
48.28
36.58
99439
003
ZZZ
0
X
48.28
36.58
99439
002
ZZZ
0
X
48.28
36.58
99439
001
ZZZ
0
X
52.73
39.22
99441
XXX
0
X
*
X
99442
XXX
0
X
*
X
99443
XXX
0
X
*
X
99446
XXX
0
X
*
X
99447
XXX
0
X
*
X
99448
XXX
0
X
*
X
99449
XXX
0
X
*
X
99450
XXX
9
X
*
X
99451
001
XXX
0
X
54.69
X
99451
002
XXX
0
X
51.07
X
99451
003
XXX
0
X
51.07
X
99451
004
XXX
0
X
51.07
X
99452
001
XXX
0
X
54.69
X
99452
002
XXX
0
X
51.07
X
99452
003
XXX
0
X
51.07
X
99452
004
XXX
0
X
51.07
X
99453
001
XXX
0
X
29.10
X
99453
002
XXX
0
X
25.27
X
99453
003
XXX
0
X
25.27
X
99453
004
XXX
0
X
25.27
X
99454
004
XXX
0
X
83.21
X
99454
002
XXX
0
X
83.21
X
99454
003
XXX
0
X
83.21
X
99454
001
XXX
0
X
95.59
X
99455
XXX
0
X
*
X
99456
XXX
0
X
*
X
99457
003
XXX
0
X
68.95
44.20
99457
002
XXX
0
X
68.95
44.20
99457
001
XXX
0
X
75.68
47.27
99457
004
XXX
0
X
68.95
44.20
99458
004
ZZZ
0
X
56.57
44.40
99458
003
ZZZ
0
X
56.57
44.40
99458
002
ZZZ
0
X
56.57
44.40
99458
001
ZZZ
0
X
61.89
47.87
99459
004
ZZZ
0
X
23.32
X
99459
003
ZZZ
0
X
23.32
X
99459
002
ZZZ
0
X
23.32
X
99459
001
ZZZ
0
X
26.50
X
99460
002
XXX
0
X
99.36
X
99460
004
XXX
0
X
99.36
X
99460
003
XXX
0
X
99.36
X
99460
001
XXX
0
X
106.07
X
99461
002
XXX
0
X
146.56
111.32
99461
003
XXX
0
X
146.56
111.32
99461
004
XXX
0
X
146.56
111.32
99461
001
XXX
0
X
161.50
119.71
99462
004
XXX
0
X
52.78
X
99462
003
XXX
0
X
52.78
X
99462
002
XXX
0
X
52.78
X
99462
001
XXX
0
X
56.21
X
99463
001
XXX
0
X
142.22
X
99463
004
XXX
0
X
132.72
X
99463
003
XXX
0
X
132.72
X
99463
002
XXX
0
X
132.72
X
99464
001
XXX
0
X
133.00
X
99464
004
XXX
0
X
124.92
X
99464
003
XXX
0
X
124.92
X
99464
002
XXX
0
X
124.92
X
99465
001
XXX
0
X
273.47
X
99465
003
XXX
0
X
255.52
X
99465
002
XXX
0
X
255.52
X
99465
004
XXX
0
X
255.52
X
99466
001
XXX
0
X
438.50
X
99466
004
XXX
0
X
409.66
X
99466
003
XXX
0
X
409.66
X
99466
002
XXX
0
X
409.66
X
99467
001
ZZZ
0
X
218.83
X
99467
003
ZZZ
0
X
204.59
X
99467
002
ZZZ
0
X
204.59
X
99467
004
ZZZ
0
X
204.59
X
99468
004
XXX
0
X
1,542.93
X
99468
001
XXX
0
X
1,652.36
X
99468
002
XXX
0
X
1,542.93
X
99468
003
XXX
0
X
1,542.93
X
99469
002
XXX
0
X
670.25
X
99469
001
XXX
0
X
714.13
X
99469
004
XXX
0
X
670.25
X
99469
003
XXX
0
X
670.25
X
99471
002
XXX
0
X
1,377.04
X
99471
004
XXX
0
X
1,377.04
X
99471
003
XXX
0
X
1,377.04
X
99471
001
XXX
0
X
1,481.91
X
99472
003
XXX
0
X
679.38
X
99472
002
XXX
0
X
679.38
X
99472
001
XXX
0
X
727.73
X
99472
004
XXX
0
X
679.38
X
99473
001
XXX
0
X
16.83
X
99473
002
XXX
0
X
14.53
X
99473
003
XXX
0
X
14.53
X
99473
004
XXX
0
X
14.53
X
99474
004
XXX
0
X
20.19
12.23
99474
002
XXX
0
X
20.19
12.23
99474
003
XXX
0
X
20.19
12.23
99474
001
XXX
0
X
22.24
13.08
99475
001
XXX
0
X
1,021.01
X
99475
003
XXX
0
X
950.59
X
99475
002
XXX
0
X
950.59
X
99475
004
XXX
0
X
950.59
X
99476
001
XXX
0
X
602.94
X
99476
004
XXX
0
X
563.93
X
99476
003
XXX
0
X
563.93
X
99476
002
XXX
0
X
563.93
X
99477
001
XXX
0
X
629.99
X
99477
002
XXX
0
X
584.18
X
99477
003
XXX
0
X
584.18
X
99477
004
XXX
0
X
584.18
X
99478
002
XXX
0
X
243.78
X
99478
003
XXX
0
X
243.78
X
99478
004
XXX
0
X
243.78
X
99478
001
XXX
0
X
262.63
X
99479
002
XXX
0
X
214.99
X
99479
004
XXX
0
X
214.99
X
99479
003
XXX
0
X
214.99
X
99479
001
XXX
0
X
231.00
X
99480
002
XXX
0
X
206.67
X
99480
001
XXX
0
X
221.98
X
99480
004
XXX
0
X
206.67
X
99480
003
XXX
0
X
206.67
X
99483
004
XXX
0
X
343.40
257.24
99483
002
XXX
0
X
343.40
257.24
99483
003
XXX
0
X
343.40
257.24
99483
001
XXX
0
X
373.37
274.50
99484
004
XXX
0
X
68.70
47.06
99484
002
XXX
0
X
68.70
47.06
99484
003
XXX
0
X
68.70
47.06
99484
001
XXX
0
X
75.22
50.38
99485
XXX
9
X
*
X
99486
XXX
9
X
*
X
99487
XXX
0
X
*
X
99489
ZZZ
0
X
*
X
99490
003
XXX
0
X
64.86
X
99490
002
XXX
0
X
64.86
X
99490
001
XXX
0
X
71.04
X
99490
004
XXX
0
X
64.86
X
99491
002
XXX
0
X
113.94
X
99491
001
XXX
0
X
122.52
X
99491
004
XXX
0
X
113.94
X
99491
003
XXX
0
X
113.94
X
99492
004
XXX
0
X
226.80
129.82
99492
003
XXX
0
X
226.80
129.82
99492
002
XXX
0
X
226.80
129.82
99492
001
XXX
0
X
250.16
138.88
99493
001
XXX
0
X
199.62
125.65
99493
002
XXX
0
X
181.88
117.41
99493
003
XXX
0
X
181.88
117.41
99493
004
XXX
0
X
181.88
117.41
99494
001
ZZZ
0
X
103.04
66.90
99494
002
ZZZ
0
X
94.08
62.60
99494
003
ZZZ
0
X
94.08
62.60
99494
004
ZZZ
0
X
94.08
62.60
99495
001
XXX
0
X
282.54
231.96
99495
002
XXX
0
X
256.15
212.56
99495
003
XXX
0
X
256.15
212.56
99495
004
XXX
0
X
256.15
212.56
99496
001
XXX
0
X
398.44
340.26
99496
004
XXX
0
X
361.77
311.54
99496
002
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0
X
361.77
311.54
99496
003
XXX
0
X
361.77
311.54
99497
XXX
0
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*
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99498
ZZZ
0
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99499
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#
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99500
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9
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*
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99501
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9
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99502
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99503
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99504
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99505
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99506
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99507
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99509
XXX
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99510
XXX
9
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*
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99511
XXX
9
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99512
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99600
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#
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99601
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99602
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99605
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99606
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99607
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A0021
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A0080
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A0120
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A0426
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440.14
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440.14
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A0426
003
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440.14
X
A0426
001
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492.94
X
A0427
002
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696.81
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A0427
003
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696.81
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A0427
004
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696.81
X
A0427
001
XXX
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X
780.49
X
A0428
003
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9
X
366.69
X
A0428
001
XXX
9
X
410.79
X
A0428
002
XXX
9
X
366.69
X
A0428
004
XXX
9
X
366.69
X
A0429
004
XXX
9
X
586.80
X
A0429
003
XXX
9
X
586.80
X
A0429
002
XXX
9
X
586.80
X
A0429
001
XXX
9
X
657.23
X
A0430
XXX
9
X
*
X
A0431
XXX
9
X
*
X
A0432
004
XXX
9
X
641.83
X
A0432
002
XXX
9
X
641.83
X
A0432
001
XXX
9
X
718.88
X
A0432
003
XXX
9
X
641.83
X
A0433
001
XXX
9
X
1,129.63
X
A0433
004
XXX
9
X
1,008.52
X
A0433
002
XXX
9
X
1,008.52
X
A0433
003
XXX
9
X
1,008.52
X
A0434
004
XXX
9
X
1,191.92
X
A0434
003
XXX
9
X
1,191.92
X
A0434
002
XXX
9
X
1,191.92
X
A0434
001
XXX
9
X
1,335.02
X
A0435
XXX
9
X
*
X
A0436
XXX
9
X
*
X
A0888
XXX
9
X
#
X
A0998
XXX
9
X
*
X
A0999
XXX
9
X
#
X
A2001
X
*
X
A2002
X
#
X
A2003
X
#
X
A2004
X
#
X
A2005
X
*
X
A2006
X
#
X
A2007
X
#
X
A2008
X
#
X
A2009
X
#
X
A2010
X
#
X
A2019
XXX
9
X
#
X
A2020
XXX
9
X
#
X
A2022
XXX
9
X
#
X
A2023
XXX
9
X
#
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XXX
9
X
#
X
A2025
XXX
9
X
#
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A4206
XXX
9
X
*
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A4207
XXX
9
X
*
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A4208
XXX
9
X
*
X
A4209
XXX
9
X
*
X
A4210
XXX
9
X
*
X
A4211
XXX
9
X
#
X
A4212
XXX
9
X
15.63
X
A4213
XXX
9
X
*
X
A4215
XXX
9
X
*
X
A4216
XXX
9
X
*
X
A4217
XXX
9
X
*
X
A4218
XXX
9
X
*
X
A4220
XXX
9
X
*
X
A4221
XXX
9
X
59.64
X
A4222
XXX
9
X
123.10
X
A4223
XXX
9
X
*
X
A4224
XXX
9
X
29.19
X
A4225
XXX
9
X
3.92
X
A4226
XXX
9
X
#
X
A4230
XXX
9
X
*
X
A4231
XXX
9
X
*
X
A4232
XXX
9
X
*
X
A4233
NU
XXX
9
X
1.60
X
A4234
NU
XXX
9
X
7.28
X
A4235
NU
XXX
9
X
4.69
X
A4236
NU
XXX
9
X
3.37
X
A4239
XXX
9
X
299.69
X
A4239
KF
XXX
9
X
348.70
X
A4244
XXX
9
X
*
X
A4245
XXX
9
X
*
X
A4246
XXX
9
X
*
X
A4247
XXX
9
X
*
X
A4248
XXX
9
X
#
X
A4250
XXX
9
X
*
X
A4252
XXX
9
X
*
X
A4253
XXX
9
X
113.45
X
A4255
XXX
9
X
10.00
X
A4256
XXX
9
X
25.97
X
A4257
XXX
9
X
28.72
X
A4258
XXX
9
X
47.59
X
A4259
XXX
9
X
28.87
X
A4261
XXX
9
X
#
X
A4262
XXX
9
X
*
X
A4263
XXX
9
X
95.86
X
A4264
XXX
9
X
*
X
A4265
XXX
9
X
*
X
A4266
XXX
9
X
*
X
A4267
XXX
9
X
*
X
A4268
XXX
9
X
*
X
A4269
XXX
9
X
*
X
A4270
XXX
9
X
*
X
A4280
XXX
9
X
11.18
X
A4281
XXX
9
X
*
X
A4282
XXX
9
X
*
X
A4283
XXX
9
X
*
X
A4284
XXX
9
X
*
X
A4285
XXX
9
X
*
X
A4286
XXX
9
X
*
X
A4290
XXX
9
X
234.72
X
A4300
XXX
9
X
95.86
X
A4301
XXX
9
X
*
X
A4305
XXX
9
X
*
X
A4306
XXX
9
X
*
X
A4310
XXX
9
X
19.06
X
A4311
XXX
9
X
33.60
X
A4312
XXX
9
X
40.86
X
A4313
XXX
9
X
48.40
X
A4314
XXX
9
X
64.02
X
A4315
XXX
9
X
68.82
X
A4316
XXX
9
X
71.92
X
A4320
XXX
9
X
13.43
X
A4321
XXX
9
X
*
X
A4322
XXX
9
X
7.87
X
A4326
XXX
9
X
30.56
X
A4327
XXX
9
X
107.55
X
A4328
XXX
9
X
27.86
X
A4330
XXX
9
X
19.06
X
A4331
XXX
9
X
*
X
A4332
XXX
9
X
#
X
A4333
XXX
9
X
*
X
A4334
XXX
9
X
*
X
A4335
XXX
9
X
#
X
A4336
XXX
9
X
*
X
A4337
XXX
9
X
#
X
A4338
XXX
9
X
28.88
X
A4340
XXX
9
X
55.23
X
A4341
XXX
9
X
376.22
X
A4342
XXX
9
X
949.95
X
A4344
XXX
9
X
36.32
X
A4346
XXX
9
X
45.51
X
A4349
XXX
9
X
2.19
X
A4351
XXX
9
X
4.59
X
A4352
XXX
9
X
17.06
X
A4353
XXX
9
X
17.77
X
A4354
XXX
9
X
31.20
X
A4355
XXX
9
X
23.72
X
A4356
XXX
9
X
121.66
X
A4357
XXX
9
X
24.47
X
A4358
XXX
9
X
17.69
X
A4360
XXX
9
X
0.90
X
A4361
XXX
9
X
48.76
X
A4362
XXX
9
X
9.22
X
A4363
XXX
9
X
9.78
X
A4364
XXX
9
X
7.85
X
A4366
XXX
9
X
27.99
X
A4367
XXX
9
X
19.66
X
A4368
XXX
9
X
0.69
X
A4369
XXX
9
X
5.64
X
A4371
XXX
9
X
8.54
X
A4372
XXX
9
X
9.76
X
A4373
XXX
9
X
14.66
X
A4375
XXX
9
X
40.09
X
A4376
XXX
9
X
111.16
X
A4377
XXX
9
X
10.05
X
A4378
XXX
9
X
71.88
X
A4379
XXX
9
X
35.10
X
A4380
XXX
9
X
87.29
X
A4381
XXX
9
X
10.76
X
A4382
XXX
9
X
57.51
X
A4383
XXX
9
X
65.87
X
A4384
XXX
9
X
22.50
X
A4385
XXX
9
X
11.90
X
A4387
XXX
9
X
9.41
X
A4388
XXX
9
X
10.17
X
A4389
XXX
9
X
14.55
X
A4390
XXX
9
X
22.47
X
A4391
XXX
9
X
16.46
X
A4392
XXX
9
X
15.51
X
A4393
XXX
9
X
21.41
X
A4394
XXX
9
X
6.06
X
A4395
XXX
9
X
#
X
A4396
XXX
9
X
*
X
A4398
XXX
9
X
30.69
X
A4399
XXX
9
X
31.65
X
A4400
XXX
9
X
130.32
X
A4402
XXX
9
X
3.65
X
A4404
XXX
9
X
4.25
X
A4405
XXX
9
X
7.50
X
A4406
XXX
9
X
12.75
X
A4407
XXX
9
X
19.44
X
A4408
XXX
9
X
21.88
X
A4409
XXX
9
X
13.77
X
A4410
XXX
9
X
20.04
X
A4411
XXX
9
X
10.22
X
A4412
XXX
9
X
5.41
X
A4413
XXX
9
X
12.23
X
A4414
XXX
9
X
10.94
X
A4415
XXX
9
X
13.31
X
A4416
XXX
9
X
5.97
X
A4417
XXX
9
X
8.07
X
A4418
XXX
9
X
3.96
X
A4419
XXX
9
X
3.79
X
A4420
XXX
9
X
*
X
A4421
XXX
9
X
#
X
A4422
XXX
9
X
0.31
X
A4423
XXX
9
X
4.04
X
A4424
XXX
9
X
10.31
X
A4425
XXX
9
X
7.76
X
A4426
XXX
9
X
5.92
X
A4427
XXX
9
X
6.06
X
A4428
XXX
9
X
14.15
X
A4429
XXX
9
X
17.89
X
A4430
XXX
9
X
18.53
X
A4431
XXX
9
X
13.52
X
A4432
XXX
9
X
7.78
X
A4433
XXX
9
X
7.24
X
A4434
XXX
9
X
8.17
X
A4435
XXX
9
X
10.19
X
A4436
X
29.14
X
A4437
X
29.14
X
A4450
XXX
9
X
0.12
X
A4452
XXX
9
X
0.83
X
A4453
X
*
X
A4455
XXX
9
X
3.70
X
A4456
XXX
9
X
0.46
X
A4458
XXX
9
X
*
X
A4459
XXX
9
X
*
X
A4461
XXX
9
X
6.31
X
A4463
XXX
9
X
25.57
X
A4465
XXX
9
X
*
X
A4467
XXX
9
X
*
X
A4470
XXX
9
X
#
X
A4480
XXX
9
X
*
X
A4481
XXX
9
X
150.94
X
A4483
XXX
9
X
*
X
A4490
XXX
9
X
*
X
A4495
XXX
9
X
*
X
A4500
XXX
9
X
*
X
A4510
XXX
9
X
*
X
A4520
XXX
9
X
*
X
A4550
XXX
9
X
95.86
X
A4553
XXX
9
X
*
X
A4554
XXX
9
X
*
X
A4555
XXX
9
X
*
X
A4556
NU
XXX
9
X
27.45
X
A4556
RR
XXX
9
X
2.74
X
A4556
UE
XXX
9
X
20.61
X
A4557
NU
XXX
9
X
47.87
X
A4557
RR
XXX
9
X
4.75
X
A4557
UE
XXX
9
X
35.92
X
A4558
NU
XXX
9
X
12.27
X
A4558
RR
XXX
9
X
1.25
X
A4558
UE
XXX
9
X
9.12
X
A4559
XXX
9
X
0.15
X
A4560
XXX
9
X
#
X
A4561
XXX
9
X
*
X
A4562
XXX
9
X
*
X
A4563
XXX
9
X
173.04
X
A4565
XXX
9
X
*
X
A4566
XXX
9
X
*
X
A4570
XXX
9
X
*
X
A4575
XXX
9
X
*
X
A4580
XXX
9
X
#
X
A4590
XXX
9
X
*
X
A4595
XXX
9
X
75.94
X
A4600
XXX
9
X
*
X
A4601
XXX
9
X
*
X
A4602
XXX
9
X
*
X
A4604
RR
XXX
9
X
#
X
A4604
UE
XXX
9
X
#
X
A4604
NU
XXX
9
X
134.28
X
A4605
NU
XXX
9
X
34.30
X
A4606
XXX
9
X
*
X
A4608
XXX
9
X
*
X
A4611
NU
XXX
9
X
523.82
X
A4611
RR
XXX
9
X
54.30
X
A4611
UE
XXX
9
X
392.89
X
A4612
NU
XXX
9
X
181.12
X
A4612
RR
XXX
9
X
18.41
X
A4612
UE
XXX
9
X
138.12
X
A4613
NU
XXX
9
X
384.50
X
A4613
RR
XXX
9
X
38.42
X
A4613
UE
XXX
9
X
278.11
X
A4614
XXX
9
X
55.60
X
A4615
XXX
9
X
*
X
A4616
XXX
9
X
#
X
A4617
XXX
9
X
*
X
A4618
NU
XXX
9
X
23.68
X
A4618
RR
XXX
9
X
2.71
X
A4618
UE
XXX
9
X
17.77
X
A4619
XXX
9
X
*
X
A4620
XXX
9
X
*
X
A4623
XXX
9
X
17.50
X
A4624
XXX
9
X
6.24
X
A4625
XXX
9
X
18.48
X
A4626
XXX
9
X
8.53
X
A4627
XXX
9
X
*
X
A4628
XXX
9
X
9.66
X
A4629
XXX
9
X
12.23
X
A4630
XXX
9
X
14.74
X
A4633
NU
XXX
9
X
91.03
X
A4634
XXX
9
X
#
X
A4635
NU
XXX
9
X
11.69
X
A4635
RR
XXX
9
X
1.53
X
A4635
UE
XXX
9
X
7.70
X
A4636
NU
XXX
9
X
9.58
X
A4636
RR
XXX
9
X
0.95
X
A4636
UE
XXX
9
X
6.97
X
A4637
NU
XXX
9
X
5.64
X
A4637
RR
XXX
9
X
0.76
X
A4637
UE
XXX
9
X
3.93
X
A4638
XXX
9
X
#
X
A4639
NU
XXX
9
X
637.21
X
A4640
NU
XXX
9
X
143.51
X
A4640
RR
XXX
9
X
14.62
X
A4640
UE
XXX
9
X
101.72
X
A4641
XXX
0
X
#
X
A4642
XXX
0
X
#
X
A4648
XXX
9
X
*
X
A4649
XXX
9
X
#
X
A4650
XXX
9
X
#
X
A4651
XXX
9
X
*
X
A4652
XXX
9
X
*
X
A4653
XXX
9
X
#
X
A4657
XXX
9
X
*
X
A4660
XXX
9
X
*
X
A4663
XXX
9
X
*
X
A4670
XXX
9
X
*
X
A4671
XXX
9
X
*
X
A4672
XXX
9
X
*
X
A4673
XXX
9
X
*
X
A4674
XXX
9
X
*
X
A4680
XXX
9
X
241.69
X
A4690
XXX
9
X
177.21
X
A4706
XXX
9
X
*
X
A4707
XXX
9
X
#
X
A4708
XXX
9
X
#
X
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