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Individuals
Individuals
Unemployment Benefits
Disability Services
Find A Job
Workers' Compensation Services
Workforce Development
PennSERVE
Individual Services
Uniform Construction Code
Labor Management Relations
Misclassified Workers
Businesses
Businesses
Employer UC Info
Finding Skilled Workers
Disability Services
Workforce Development
Workers' Compensation Services
Labor-Management Relations
Pennsylvania Business One-Stop
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Employer Services
About L&I
About L&I
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Fee Schedule
>
Fee Schedule 21436-22849
Begin Main Content Area
Page Content
2021 Workers' Compensation Part B Fee Schedule
21436-22849
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
21436
4
90
2
X
3,793.09
X
21436
3
90
2
X
3,836.35
X
21436
2
90
2
X
4,056.58
X
21436
1
90
2
X
4,109.97
X
21440
90
2
X
*
X
21445
90
2
X
*
X
21450
3
90
2
X
563.49
X
21450
2
90
2
X
579.88
X
21450
1
90
2
X
596.06
X
21450
4
90
2
X
626.05
X
21451
4
90
2
X
1,058.28
X
21451
3
90
2
X
1,072.11
X
21451
2
90
2
X
1,148.30
X
21451
1
90
2
X
1,166.56
X
21452
4
90
2
X
300.54
X
21452
3
90
2
X
304.08
X
21452
1
90
2
X
326.78
X
21452
2
90
2
X
416.74
X
21453
2
90
2
X
1,080.92
X
21453
4
90
2
X
1,082.84
X
21453
3
90
2
X
1,096.91
X
21453
1
90
2
X
1,182.22
X
21454
4
90
2
X
1,740.59
X
21454
3
90
2
X
1,763.93
X
21454
2
90
2
X
1,901.30
X
21454
1
90
2
X
1,934.27
X
21461
4
90
2
X
1,770.78
X
21461
3
90
2
X
1,793.85
X
21461
2
90
2
X
1,923.50
X
21461
1
90
2
X
1,954.64
X
21462
3
90
2
X
2,025.09
X
21462
2
90
2
X
2,185.98
X
21462
1
90
2
X
2,198.47
X
21462
4
90
2
X
2,355.37
X
21465
4
90
2
X
1,809.67
X
21465
3
90
2
X
1,831.36
X
21465
2
90
2
X
1,940.72
X
21465
1
90
2
X
1,967.14
X
21470
3
90
2
X
2,480.78
X
21470
4
90
2
X
2,896.43
X
21470
1
90
2
X
2,922.41
X
21470
2
90
2
X
3,018.67
X
21480
3
0
2
X
208.24
X
21480
1
0
2
X
225.28
X
21480
2
0
2
X
227.87
X
21480
4
0
2
X
236.78
X
21485
4
90
2
X
579.07
X
21485
3
90
2
X
581.77
X
21485
2
90
2
X
593.75
X
21485
1
90
2
X
596.61
X
21490
4
90
2
X
1,581.24
X
21490
3
90
2
X
1,599.69
X
21490
2
90
2
X
1,678.57
X
21490
1
90
2
X
1,697.67
X
21497
4
90
2
X
697.24
X
21497
3
90
2
X
706.08
X
21497
2
90
2
X
750.18
X
21497
1
90
2
X
760.78
X
21499
YYY
2
X
#
X
21501
4
90
2
X
494.94
X
21501
3
90
2
X
500.54
X
21501
2
90
2
X
528.43
X
21501
1
90
2
X
535.21
X
21502
4
90
2
X
1,007.22
X
21502
3
90
2
X
1,018.74
X
21502
2
90
2
X
1,086.12
X
21502
1
90
2
X
1,102.52
X
21510
4
90
2
X
823.99
X
21510
2
90
2
X
885.65
X
21510
3
90
2
X
917.52
X
21510
1
90
2
X
1,020.23
X
21550
4
10
2
X
215.49
X
21550
3
10
2
X
221.32
X
21550
1
10
2
X
225.72
X
21550
2
10
2
X
231.33
X
21552
2
90
2
X
644.17
X
21552
3
90
2
X
644.17
X
21552
4
90
2
X
644.17
X
21552
1
90
2
X
723.36
X
21554
2
90
2
X
1,058.64
X
21554
3
90
2
X
1,058.64
X
21554
4
90
2
X
1,058.64
X
21554
1
90
2
X
1,184.41
X
21555
4
90
2
X
510.80
X
21555
3
90
2
X
517.78
X
21555
1
90
2
X
549.17
X
21555
2
90
2
X
555.25
X
21556
4
90
2
X
683.13
X
21556
2
90
2
X
721.13
X
21556
1
90
2
X
732.89
X
21556
3
90
2
X
833.88
X
21557
4
90
2
X
1,470.93
X
21557
3
90
2
X
1,482.23
X
21557
2
90
2
X
1,534.95
X
21557
1
90
2
X
1,569.05
X
21558
2
90
2
X
1,991.17
X
21558
3
90
2
X
1,991.17
X
21558
4
90
2
X
1,991.17
X
21558
1
90
2
X
2,224.19
X
21600
3
90
2
X
1,102.19
X
21600
2
90
2
X
1,137.37
X
21600
4
90
2
X
1,185.11
X
21600
1
90
2
X
1,228.60
X
21601
2
90
2
X
1,412.31
X
21601
3
90
2
X
1,412.31
X
21601
4
90
2
X
1,412.31
X
21601
1
90
2
X
1,566.69
X
21602
2
90
2
X
1,889.78
X
21602
3
90
2
X
1,889.78
X
21602
4
90
2
X
1,889.78
X
21602
1
90
2
X
2,100.62
X
21603
2
90
2
X
2,093.12
X
21603
3
90
2
X
2,093.12
X
21603
4
90
2
X
2,093.12
X
21603
1
90
2
X
2,325.60
X
21610
3
90
2
X
810.11
X
21610
1
90
2
X
842.11
X
21610
2
90
2
X
882.33
X
21610
4
90
2
X
1,278.27
X
21615
4
90
2
X
1,854.11
X
21615
3
90
2
X
1,876.48
X
21615
2
90
2
X
2,030.45
X
21615
1
90
2
X
2,067.77
X
21616
4
90
2
X
1,753.94
X
21616
2
90
2
X
1,898.61
X
21616
3
90
2
X
2,051.90
X
21616
1
90
2
X
2,117.05
X
21620
4
90
2
X
1,239.71
X
21620
3
90
2
X
1,295.63
X
21620
2
90
2
X
1,354.72
X
21620
1
90
2
X
1,378.97
X
21627
4
90
2
X
1,056.22
X
21627
3
90
2
X
1,068.66
X
21627
2
90
2
X
1,145.61
X
21627
1
90
2
X
1,164.30
X
21630
4
90
2
X
2,540.14
X
21630
3
90
2
X
2,569.55
X
21630
2
90
2
X
2,746.87
X
21630
1
90
2
X
2,789.85
X
21632
4
90
2
X
2,679.12
X
21632
3
90
2
X
2,709.90
X
21632
2
90
2
X
2,898.66
X
21632
1
90
2
X
2,944.51
X
21685
2
90
2
X
1,629.19
X
21685
3
90
2
X
1,629.19
X
21685
4
90
2
X
1,629.19
X
21685
1
90
2
X
1,827.73
X
21700
2
90
2
X
860.35
X
21700
4
90
2
X
926.35
X
21700
3
90
2
X
937.35
X
21700
1
90
2
X
1,006.20
X
21705
4
90
2
X
1,311.83
X
21705
3
90
2
X
1,326.45
X
21705
2
90
2
X
1,411.46
X
21705
1
90
2
X
1,432.15
X
21720
4
90
2
X
863.88
X
21720
3
90
2
X
874.06
X
21720
2
90
2
X
1,024.56
X
21720
1
90
2
X
1,166.22
X
21725
4
90
2
X
1,068.46
X
21725
3
90
2
X
1,080.97
X
21725
2
90
2
X
1,151.41
X
21725
1
90
2
X
1,168.47
X
21740
4
90
2
X
2,301.50
X
21740
3
90
2
X
2,327.54
X
21740
2
90
2
X
2,476.55
X
21740
1
90
2
X
2,512.73
X
21742
90
2
X
*
X
21743
90
2
X
*
X
21750
4
90
2
X
1,660.39
X
21750
3
90
2
X
1,679.52
X
21750
2
90
2
X
1,799.44
X
21750
1
90
2
X
1,828.60
X
21811
2
0
2
X
719.63
743.76
21811
3
0
2
X
719.63
743.76
21811
4
0
2
X
719.63
743.76
21811
1
0
2
X
767.71
795.94
21812
2
0
2
X
861.23
885.36
21812
3
0
2
X
861.23
885.36
21812
4
0
2
X
861.23
885.36
21812
1
0
2
X
917.59
945.81
21813
2
0
2
X
1,175.98
1,194.74
21813
3
0
2
X
1,175.98
1,194.74
21813
4
0
2
X
1,175.98
1,194.74
21813
1
0
2
X
1,252.77
1,274.74
21820
4
90
2
X
282.24
X
21820
3
90
2
X
283.48
X
21820
2
90
2
X
287.79
X
21820
1
90
2
X
292.25
X
21825
3
90
2
X
976.04
X
21825
2
90
2
X
1,029.75
X
21825
4
90
2
X
1,304.13
X
21825
1
90
2
X
1,440.90
X
21899
YYY
2
X
#
X
21920
3
10
2
X
212.69
X
21920
4
10
2
X
220.72
X
21920
1
10
2
X
222.20
X
21920
2
10
2
X
231.31
X
21925
3
90
2
X
470.08
X
21925
2
90
2
X
476.72
X
21925
1
90
2
X
493.39
X
21925
4
90
2
X
575.20
X
21930
4
90
2
X
769.09
X
21930
3
90
2
X
774.32
X
21930
2
90
2
X
801.73
X
21930
1
90
2
X
809.58
X
21931
2
90
2
X
675.20
X
21931
3
90
2
X
675.20
X
21931
4
90
2
X
675.20
X
21931
1
90
2
X
758.58
X
21932
2
90
2
X
969.55
X
21932
3
90
2
X
969.55
X
21932
4
90
2
X
969.55
X
21932
1
90
2
X
1,090.31
X
21933
2
90
2
X
1,070.45
X
21933
3
90
2
X
1,070.45
X
21933
4
90
2
X
1,070.45
X
21933
1
90
2
X
1,202.05
X
21935
3
90
2
X
1,607.29
X
21935
2
90
2
X
1,680.88
X
21935
1
90
2
X
1,694.99
X
21935
4
90
2
X
2,217.23
X
21936
2
90
2
X
2,076.04
X
21936
3
90
2
X
2,076.04
X
21936
4
90
2
X
2,076.04
X
21936
1
90
2
X
2,322.82
X
22010
2
90
2
X
1,270.88
X
22010
3
90
2
X
1,270.88
X
22010
4
90
2
X
1,270.88
X
22010
1
90
2
X
1,455.81
X
22015
2
90
2
X
1,259.73
X
22015
3
90
2
X
1,259.73
X
22015
4
90
2
X
1,259.73
X
22015
1
90
2
X
1,443.04
X
22100
4
90
2
X
1,354.94
X
22100
3
90
2
X
1,371.11
X
22100
2
90
2
X
1,456.77
X
22100
1
90
2
X
1,477.46
X
22101
4
90
2
X
1,404.15
X
22101
3
90
2
X
1,420.64
X
22101
2
90
2
X
1,522.14
X
22101
1
90
2
X
1,546.74
X
22102
4
90
2
X
1,219.36
X
22102
2
90
2
X
1,301.11
X
22102
1
90
2
X
1,317.64
X
22102
3
90
2
X
1,638.57
X
22103
4
ZZZ
0
X
449.79
X
22103
3
ZZZ
0
X
456.69
X
22103
2
ZZZ
0
X
488.05
X
22103
1
ZZZ
0
X
511.47
X
22110
1
90
2
X
1,921.23
X
22110
4
90
2
X
2,020.56
X
22110
3
90
2
X
2,044.51
X
22110
2
90
2
X
2,188.85
X
22112
1
90
2
X
1,930.00
X
22112
4
90
2
X
2,034.90
X
22112
3
90
2
X
2,059.10
X
22112
2
90
2
X
2,203.94
X
22114
4
90
2
X
1,766.09
X
22114
3
90
2
X
1,786.39
X
22114
2
90
2
X
1,898.06
X
22114
1
90
2
X
1,925.22
X
22116
4
ZZZ
0
X
445.36
X
22116
3
ZZZ
0
X
452.16
X
22116
2
ZZZ
0
X
483.15
X
22116
1
ZZZ
0
X
506.17
X
22206
2
90
2
X
3,293.28
X
22206
3
90
2
X
3,293.28
X
22206
4
90
2
X
3,293.28
X
22206
1
90
2
X
3,733.71
X
22207
2
90
2
X
3,251.11
X
22207
3
90
2
X
3,251.11
X
22207
4
90
2
X
3,251.11
X
22207
1
90
2
X
3,684.41
X
22208
2
ZZZ
0
X
835.61
X
22208
3
ZZZ
0
X
835.61
X
22208
4
ZZZ
0
X
835.61
X
22208
1
ZZZ
0
X
955.19
X
22210
4
90
2
X
3,423.21
X
22210
3
90
2
X
3,462.23
X
22210
2
90
2
X
3,684.90
X
22210
1
90
2
X
3,911.83
X
22212
4
90
2
X
3,362.86
X
22212
3
90
2
X
3,403.35
X
22212
2
90
2
X
3,650.73
X
22212
1
90
2
X
3,710.60
X
22214
4
90
2
X
3,163.31
X
22214
3
90
2
X
3,200.58
X
22214
2
90
2
X
3,430.64
X
22214
1
90
2
X
3,486.27
X
22216
4
ZZZ
0
X
1,095.33
X
22216
3
ZZZ
0
X
1,111.78
X
22216
2
ZZZ
0
X
1,185.82
X
22216
1
ZZZ
0
X
1,241.77
X
22220
4
90
2
X
3,470.09
X
22220
3
90
2
X
3,511.29
X
22220
2
90
2
X
3,751.55
X
22220
1
90
2
X
3,809.66
X
22222
4
90
2
X
3,115.35
X
22222
3
90
2
X
3,152.05
X
22222
2
90
2
X
3,984.28
X
22222
1
90
2
X
4,334.85
X
22224
4
90
2
X
3,304.49
X
22224
3
90
2
X
3,342.76
X
22224
2
90
2
X
3,574.12
X
22224
1
90
2
X
3,630.24
X
22226
4
ZZZ
0
X
1,095.33
X
22226
3
ZZZ
0
X
1,111.78
X
22226
2
ZZZ
0
X
1,185.82
X
22226
1
ZZZ
0
X
1,241.77
X
22310
3
90
2
X
803.89
X
22310
4
90
2
X
861.45
X
22310
2
90
2
X
986.74
X
22310
1
90
2
X
998.64
X
22315
3
90
2
X
1,314.20
X
22315
1
90
2
X
1,417.14
X
22315
4
90
2
X
1,419.96
X
22315
2
90
2
X
1,460.15
X
22318
2
90
2
X
2,850.36
X
22318
3
90
2
X
2,850.36
X
22318
4
90
2
X
2,850.36
X
22318
1
90
2
X
3,253.02
X
22319
2
90
2
X
3,219.67
X
22319
3
90
2
X
3,219.67
X
22319
4
90
2
X
3,219.67
X
22319
1
90
2
X
3,675.56
X
22325
4
90
2
X
2,375.01
X
22325
3
90
2
X
2,401.53
X
22325
2
90
2
X
3,568.27
X
22325
1
90
2
X
3,582.20
X
22326
4
90
2
X
3,264.62
X
22326
3
90
2
X
3,303.37
X
22326
2
90
2
X
3,540.67
X
22326
1
90
2
X
3,598.16
X
22327
4
90
2
X
3,154.16
X
22327
2
90
2
X
3,411.58
X
22327
1
90
2
X
3,464.60
X
22327
3
90
2
X
3,579.37
X
22328
4
ZZZ
0
X
886.02
X
22328
3
ZZZ
0
X
899.63
X
22328
2
ZZZ
0
X
961.34
X
22328
1
ZZZ
0
X
1,007.24
X
22505
4
10
2
X
202.51
X
22505
2
10
2
X
211.40
X
22505
1
10
2
X
216.16
X
22505
3
10
2
X
323.16
X
22510
2
10
2
X
2,217.67
597.58
22510
3
10
2
X
2,217.67
597.58
22510
4
10
2
X
2,217.67
597.58
22510
1
10
2
X
2,539.60
643.96
22511
2
10
2
X
2,195.05
559.76
22511
3
10
2
X
2,195.05
559.76
22511
4
10
2
X
2,195.05
559.76
22511
1
10
2
X
2,517.01
603.59
22512
2
ZZZ
0
X
1,226.08
273.23
22512
3
ZZZ
0
X
1,226.08
273.23
22512
4
ZZZ
0
X
1,226.08
273.23
22512
1
ZZZ
0
X
1,407.43
292.53
22513
2
10
2
X
9,263.27
680.12
22513
3
10
2
X
9,263.27
680.12
22513
4
10
2
X
9,263.27
680.12
22513
1
10
2
X
10,778.03
735.11
22514
2
10
2
X
9,226.51
635.30
22514
3
10
2
X
9,226.51
635.30
22514
4
10
2
X
9,226.51
635.30
22514
1
10
2
X
10,739.63
687.26
22515
2
ZZZ
0
X
5,595.23
284.89
22515
3
ZZZ
0
X
5,595.23
284.89
22515
4
ZZZ
0
X
5,595.23
284.89
22515
1
ZZZ
0
X
6,519.73
306.22
22526
2
10
2
X
2,854.88
484.83
22526
3
10
2
X
2,854.88
484.83
22526
4
10
2
X
2,854.88
484.83
22526
1
10
2
X
3,456.06
556.42
22527
2
ZZZ
0
X
2,314.79
224.27
22527
3
ZZZ
0
X
2,314.79
224.27
22527
4
ZZZ
0
X
2,314.79
224.27
22527
1
ZZZ
0
X
2,813.66
256.03
22532
2
90
2
X
2,858.73
X
22532
3
90
2
X
2,858.73
X
22532
4
90
2
X
2,858.73
X
22532
1
90
2
X
3,256.29
X
22533
2
90
2
X
2,673.09
X
22533
3
90
2
X
2,673.09
X
22533
4
90
2
X
2,673.09
X
22533
1
90
2
X
3,023.85
X
22534
2
ZZZ
0
X
674.15
X
22534
3
ZZZ
0
X
674.15
X
22534
4
ZZZ
0
X
674.15
X
22534
1
ZZZ
0
X
767.73
X
22548
4
90
2
X
4,452.05
X
22548
3
90
2
X
4,505.50
X
22548
1
90
2
X
4,763.48
X
22548
2
90
2
X
4,835.41
X
22551
2
90
2
X
2,586.18
X
22551
3
90
2
X
2,586.18
X
22551
4
90
2
X
2,586.18
X
22551
1
90
2
X
2,921.90
X
22552
2
ZZZ
0
X
604.36
X
22552
3
ZZZ
0
X
604.36
X
22552
4
ZZZ
0
X
604.36
X
22552
1
ZZZ
0
X
679.13
X
22554
4
90
2
X
3,599.10
X
22554
3
90
2
X
3,624.52
X
22554
2
90
2
X
3,938.67
X
22554
1
90
2
X
4,044.87
X
22556
4
90
2
X
4,258.37
X
22556
3
90
2
X
4,309.47
X
22556
2
90
2
X
4,622.03
X
22556
1
90
2
X
4,697.64
X
22558
4
90
2
X
4,016.92
X
22558
3
90
2
X
4,064.95
X
22558
2
90
2
X
4,359.08
X
22558
1
90
2
X
4,430.30
X
22585
4
ZZZ
0
X
1,042.31
X
22585
3
ZZZ
0
X
1,054.82
X
22585
2
ZZZ
0
X
1,133.74
X
22585
1
ZZZ
0
X
1,152.83
X
22586
2
90
2
X
2,140.54
X
22586
3
90
2
X
2,140.54
X
22586
4
90
2
X
2,140.54
X
22586
1
90
2
X
2,391.41
X
22590
4
90
2
X
3,728.02
X
22590
3
90
2
X
3,811.51
X
22590
2
90
2
X
3,995.01
X
22590
1
90
2
X
4,274.48
X
22595
4
90
2
X
3,997.94
X
22595
3
90
2
X
4,046.90
X
22595
2
90
2
X
4,366.80
X
22595
1
90
2
X
4,444.15
X
22600
4
90
2
X
3,577.33
X
22600
3
90
2
X
3,620.82
X
22600
2
90
2
X
3,846.47
X
22600
1
90
2
X
4,014.67
X
22610
4
90
2
X
3,133.97
X
22610
2
90
2
X
3,413.25
X
22610
1
90
2
X
3,495.23
X
22610
3
90
2
X
3,541.00
X
22612
4
90
2
X
3,920.37
X
22612
1
90
2
X
3,937.53
X
22612
3
90
2
X
3,967.05
X
22612
2
90
2
X
4,018.64
X
22614
4
ZZZ
0
X
1,187.53
X
22614
3
ZZZ
0
X
1,205.48
X
22614
2
ZZZ
0
X
1,285.84
X
22614
1
ZZZ
0
X
1,345.68
X
22630
3
90
2
X
3,785.34
X
22630
4
90
2
X
4,166.40
X
22630
2
90
2
X
4,380.46
X
22630
1
90
2
X
4,447.40
X
22632
4
ZZZ
0
X
1,005.28
X
22632
3
ZZZ
0
X
1,020.69
X
22632
2
ZZZ
0
X
1,090.76
X
22632
1
ZZZ
0
X
1,142.90
X
22633
2
90
2
X
2,643.10
X
22633
3
90
2
X
2,643.10
X
22633
4
90
2
X
2,643.10
X
22633
1
90
2
X
2,983.16
X
22634
2
ZZZ
0
X
718.60
X
22634
3
ZZZ
0
X
718.60
X
22634
4
ZZZ
0
X
718.60
X
22634
1
ZZZ
0
X
810.63
X
22800
4
90
2
X
3,695.71
X
22800
3
90
2
X
3,741.58
X
22800
2
90
2
X
4,040.23
X
22800
1
90
2
X
4,112.37
X
22802
4
90
2
X
5,650.52
X
22802
3
90
2
X
5,702.92
X
22802
2
90
2
X
5,875.75
X
22802
1
90
2
X
5,950.77
X
22804
4
90
2
X
6,213.97
X
22804
3
90
2
X
6,306.76
X
22804
2
90
2
X
6,715.59
X
22804
1
90
2
X
7,021.03
X
22808
4
90
2
X
4,266.67
X
22808
3
90
2
X
4,329.46
X
22808
2
90
2
X
4,603.43
X
22808
1
90
2
X
4,810.82
X
22810
4
90
2
X
4,462.59
X
22810
3
90
2
X
4,513.75
X
22810
2
90
2
X
4,804.53
X
22810
1
90
2
X
4,875.04
X
22812
4
90
2
X
5,043.36
X
22812
3
90
2
X
5,104.08
X
22812
2
90
2
X
5,475.15
X
22812
1
90
2
X
5,564.93
X
22818
2
90
2
X
4,885.24
X
22818
3
90
2
X
4,885.24
X
22818
4
90
2
X
4,885.24
X
22818
1
90
2
X
5,585.84
X
22819
2
90
2
X
5,235.07
X
22819
3
90
2
X
5,235.07
X
22819
4
90
2
X
5,235.07
X
22819
1
90
2
X
5,948.05
X
22830
4
90
2
X
2,232.40
X
22830
3
90
2
X
2,260.12
X
22830
2
90
2
X
2,440.98
X
22830
1
90
2
X
2,484.71
X
22840
4
ZZZ
0
X
3,178.44
X
22840
3
ZZZ
0
X
3,440.60
X
22840
2
ZZZ
0
X
4,078.28
X
22840
1
ZZZ
0
X
4,133.72
X
22841
XXX
9
X
*
X
22842
4
ZZZ
0
X
3,559.68
X
22842
3
ZZZ
0
X
3,604.39
X
22842
1
ZZZ
0
X
3,994.59
X
22842
2
ZZZ
0
X
4,180.80
X
22843
4
ZZZ
0
X
1,722.97
X
22843
3
ZZZ
0
X
1,749.40
X
22843
2
ZZZ
0
X
1,869.40
X
22843
1
ZZZ
0
X
1,958.51
X
22844
4
ZZZ
0
X
2,105.46
X
22844
3
ZZZ
0
X
2,137.77
X
22844
2
ZZZ
0
X
2,284.37
X
22844
1
ZZZ
0
X
2,393.23
X
22845
4
ZZZ
0
X
2,907.39
X
22845
3
ZZZ
0
X
2,943.41
X
22845
2
ZZZ
0
X
3,197.54
X
22845
1
ZZZ
0
X
3,259.03
X
22846
4
ZZZ
0
X
1,590.95
X
22846
3
ZZZ
0
X
1,615.34
X
22846
2
ZZZ
0
X
1,726.11
X
22846
1
ZZZ
0
X
1,808.37
X
22847
4
ZZZ
0
X
1,767.51
X
22847
3
ZZZ
0
X
1,794.61
X
22847
2
ZZZ
0
X
1,917.74
X
22847
1
ZZZ
0
X
2,009.28
X
22848
4
ZZZ
0
X
1,152.81
X
22848
3
ZZZ
0
X
1,170.53
X
22848
2
ZZZ
0
X
1,250.89
X
22848
1
ZZZ
0
X
1,310.56
X
22849
4
90
2
X
2,337.98
X
22849
3
90
2
X
2,366.00
X
22849
2
90
2
X
2,537.25
X
22849
1
90
2
X
2,578.72
X
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