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Health Care Services Review
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Fee Schedule
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Fee Schedule 31636-33211
Begin Main Content Area
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Content Editor
2024 Workers' Compensation Part B Fee Schedule
31636-33211
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
31636
002
0
3
X
488.37
X
31636
003
0
3
X
488.37
X
31636
004
0
3
X
488.37
X
31636
001
0
3
X
534.83
X
31637
001
ZZZ
0
X
190.73
X
31637
002
ZZZ
0
X
174.19
X
31637
003
ZZZ
0
X
174.19
X
31637
004
ZZZ
0
X
174.19
X
31638
004
0
3
X
543.87
X
31638
001
0
3
X
590.12
X
31638
003
0
3
X
543.87
X
31638
002
0
3
X
543.87
X
31640
004
0
3
X
1,094.03
X
31640
002
0
3
X
1,183.50
X
31640
003
0
3
X
1,107.44
X
31640
001
0
3
X
1,201.83
X
31641
001
0
3
X
1,326.58
X
31641
003
0
3
X
1,271.80
X
31641
002
0
3
X
1,314.15
X
31641
004
0
3
X
1,125.59
X
31643
003
0
2
X
485.97
444.80
31643
002
0
2
X
485.97
444.80
31643
004
0
2
X
485.97
444.80
31643
001
0
2
X
554.31
506.07
31645
001
0
3
X
806.50
X
31645
004
0
3
X
753.57
X
31645
002
0
3
X
786.23
X
31645
003
0
3
X
770.65
X
31646
001
0
2
X
755.93
X
31646
003
0
2
X
720.68
X
31646
002
0
2
X
749.12
X
31646
004
0
2
X
659.70
X
31647
004
0
3
X
364.49
X
31647
002
0
3
X
364.49
X
31647
003
0
3
X
364.49
X
31647
001
0
3
X
397.30
X
31648
004
0
3
X
378.60
X
31648
002
0
3
X
378.60
X
31648
003
0
3
X
378.60
X
31648
001
0
3
X
415.12
X
31649
001
ZZZ
0
X
127.69
X
31649
004
ZZZ
0
X
118.61
X
31649
003
ZZZ
0
X
118.61
X
31649
002
ZZZ
0
X
118.61
X
31651
004
ZZZ
0
X
126.01
X
31651
001
ZZZ
0
X
135.34
X
31651
002
ZZZ
0
X
126.01
X
31651
003
ZZZ
0
X
126.01
X
31652
002
0
2
X
1,328.36
363.26
31652
003
0
2
X
1,328.36
363.26
31652
004
0
2
X
1,328.36
363.26
31652
001
0
2
X
1,518.36
389.16
31653
001
0
2
X
1,613.50
429.52
31653
004
0
2
X
1,412.90
400.98
31653
003
0
2
X
1,412.90
400.98
31653
002
0
2
X
1,412.90
400.98
31654
002
ZZZ
0
X
214.53
105.11
31654
003
ZZZ
0
X
214.53
105.11
31654
001
ZZZ
0
X
240.39
112.35
31654
004
ZZZ
0
X
214.53
105.11
31660
001
0
3
X
398.21
X
31660
003
0
3
X
364.54
X
31660
002
0
3
X
364.54
X
31660
004
0
3
X
364.54
X
31661
004
0
3
X
385.09
X
31661
001
0
3
X
420.90
X
31661
002
0
3
X
385.09
X
31661
003
0
3
X
385.09
X
31717
003
0
2
X
285.99
X
31717
002
0
2
X
297.95
X
31717
001
0
2
X
300.88
X
31717
004
0
2
X
282.87
X
31720
004
0
2
X
169.25
X
31720
002
0
2
X
172.20
X
31720
003
0
2
X
170.50
X
31720
001
0
2
X
178.12
X
31725
003
0
2
X
344.18
X
31725
002
0
2
X
363.75
X
31725
004
0
2
X
340.15
X
31725
001
0
2
X
368.48
X
31730
001
0
2
X
580.37
X
31730
004
0
2
X
1,099.61
X
31730
002
0
2
X
1,128.83
X
31730
003
0
2
X
541.47
X
31750
004
90
2
X
1,685.09
X
31750
003
90
2
X
1,981.45
X
31750
002
90
2
X
1,716.50
X
31750
001
90
2
X
1,764.85
X
31755
002
90
2
X
2,111.77
X
31755
003
90
2
X
1,981.45
X
31755
004
90
2
X
1,957.32
X
31755
001
90
2
X
2,143.23
X
31760
001
90
2
X
3,905.91
X
31760
004
90
2
X
3,562.18
X
31760
002
90
2
X
3,846.30
X
31760
003
90
2
X
3,601.27
X
31766
001
90
2
X
5,351.15
X
31766
003
90
2
X
5,052.77
X
31766
002
90
2
X
5,293.16
X
31766
004
90
2
X
4,992.97
X
31770
002
90
2
X
4,250.04
X
31770
003
90
2
X
4,002.53
X
31770
001
90
2
X
4,309.90
X
31770
004
90
2
X
3,955.98
X
31775
001
90
2
X
4,534.45
X
31775
002
90
2
X
4,473.92
X
31775
003
90
2
X
4,223.81
X
31775
004
90
2
X
4,174.05
X
31780
001
90
2
X
4,008.16
X
31780
004
90
2
X
3,654.63
X
31780
003
90
2
X
3,700.16
X
31780
002
90
2
X
2,740.81
X
31781
004
90
2
X
4,235.09
X
31781
001
90
2
X
4,602.76
X
31781
002
90
2
X
4,541.04
X
31781
003
90
2
X
4,285.69
X
31785
002
90
2
X
2,899.34
X
31785
003
90
2
X
2,096.92
X
31785
004
90
2
X
2,715.49
X
31785
001
90
2
X
2,936.40
X
31786
001
90
2
X
4,294.31
X
31786
003
90
2
X
3,985.82
X
31786
002
90
2
X
4,234.08
X
31786
004
90
2
X
3,941.03
X
31800
001
90
2
X
1,695.16
X
31800
004
90
2
X
1,284.02
X
31800
003
90
2
X
1,299.06
X
31800
002
90
2
X
1,563.83
X
31805
004
90
2
X
2,458.55
X
31805
001
90
2
X
2,687.90
X
31805
002
90
2
X
2,648.90
X
31805
003
90
2
X
2,487.77
X
31820
002
90
2
X
905.02
X
31820
003
90
2
X
849.98
X
31820
004
90
2
X
839.83
X
31820
001
90
2
X
918.28
X
31825
003
90
2
X
1,361.48
X
31825
002
90
2
X
1,375.13
X
31825
004
90
2
X
1,337.43
X
31825
001
90
2
X
1,414.39
X
31830
002
90
2
X
923.06
X
31830
003
90
2
X
869.64
X
31830
001
90
2
X
935.99
X
31830
004
90
2
X
859.12
X
31899
YYY
2
X
#
X
32035
002
90
2
X
2,210.36
X
32035
003
90
2
X
2,234.10
X
32035
001
90
2
X
1,868.94
X
32035
004
90
2
X
2,263.21
X
32036
001
90
2
X
1,826.57
X
32036
004
90
2
X
1,675.32
X
32036
002
90
2
X
1,795.74
X
32036
003
90
2
X
1,668.78
X
32096
004
90
2
X
1,377.77
X
32096
001
90
2
X
1,542.35
X
32096
002
90
2
X
1,377.77
X
32096
003
90
2
X
1,377.77
X
32097
004
90
2
X
1,377.77
X
32097
001
90
2
X
1,542.35
X
32097
003
90
2
X
1,377.77
X
32097
002
90
2
X
1,377.77
X
32098
004
90
2
X
1,294.57
X
32098
001
90
2
X
1,449.03
X
32098
003
90
2
X
1,294.57
X
32098
002
90
2
X
1,294.57
X
32100
001
90
2
X
2,866.75
X
32100
002
90
2
X
2,856.00
X
32100
003
90
2
X
2,782.49
X
32100
004
90
2
X
2,736.98
X
32110
003
90
2
X
2,680.19
X
32110
002
90
2
X
2,956.32
X
32110
004
90
2
X
2,603.79
X
32110
001
90
2
X
2,918.12
X
32120
004
90
2
X
2,358.94
X
32120
001
90
2
X
2,525.30
X
32120
003
90
2
X
2,366.24
X
32120
002
90
2
X
2,473.84
X
32124
001
90
2
X
2,423.79
X
32124
003
90
2
X
2,379.11
X
32124
002
90
2
X
2,711.82
X
32124
004
90
2
X
2,395.53
X
32140
004
90
2
X
2,942.26
X
32140
002
90
2
X
3,078.77
X
32140
003
90
2
X
2,966.05
X
32140
001
90
2
X
3,087.19
X
32141
002
90
2
X
3,162.78
X
32141
003
90
2
X
2,973.06
X
32141
004
90
2
X
2,991.29
X
32141
001
90
2
X
3,220.02
X
32150
001
90
2
X
3,054.25
X
32150
004
90
2
X
2,556.48
X
32150
002
90
2
X
3,034.58
X
32150
003
90
2
X
2,586.42
X
32151
002
90
2
X
2,551.87
X
32151
003
90
2
X
2,397.15
X
32151
004
90
2
X
2,369.29
X
32151
001
90
2
X
2,711.90
X
32160
001
90
2
X
2,990.26
X
32160
002
90
2
X
2,735.42
X
32160
003
90
2
X
2,756.10
X
32160
004
90
2
X
1,846.45
X
32200
004
90
2
X
2,167.74
X
32200
002
90
2
X
2,753.60
X
32200
003
90
2
X
2,192.39
X
32200
001
90
2
X
2,342.84
X
32215
003
90
2
X
1,746.56
X
32215
002
90
2
X
1,950.15
X
32215
001
90
2
X
1,907.96
X
32215
004
90
2
X
1,890.23
X
32220
004
90
2
X
4,163.49
X
32220
001
90
2
X
4,334.94
X
32220
002
90
2
X
4,305.60
X
32220
003
90
2
X
4,184.56
X
32225
002
90
2
X
2,948.12
X
32225
003
90
2
X
2,733.46
X
32225
001
90
2
X
3,000.18
X
32225
004
90
2
X
2,701.32
X
32310
003
90
2
X
3,804.85
X
32310
002
90
2
X
3,900.38
X
32310
001
90
2
X
3,180.04
X
32310
004
90
2
X
3,790.23
X
32320
004
90
2
X
4,437.18
X
32320
002
90
2
X
4,564.39
X
32320
003
90
2
X
4,436.24
X
32320
001
90
2
X
4,643.29
X
32400
004
0
2
X
318.72
X
32400
002
0
2
X
349.59
X
32400
003
0
2
X
324.96
X
32400
001
0
2
X
410.34
X
32408
003
0
2
X
1,210.57
200.98
32408
002
0
2
X
1,210.57
200.98
32408
004
0
2
X
1,210.57
200.98
32408
001
0
2
X
1,379.01
214.61
32440
003
90
2
X
4,588.76
X
32440
002
90
2
X
4,871.52
X
32440
004
90
2
X
4,517.60
X
32440
001
90
2
X
4,911.49
X
32442
003
90
2
X
4,820.04
X
32442
002
90
2
X
5,163.75
X
32442
001
90
2
X
5,247.16
X
32442
004
90
2
X
4,765.12
X
32445
001
90
2
X
5,443.13
X
32445
004
90
2
X
4,920.53
X
32445
003
90
2
X
4,978.49
X
32445
002
90
2
X
5,352.54
X
32480
004
90
2
X
4,281.36
X
32480
001
90
2
X
4,504.95
X
32480
003
90
2
X
4,141.66
X
32480
002
90
2
X
4,491.26
X
32482
004
90
2
X
4,340.42
X
32482
001
90
2
X
4,566.34
X
32482
003
90
2
X
4,201.24
X
32482
002
90
2
X
4,552.33
X
32484
001
90
2
X
4,601.73
X
32484
004
90
2
X
4,374.39
X
32484
003
90
2
X
4,235.60
X
32484
002
90
2
X
4,587.44
X
32486
004
90
2
X
4,393.19
X
32486
002
90
2
X
4,760.91
X
32486
003
90
2
X
4,443.80
X
32486
001
90
2
X
4,837.94
X
32488
003
90
2
X
4,767.29
X
32488
002
90
2
X
5,107.13
X
32488
004
90
2
X
4,713.02
X
32488
001
90
2
X
5,189.65
X
32501
001
ZZZ
0
X
1,176.15
X
32501
003
ZZZ
0
X
1,052.05
X
32501
002
ZZZ
0
X
1,123.32
X
32501
004
ZZZ
0
X
1,036.28
X
32503
002
90
2
X
3,428.57
X
32503
003
90
2
X
3,428.57
X
32503
001
90
2
X
3,869.72
X
32503
004
90
2
X
3,428.57
X
32504
004
90
2
X
3,924.25
X
32504
003
90
2
X
3,924.25
X
32504
002
90
2
X
3,924.25
X
32504
001
90
2
X
4,424.14
X
32505
001
90
2
X
1,775.88
X
32505
003
90
2
X
1,587.33
X
32505
002
90
2
X
1,587.33
X
32505
004
90
2
X
1,587.33
X
32506
001
ZZZ
0
X
302.08
X
32506
004
ZZZ
0
X
270.78
X
32506
003
ZZZ
0
X
270.78
X
32506
002
ZZZ
0
X
270.78
X
32507
003
ZZZ
0
X
270.78
X
32507
002
ZZZ
0
X
270.78
X
32507
004
ZZZ
0
X
270.78
X
32507
001
ZZZ
0
X
302.08
X
32540
001
90
2
X
3,075.09
X
32540
004
90
2
X
2,787.11
X
32540
003
90
2
X
2,820.17
X
32540
002
90
2
X
3,025.36
X
32550
002
0
0
X
1,415.08
389.10
32550
003
0
0
X
1,415.08
389.10
32550
004
0
0
X
1,415.08
389.10
32550
001
0
0
X
1,667.71
430.67
32551
002
0
2
X
308.29
X
32551
003
0
2
X
308.29
X
32551
001
0
2
X
343.75
X
32551
004
0
2
X
308.29
X
32552
001
10
2
X
352.07
312.08
32552
003
10
2
X
311.31
277.65
32552
002
10
2
X
311.31
277.65
32552
004
10
2
X
311.31
277.65
32553
001
0
2
X
1,130.89
403.23
32553
004
0
2
X
975.09
361.58
32553
003
0
2
X
975.09
361.58
32553
002
0
2
X
975.09
361.58
32554
002
0
2
X
854.77
144.60
32554
003
0
2
X
854.77
144.60
32554
001
0
2
X
979.74
156.04
32554
004
0
2
X
854.77
144.60
32555
001
0
2
X
1,130.42
195.59
32555
004
0
2
X
986.89
180.93
32555
002
0
2
X
986.89
180.93
32555
003
0
2
X
986.89
180.93
32556
004
0
2
X
904.60
198.47
32556
002
0
2
X
904.60
198.47
32556
003
0
2
X
904.60
198.47
32556
001
0
2
X
1,033.46
214.45
32557
003
0
2
X
1,467.27
270.49
32557
002
0
2
X
1,467.27
270.49
32557
004
0
2
X
1,467.27
270.49
32557
001
0
2
X
1,688.93
300.79
32560
002
0
2
X
523.47
192.89
32560
003
0
2
X
523.47
192.89
32560
004
0
2
X
523.47
192.89
32560
001
0
2
X
611.16
212.58
32561
001
0
2
X
181.73
138.98
32561
004
0
2
X
162.08
126.05
32561
002
0
2
X
162.08
126.05
32561
003
0
2
X
162.08
126.05
32562
001
0
2
X
161.52
124.36
32562
004
0
2
X
144.13
112.81
32562
002
0
2
X
144.13
112.81
32562
003
0
2
X
144.13
112.81
32601
001
0
2
X
1,072.80
X
32601
004
0
2
X
982.97
X
32601
003
0
2
X
994.26
X
32601
002
0
2
X
1,057.47
X
32604
001
0
2
X
1,288.99
X
32604
004
0
2
X
1,379.46
X
32604
002
0
2
X
1,277.86
X
32604
003
0
2
X
1,394.66
X
32606
003
0
2
X
1,353.75
X
32606
002
0
2
X
1,264.02
X
32606
001
0
2
X
1,275.00
X
32606
004
0
2
X
1,338.92
X
32607
004
0
2
X
529.54
X
32607
003
0
2
X
529.54
X
32607
002
0
2
X
529.54
X
32607
001
0
2
X
591.80
X
32608
004
0
2
X
651.11
X
32608
002
0
2
X
651.11
X
32608
003
0
2
X
651.11
X
32608
001
0
2
X
727.50
X
32609
001
0
2
X
503.57
X
32609
003
0
2
X
449.56
X
32609
002
0
2
X
449.56
X
32609
004
0
2
X
449.56
X
32650
001
90
2
X
1,907.96
X
32650
004
90
2
X
1,890.23
X
32650
002
90
2
X
1,950.15
X
32650
003
90
2
X
1,746.56
X
32651
002
90
2
X
2,948.12
X
32651
003
90
2
X
2,733.46
X
32651
004
90
2
X
2,701.32
X
32651
001
90
2
X
3,000.18
X
32652
001
90
2
X
4,334.94
X
32652
004
90
2
X
4,163.49
X
32652
003
90
2
X
4,184.56
X
32652
002
90
2
X
4,305.60
X
32653
002
90
2
X
3,034.58
X
32653
003
90
2
X
2,586.42
X
32653
004
90
2
X
2,556.48
X
32653
001
90
2
X
3,054.25
X
32654
004
90
2
X
2,603.79
X
32654
001
90
2
X
2,918.12
X
32654
003
90
2
X
2,680.19
X
32654
002
90
2
X
2,956.32
X
32655
004
90
2
X
3,000.89
X
32655
001
90
2
X
3,250.35
X
32655
003
90
2
X
2,982.80
X
32655
002
90
2
X
3,192.88
X
32656
001
90
2
X
3,180.04
X
32656
004
90
2
X
3,790.23
X
32656
002
90
2
X
3,900.38
X
32656
003
90
2
X
3,804.85
X
32658
001
90
2
X
3,359.02
X
32658
004
90
2
X
3,223.82
X
32658
002
90
2
X
3,319.68
X
32658
003
90
2
X
3,237.99
X
32659
004
90
2
X
2,824.27
X
32659
001
90
2
X
3,411.49
X
32659
002
90
2
X
3,372.45
X
32659
003
90
2
X
3,274.24
X
32661
002
90
2
X
2,608.03
X
32661
003
90
2
X
2,447.13
X
32661
001
90
2
X
2,647.07
X
32661
004
90
2
X
2,536.09
X
32662
004
90
2
X
3,701.00
X
32662
001
90
2
X
3,876.09
X
32662
003
90
2
X
3,669.69
X
32662
002
90
2
X
3,845.68
X
32663
001
90
2
X
4,526.07
X
32663
004
90
2
X
4,301.62
X
32663
002
90
2
X
4,512.22
X
32663
003
90
2
X
4,162.10
X
32664
003
90
2
X
2,740.87
X
32664
002
90
2
X
2,939.68
X
32664
004
90
2
X
2,709.41
X
32664
001
90
2
X
3,078.73
X
32665
004
90
2
X
3,265.55
X
32665
002
90
2
X
3,558.59
X
32665
003
90
2
X
3,304.54
X
32665
001
90
2
X
3,620.08
X
32666
004
90
2
X
1,483.64
X
32666
001
90
2
X
1,661.99
X
32666
003
90
2
X
1,483.64
X
32666
002
90
2
X
1,483.64
X
32667
001
ZZZ
0
X
302.08
X
32667
004
ZZZ
0
X
270.78
X
32667
003
ZZZ
0
X
270.78
X
32667
002
ZZZ
0
X
270.78
X
32668
003
ZZZ
0
X
272.58
X
32668
002
ZZZ
0
X
272.58
X
32668
004
ZZZ
0
X
272.58
X
32668
001
ZZZ
0
X
304.54
X
32669
004
90
2
X
2,294.60
X
32669
002
90
2
X
2,294.60
X
32669
003
90
2
X
2,294.60
X
32669
001
90
2
X
2,565.61
X
32670
003
90
2
X
2,740.85
X
32670
002
90
2
X
2,740.85
X
32670
004
90
2
X
2,740.85
X
32670
001
90
2
X
3,061.72
X
32671
002
90
2
X
3,047.00
X
32671
003
90
2
X
3,047.00
X
32671
004
90
2
X
3,047.00
X
32671
001
90
2
X
3,406.11
X
32672
001
90
2
X
2,911.48
X
32672
004
90
2
X
2,603.83
X
32672
002
90
2
X
2,603.83
X
32672
003
90
2
X
2,603.83
X
32673
001
90
2
X
2,278.47
X
32673
004
90
2
X
2,045.17
X
32673
002
90
2
X
2,045.17
X
32673
003
90
2
X
2,045.17
X
32674
003
ZZZ
0
X
371.07
X
32674
002
ZZZ
0
X
371.07
X
32674
004
ZZZ
0
X
371.07
X
32674
001
ZZZ
0
X
413.63
X
32701
002
XXX
0
X
364.46
X
32701
003
XXX
0
X
364.46
X
32701
004
XXX
0
X
364.46
X
32701
001
XXX
0
X
407.62
X
32800
90
2
X
*
X
32810
002
90
2
X
2,146.14
X
32810
003
90
2
X
2,018.80
X
32810
004
90
2
X
1,996.34
X
32810
001
90
2
X
2,177.14
X
32815
001
90
2
X
4,416.16
X
32815
004
90
2
X
4,050.56
X
32815
003
90
2
X
4,097.58
X
32815
002
90
2
X
4,296.21
X
32820
90
2
X
*
X
32851
90
2
X
*
X
32852
90
2
X
*
X
32853
90
2
X
*
X
32854
004
90
2
X
9,571.89
X
32854
003
90
2
X
9,700.48
X
32854
002
90
2
X
10,359.30
X
32854
001
90
2
X
10,679.01
X
32855
XXX
2
X
*
X
32856
XXX
2
X
*
X
32900
004
90
2
X
2,929.44
X
32900
001
90
2
X
3,182.96
X
32900
003
90
2
X
2,961.69
X
32900
002
90
2
X
3,139.64
X
32905
003
90
2
X
3,607.29
X
32905
002
90
2
X
3,628.59
X
32905
001
90
2
X
3,922.87
X
32905
004
90
2
X
3,566.74
X
32906
004
90
2
X
4,502.38
X
32906
001
90
2
X
4,927.77
X
32906
002
90
2
X
4,854.56
X
32906
003
90
2
X
4,553.40
X
32940
001
90
2
X
3,520.84
X
32940
004
90
2
X
3,233.42
X
32940
002
90
2
X
3,472.06
X
32940
003
90
2
X
3,270.64
X
32960
003
0
2
X
284.14
X
32960
002
0
2
X
270.59
X
32960
004
0
2
X
282.33
X
32960
001
0
2
X
296.45
X
32994
001
0
2
X
9,888.86
786.75
32994
003
0
2
X
8,659.32
726.74
32994
002
0
2
X
8,659.32
726.74
32994
004
0
2
X
8,659.32
726.74
32997
003
0
2
X
755.77
X
32997
002
0
2
X
755.77
X
32997
001
0
2
X
836.56
X
32997
004
0
2
X
755.77
X
32998
001
0
2
X
5,642.31
528.31
32998
004
0
2
X
4,660.87
480.92
32998
002
0
2
X
4,660.87
480.92
32998
003
0
2
X
4,660.87
480.92
32999
YYY
2
X
#
X
33016
004
0
2
X
334.21
X
33016
001
0
2
X
366.59
X
33016
002
0
2
X
334.21
X
33016
003
0
2
X
334.21
X
33017
004
0
2
X
346.52
X
33017
001
0
2
X
379.23
X
33017
003
0
2
X
346.52
X
33017
002
0
2
X
346.52
X
33018
001
0
2
X
430.61
X
33018
004
0
2
X
395.10
X
33018
003
0
2
X
395.10
X
33018
002
0
2
X
395.10
X
33019
002
0
2
X
320.66
X
33019
003
0
2
X
320.66
X
33019
004
0
2
X
320.66
X
33019
001
0
2
X
350.64
X
33020
004
90
2
X
3,223.82
X
33020
001
90
2
X
3,359.02
X
33020
003
90
2
X
3,237.99
X
33020
002
90
2
X
3,319.68
X
33025
001
90
2
X
3,411.49
X
33025
004
90
2
X
2,824.27
X
33025
003
90
2
X
3,274.24
X
33025
002
90
2
X
3,372.45
X
33030
003
90
2
X
4,387.45
X
33030
002
90
2
X
4,520.65
X
33030
004
90
2
X
4,334.61
X
33030
001
90
2
X
4,861.46
X
33031
001
90
2
X
4,016.63
X
33031
003
90
2
X
3,701.70
X
33031
002
90
2
X
4,985.33
X
33031
004
90
2
X
3,659.75
X
33050
002
90
2
X
2,608.03
X
33050
003
90
2
X
2,447.13
X
33050
001
90
2
X
2,647.07
X
33050
004
90
2
X
2,536.09
X
33120
001
90
2
X
8,902.59
X
33120
004
90
2
X
7,210.52
X
33120
002
90
2
X
9,012.34
X
33120
003
90
2
X
8,248.83
X
33130
004
90
2
X
3,642.59
X
33130
001
90
2
X
3,983.78
X
33130
003
90
2
X
3,684.83
X
33130
002
90
2
X
3,963.12
X
33140
001
90
2
X
3,398.36
X
33140
004
90
2
X
3,018.32
X
33140
002
90
2
X
3,018.32
X
33140
003
90
2
X
3,018.32
X
33141
002
ZZZ
0
X
626.72
X
33141
003
ZZZ
0
X
626.72
X
33141
004
ZZZ
0
X
626.72
X
33141
001
ZZZ
0
X
701.70
X
33202
002
90
2
X
1,294.03
X
33202
003
90
2
X
1,294.03
X
33202
001
90
2
X
1,468.06
X
33202
004
90
2
X
1,294.03
X
33203
001
90
2
X
1,491.73
X
33203
004
90
2
X
1,328.20
X
33203
002
90
2
X
1,328.20
X
33203
003
90
2
X
1,328.20
X
33206
001
90
2
X
2,065.25
X
33206
003
90
2
X
1,929.91
X
33206
002
90
2
X
2,032.90
X
33206
004
90
2
X
1,916.55
X
33207
004
90
2
X
1,997.44
X
33207
002
90
2
X
2,133.76
X
33207
003
90
2
X
2,004.95
X
33207
001
90
2
X
2,167.14
X
33208
001
90
2
X
2,446.60
X
33208
004
90
2
X
2,128.33
X
33208
002
90
2
X
2,436.71
X
33208
003
90
2
X
2,262.32
X
33210
003
0
2
X
716.25
X
33210
002
0
2
X
770.33
X
33210
001
0
2
X
775.10
X
33210
004
0
2
X
721.92
X
33211
003
0
2
X
719.49
X
33211
002
0
2
X
773.70
X
33211
004
0
2
X
725.13
X
33211
001
0
2
X
778.39
X
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