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2020 Workers' Compensation Part B Fee Schedule

21436-22849

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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
21436   4 90 2 X 3,626.28 X
21436   3 90 2 X 3,667.64 X
21436   2 90 2 X 3,878.18 X
21436   1 90 2 X 3,929.23 X
21440     90 2 X * X
21445     90 2 X * X
21450   3 90 2 X 538.71 X
21450   2 90 2 X 554.38 X
21450   1 90 2 X 569.85 X
21450   4 90 2 X 598.52 X
21451   4 90 2 X 1,011.74 X
21451   3 90 2 X 1,024.96 X
21451   2 90 2 X 1,097.80 X
21451   1 90 2 X 1,115.26 X
21452   4 90 2 X 287.32 X
21452   3 90 2 X 290.71 X
21452   1 90 2 X 312.41 X
21452   2 90 2 X 398.41 X
21453   2 90 2 X 1,033.38 X
21453   4 90 2 X 1,035.22 X
21453   3 90 2 X 1,048.67 X
21453   1 90 2 X 1,130.23 X
21454   4 90 2 X 1,664.04 X
21454   3 90 2 X 1,686.36 X
21454   2 90 2 X 1,817.69 X
21454   1 90 2 X 1,849.21 X
21461   4 90 2 X 1,692.91 X
21461   3 90 2 X 1,714.96 X
21461   2 90 2 X 1,838.91 X
21461   1 90 2 X 1,868.68 X
21462   3 90 2 X 1,936.03 X
21462   2 90 2 X 2,089.85 X
21462   1 90 2 X 2,101.79 X
21462   4 90 2 X 2,251.79 X
21465   4 90 2 X 1,730.09 X
21465   3 90 2 X 1,750.82 X
21465   2 90 2 X 1,855.37 X
21465   1 90 2 X 1,880.63 X
21470   3 90 2 X 2,371.68 X
21470   4 90 2 X 2,769.05 X
21470   1 90 2 X 2,793.89 X
21470   2 90 2 X 2,885.92 X
21480   3 0 2 X 199.08 X
21480   1 0 2 X 215.37 X
21480   2 0 2 X 217.85 X
21480   4 0 2 X 226.37 X
21485   4 90 2 X 553.60 X
21485   3 90 2 X 556.19 X
21485   2 90 2 X 567.64 X
21485   1 90 2 X 570.37 X
21490   4 90 2 X 1,511.70 X
21490   3 90 2 X 1,529.34 X
21490   2 90 2 X 1,604.75 X
21490   1 90 2 X 1,623.01 X
21497   4 90 2 X 666.58 X
21497   3 90 2 X 675.03 X
21497   2 90 2 X 717.19 X
21497   1 90 2 X 727.32 X
21499     YYY 2 X * X
21501   4 90 2 X 473.17 X
21501   3 90 2 X 478.53 X
21501   2 90 2 X 505.19 X
21501   1 90 2 X 511.67 X
21502   4 90 2 X 962.93 X
21502   3 90 2 X 973.94 X
21502   2 90 2 X 1,038.36 X
21502   1 90 2 X 1,054.03 X
21510   4 90 2 X 787.75 X
21510   2 90 2 X 846.70 X
21510   3 90 2 X 877.17 X
21510   1 90 2 X 975.36 X
21550   4 10 2 X 206.01 X
21550   3 10 2 X 211.59 X
21550   1 10 2 X 215.79 X
21550   2 10 2 X 221.16 X
21552   2 90 2 X 615.84 X
21552   3 90 2 X 615.84 X
21552   4 90 2 X 615.84 X
21552   1 90 2 X 691.55 X
21554   2 90 2 X 1,012.08 X
21554   3 90 2 X 1,012.08 X
21554   4 90 2 X 1,012.08 X
21554   1 90 2 X 1,132.32 X
21555   4 90 2 X 488.34 X
21555   3 90 2 X 495.01 X
21555   1 90 2 X 525.02 X
21555   2 90 2 X 530.83 X
21556   4 90 2 X 653.09 X
21556   2 90 2 X 689.42 X
21556   1 90 2 X 700.66 X
21556   3 90 2 X 797.21 X
21557   4 90 2 X 1,406.24 X
21557   3 90 2 X 1,417.05 X
21557   2 90 2 X 1,467.45 X
21557   1 90 2 X 1,500.05 X
21558   2 90 2 X 1,903.60 X
21558   3 90 2 X 1,903.60 X
21558   4 90 2 X 1,903.60 X
21558   1 90 2 X 2,126.38 X
21600   3 90 2 X 1,053.72 X
21600   2 90 2 X 1,087.35 X
21600   4 90 2 X 1,132.99 X
21600   1 90 2 X 1,174.57 X
21601   2 90 2 X 1,350.20 X
21601   3 90 2 X 1,350.20 X
21601   4 90 2 X 1,350.20 X
21601   1 90 2 X 1,497.79 X
21602   2 90 2 X 1,806.67 X
21602   3 90 2 X 1,806.67 X
21602   4 90 2 X 1,806.67 X
21602   1 90 2 X 2,008.24 X
21603   2 90 2 X 2,001.07 X
21603   3 90 2 X 2,001.07 X
21603   4 90 2 X 2,001.07 X
21603   1 90 2 X 2,223.33 X
21610   3 90 2 X 774.48 X
21610   1 90 2 X 805.08 X
21610   2 90 2 X 843.53 X
21610   4 90 2 X 1,222.06 X
21615   4 90 2 X 1,772.57 X
21615   3 90 2 X 1,793.96 X
21615   2 90 2 X 1,941.16 X
21615   1 90 2 X 1,976.84 X
21616   4 90 2 X 1,676.81 X
21616   2 90 2 X 1,815.11 X
21616   3 90 2 X 1,961.66 X
21616   1 90 2 X 2,023.95 X
21620   4 90 2 X 1,185.19 X
21620   3 90 2 X 1,238.65 X
21620   2 90 2 X 1,295.14 X
21620   1 90 2 X 1,318.33 X
21627   4 90 2 X 1,009.77 X
21627   3 90 2 X 1,021.66 X
21627   2 90 2 X 1,095.23 X
21627   1 90 2 X 1,113.10 X
21630   4 90 2 X 2,428.43 X
21630   3 90 2 X 2,456.55 X
21630   2 90 2 X 2,626.07 X
21630   1 90 2 X 2,667.16 X
21632   4 90 2 X 2,561.30 X
21632   3 90 2 X 2,590.73 X
21632   2 90 2 X 2,771.19 X
21632   1 90 2 X 2,815.02 X
21685   2 90 2 X 1,557.54 X
21685   3 90 2 X 1,557.54 X
21685   4 90 2 X 1,557.54 X
21685   1 90 2 X 1,747.35 X
21700   2 90 2 X 822.51 X
21700   4 90 2 X 885.61 X
21700   3 90 2 X 896.13 X
21700   1 90 2 X 961.95 X
21705   4 90 2 X 1,254.14 X
21705   3 90 2 X 1,268.12 X
21705   2 90 2 X 1,349.39 X
21705   1 90 2 X 1,369.17 X
21720   4 90 2 X 825.89 X
21720   3 90 2 X 835.62 X
21720   2 90 2 X 979.50 X
21720   1 90 2 X 1,114.93 X
21725   4 90 2 X 1,021.47 X
21725   3 90 2 X 1,033.43 X
21725   2 90 2 X 1,100.77 X
21725   1 90 2 X 1,117.08 X
21740   4 90 2 X 2,200.29 X
21740   3 90 2 X 2,225.18 X
21740   2 90 2 X 2,367.64 X
21740   1 90 2 X 2,402.23 X
21742     90 2 X * X
21743     90 2 X * X
21750   4 90 2 X 1,587.37 X
21750   3 90 2 X 1,605.66 X
21750   2 90 2 X 1,720.31 X
21750   1 90 2 X 1,748.18 X
21811   2 0 2 X 687.98 711.05
21811   3 0 2 X 687.98 711.05
21811   4 0 2 X 687.98 711.05
21811   1 0 2 X 733.95 760.94
21812   2 0 2 X 823.36 846.42
21812   3 0 2 X 823.36 846.42
21812   4 0 2 X 823.36 846.42
21812   1 0 2 X 877.24 904.22
21813   2 0 2 X 1,124.26 1,142.20
21813   3 0 2 X 1,124.26 1,142.20
21813   4 0 2 X 1,124.26 1,142.20
21813   1 0 2 X 1,197.68 1,218.68
21820   4 90 2 X 269.83 X
21820   3 90 2 X 271.01 X
21820   2 90 2 X 275.13 X
21820   1 90 2 X 279.40 X
21825   3 90 2 X 933.12 X
21825   2 90 2 X 984.46 X
21825   4 90 2 X 1,246.78 X
21825   1 90 2 X 1,377.53 X
21899     YYY 2 X * X
21920   3 10 2 X 203.34 X
21920   4 10 2 X 211.01 X
21920   1 10 2 X 212.43 X
21920   2 10 2 X 221.14 X
21925   3 90 2 X 449.41 X
21925   2 90 2 X 455.76 X
21925   1 90 2 X 471.69 X
21925   4 90 2 X 549.90 X
21930   4 90 2 X 735.27 X
21930   3 90 2 X 740.27 X
21930   2 90 2 X 766.47 X
21930   1 90 2 X 773.98 X
21931   2 90 2 X 645.51 X
21931   3 90 2 X 645.51 X
21931   4 90 2 X 645.51 X
21931   1 90 2 X 725.22 X
21932   2 90 2 X 926.91 X
21932   3 90 2 X 926.91 X
21932   4 90 2 X 926.91 X
21932   1 90 2 X 1,042.36 X
21933   2 90 2 X 1,023.37 X
21933   3 90 2 X 1,023.37 X
21933   4 90 2 X 1,023.37 X
21933   1 90 2 X 1,149.19 X
21935   3 90 2 X 1,536.61 X
21935   2 90 2 X 1,606.96 X
21935   1 90 2 X 1,620.45 X
21935   4 90 2 X 2,119.72 X
21936   2 90 2 X 1,984.74 X
21936   3 90 2 X 1,984.74 X
21936   4 90 2 X 1,984.74 X
21936   1 90 2 X 2,220.67 X
22010   2 90 2 X 1,214.99 X
22010   3 90 2 X 1,214.99 X
22010   4 90 2 X 1,214.99 X
22010   1 90 2 X 1,391.79 X
22015   2 90 2 X 1,204.33 X
22015   3 90 2 X 1,204.33 X
22015   4 90 2 X 1,204.33 X
22015   1 90 2 X 1,379.58 X
22100   4 90 2 X 1,295.35 X
22100   3 90 2 X 1,310.81 X
22100   2 90 2 X 1,392.71 X
22100   1 90 2 X 1,412.49 X
22101   4 90 2 X 1,342.40 X
22101   3 90 2 X 1,358.16 X
22101   2 90 2 X 1,455.20 X
22101   1 90 2 X 1,478.72 X
22102   4 90 2 X 1,165.74 X
22102   2 90 2 X 1,243.89 X
22102   1 90 2 X 1,259.69 X
22102   3 90 2 X 1,566.51 X
22103   4 ZZZ 0 X 430.01 X
22103   3 ZZZ 0 X 436.61 X
22103   2 ZZZ 0 X 466.59 X
22103   1 ZZZ 0 X 488.98 X
22110   1 90 2 X 1,836.74 X
22110   4 90 2 X 1,931.70 X
22110   3 90 2 X 1,954.60 X
22110   2 90 2 X 2,092.59 X
22112   1 90 2 X 1,845.12 X
22112   4 90 2 X 1,945.41 X
22112   3 90 2 X 1,968.55 X
22112   2 90 2 X 2,107.02 X
22114   4 90 2 X 1,688.42 X
22114   3 90 2 X 1,707.83 X
22114   2 90 2 X 1,814.59 X
22114   1 90 2 X 1,840.55 X
22116   4 ZZZ 0 X 425.77 X
22116   3 ZZZ 0 X 432.28 X
22116   2 ZZZ 0 X 461.90 X
22116   1 ZZZ 0 X 483.91 X
22206   2 90 2 X 3,148.45 X
22206   3 90 2 X 3,148.45 X
22206   4 90 2 X 3,148.45 X
22206   1 90 2 X 3,569.51 X
22207   2 90 2 X 3,108.14 X
22207   3 90 2 X 3,108.14 X
22207   4 90 2 X 3,108.14 X
22207   1 90 2 X 3,522.38 X
22208   2 ZZZ 0 X 798.86 X
22208   3 ZZZ 0 X 798.86 X
22208   4 ZZZ 0 X 798.86 X
22208   1 ZZZ 0 X 913.18 X
22210   4 90 2 X 3,272.67 X
22210   3 90 2 X 3,309.97 X
22210   2 90 2 X 3,522.85 X
22210   1 90 2 X 3,739.80 X
22212   4 90 2 X 3,214.97 X
22212   3 90 2 X 3,253.68 X
22212   2 90 2 X 3,490.18 X
22212   1 90 2 X 3,547.42 X
22214   4 90 2 X 3,024.20 X
22214   3 90 2 X 3,059.83 X
22214   2 90 2 X 3,279.77 X
22214   1 90 2 X 3,332.95 X
22216   4 ZZZ 0 X 1,047.16 X
22216   3 ZZZ 0 X 1,062.89 X
22216   2 ZZZ 0 X 1,133.67 X
22216   1 ZZZ 0 X 1,187.16 X
22220   4 90 2 X 3,317.49 X
22220   3 90 2 X 3,356.87 X
22220   2 90 2 X 3,586.57 X
22220   1 90 2 X 3,642.12 X
22222   4 90 2 X 2,978.35 X
22222   3 90 2 X 3,013.43 X
22222   2 90 2 X 3,809.06 X
22222   1 90 2 X 4,144.22 X
22224   4 90 2 X 3,159.17 X
22224   3 90 2 X 3,195.76 X
22224   2 90 2 X 3,416.94 X
22224   1 90 2 X 3,470.59 X
22226   4 ZZZ 0 X 1,047.16 X
22226   3 ZZZ 0 X 1,062.89 X
22226   2 ZZZ 0 X 1,133.67 X
22226   1 ZZZ 0 X 1,187.16 X
22310   3 90 2 X 768.54 X
22310   4 90 2 X 823.57 X
22310   2 90 2 X 943.35 X
22310   1 90 2 X 954.72 X
22315   3 90 2 X 1,256.41 X
22315   1 90 2 X 1,354.82 X
22315   4 90 2 X 1,357.51 X
22315   2 90 2 X 1,395.94 X
22318   2 90 2 X 2,725.01 X
22318   3 90 2 X 2,725.01 X
22318   4 90 2 X 2,725.01 X
22318   1 90 2 X 3,109.96 X
22319   2 90 2 X 3,078.08 X
22319   3 90 2 X 3,078.08 X
22319   4 90 2 X 3,078.08 X
22319   1 90 2 X 3,513.92 X
22325   4 90 2 X 2,270.56 X
22325   3 90 2 X 2,295.92 X
22325   2 90 2 X 3,411.35 X
22325   1 90 2 X 3,424.67 X
22326   4 90 2 X 3,121.05 X
22326   3 90 2 X 3,158.10 X
22326   2 90 2 X 3,384.96 X
22326   1 90 2 X 3,439.92 X
22327   4 90 2 X 3,015.45 X
22327   2 90 2 X 3,261.55 X
22327   1 90 2 X 3,312.24 X
22327   3 90 2 X 3,421.96 X
22328   4 ZZZ 0 X 847.06 X
22328   3 ZZZ 0 X 860.07 X
22328   2 ZZZ 0 X 919.06 X
22328   1 ZZZ 0 X 962.94 X
22505   4 10 2 X 193.60 X
22505   2 10 2 X 202.10 X
22505   1 10 2 X 206.65 X
22505   3 10 2 X 308.95 X
22510   2 10 2 X 2,120.14 571.30
22510   3 10 2 X 2,120.14 571.30
22510   4 10 2 X 2,120.14 571.30
22510   1 10 2 X 2,427.92 615.64
22511   2 10 2 X 2,098.52 535.14
22511   3 10 2 X 2,098.52 535.14
22511   4 10 2 X 2,098.52 535.14
22511   1 10 2 X 2,406.32 577.05
22512   2 ZZZ 0 X 1,172.16 261.21
22512   3 ZZZ 0 X 1,172.16 261.21
22512   4 ZZZ 0 X 1,172.16 261.21
22512   1 ZZZ 0 X 1,345.54 279.67
22513   2 10 2 X 8,855.90 650.21
22513   3 10 2 X 8,855.90 650.21
22513   4 10 2 X 8,855.90 650.21
22513   1 10 2 X 10,304.04 702.78
22514   2 10 2 X 8,820.76 607.36
22514   3 10 2 X 8,820.76 607.36
22514   4 10 2 X 8,820.76 607.36
22514   1 10 2 X 10,267.33 657.04
22515   2 ZZZ 0 X 5,349.17 272.36
22515   3 ZZZ 0 X 5,349.17 272.36
22515   4 ZZZ 0 X 5,349.17 272.36
22515   1 ZZZ 0 X 6,233.01 292.75
22526   2 10 2 X 2,729.33 463.51
22526   3 10 2 X 2,729.33 463.51
22526   4 10 2 X 2,729.33 463.51
22526   1 10 2 X 3,304.07 531.95
22527   2 ZZZ 0 X 2,212.99 214.41
22527   3 ZZZ 0 X 2,212.99 214.41
22527   4 ZZZ 0 X 2,212.99 214.41
22527   1 ZZZ 0 X 2,689.92 244.77
22532   2 90 2 X 2,733.01 X
22532   3 90 2 X 2,733.01 X
22532   4 90 2 X 2,733.01 X
22532   1 90 2 X 3,113.09 X
22533   2 90 2 X 2,555.54 X
22533   3 90 2 X 2,555.54 X
22533   4 90 2 X 2,555.54 X
22533   1 90 2 X 2,890.87 X
22534   2 ZZZ 0 X 644.50 X
22534   3 ZZZ 0 X 644.50 X
22534   4 ZZZ 0 X 644.50 X
22534   1 ZZZ 0 X 733.97 X
22548   4 90 2 X 4,256.26 X
22548   3 90 2 X 4,307.36 X
22548   1 90 2 X 4,554.00 X
22548   2 90 2 X 4,622.76 X
22551   2 90 2 X 2,472.45 X
22551   3 90 2 X 2,472.45 X
22551   4 90 2 X 2,472.45 X
22551   1 90 2 X 2,793.40 X
22552   2 ZZZ 0 X 577.78 X
22552   3 ZZZ 0 X 577.78 X
22552   4 ZZZ 0 X 577.78 X
22552   1 ZZZ 0 X 649.26 X
22554   4 90 2 X 3,440.82 X
22554   3 90 2 X 3,465.12 X
22554   2 90 2 X 3,765.46 X
22554   1 90 2 X 3,866.99 X
22556   4 90 2 X 4,071.10 X
22556   3 90 2 X 4,119.95 X
22556   2 90 2 X 4,418.77 X
22556   1 90 2 X 4,491.05 X
22558   4 90 2 X 3,840.27 X
22558   3 90 2 X 3,886.19 X
22558   2 90 2 X 4,167.38 X
22558   1 90 2 X 4,235.47 X
22585   4 ZZZ 0 X 996.47 X
22585   3 ZZZ 0 X 1,008.43 X
22585   2 ZZZ 0 X 1,083.88 X
22585   1 ZZZ 0 X 1,102.13 X
22586   2 90 2 X 2,046.41 X
22586   3 90 2 X 2,046.41 X
22586   4 90 2 X 2,046.41 X
22586   1 90 2 X 2,286.24 X
22590   4 90 2 X 3,564.07 X
22590   3 90 2 X 3,643.89 X
22590   2 90 2 X 3,819.32 X
22590   1 90 2 X 4,086.50 X
22595   4 90 2 X 3,822.12 X
22595   3 90 2 X 3,868.93 X
22595   2 90 2 X 4,174.76 X
22595   1 90 2 X 4,248.71 X
22600   4 90 2 X 3,420.01 X
22600   3 90 2 X 3,461.59 X
22600   2 90 2 X 3,677.31 X
22600   1 90 2 X 3,838.12 X
22610   4 90 2 X 2,996.15 X
22610   2 90 2 X 3,263.15 X
22610   1 90 2 X 3,341.52 X
22610   3 90 2 X 3,385.28 X
22612   4 90 2 X 3,747.96 X
22612   1 90 2 X 3,764.37 X
22612   3 90 2 X 3,792.59 X
22612   2 90 2 X 3,841.91 X
22614   4 ZZZ 0 X 1,135.31 X
22614   3 ZZZ 0 X 1,152.47 X
22614   2 ZZZ 0 X 1,229.29 X
22614   1 ZZZ 0 X 1,286.50 X
22630   3 90 2 X 3,618.87 X
22630   4 90 2 X 3,983.17 X
22630   2 90 2 X 4,187.82 X
22630   1 90 2 X 4,251.82 X
22632   4 ZZZ 0 X 961.07 X
22632   3 ZZZ 0 X 975.80 X
22632   2 ZZZ 0 X 1,042.79 X
22632   1 ZZZ 0 X 1,092.64 X
22633   2 90 2 X 2,526.86 X
22633   3 90 2 X 2,526.86 X
22633   4 90 2 X 2,526.86 X
22633   1 90 2 X 2,851.97 X
22634   2 ZZZ 0 X 687.00 X
22634   3 ZZZ 0 X 687.00 X
22634   4 ZZZ 0 X 687.00 X
22634   1 ZZZ 0 X 774.98 X
22800   4 90 2 X 3,533.18 X
22800   3 90 2 X 3,577.04 X
22800   2 90 2 X 3,862.55 X
22800   1 90 2 X 3,931.52 X
22802   4 90 2 X 5,402.03 X
22802   3 90 2 X 5,452.12 X
22802   2 90 2 X 5,617.35 X
22802   1 90 2 X 5,689.07 X
22804   4 90 2 X 5,940.70 X
22804   3 90 2 X 6,029.41 X
22804   2 90 2 X 6,420.26 X
22804   1 90 2 X 6,712.27 X
22808   4 90 2 X 4,079.03 X
22808   3 90 2 X 4,139.06 X
22808   2 90 2 X 4,400.98 X
22808   1 90 2 X 4,599.25 X
22810   4 90 2 X 4,266.34 X
22810   3 90 2 X 4,315.25 X
22810   2 90 2 X 4,593.24 X
22810   1 90 2 X 4,660.65 X
22812   4 90 2 X 4,821.57 X
22812   3 90 2 X 4,879.62 X
22812   2 90 2 X 5,234.37 X
22812   1 90 2 X 5,320.20 X
22818   2 90 2 X 4,670.40 X
22818   3 90 2 X 4,670.40 X
22818   4 90 2 X 4,670.40 X
22818   1 90 2 X 5,340.19 X
22819   2 90 2 X 5,004.85 X
22819   3 90 2 X 5,004.85 X
22819   4 90 2 X 5,004.85 X
22819   1 90 2 X 5,686.47 X
22830   4 90 2 X 2,134.23 X
22830   3 90 2 X 2,160.73 X
22830   2 90 2 X 2,333.63 X
22830   1 90 2 X 2,375.44 X
22840   4 ZZZ 0 X 3,038.66 X
22840   3 ZZZ 0 X 3,289.29 X
22840   2 ZZZ 0 X 3,898.93 X
22840   1 ZZZ 0 X 3,951.93 X
22841     XXX 9 X * X
22842   4 ZZZ 0 X 3,403.14 X
22842   3 ZZZ 0 X 3,445.88 X
22842   1 ZZZ 0 X 3,818.92 X
22842   2 ZZZ 0 X 3,996.94 X
22843   4 ZZZ 0 X 1,647.20 X
22843   3 ZZZ 0 X 1,672.47 X
22843   2 ZZZ 0 X 1,787.19 X
22843   1 ZZZ 0 X 1,872.38 X
22844   4 ZZZ 0 X 2,012.87 X
22844   3 ZZZ 0 X 2,043.76 X
22844   2 ZZZ 0 X 2,183.91 X
22844   1 ZZZ 0 X 2,287.98 X
22845   4 ZZZ 0 X 2,779.53 X
22845   3 ZZZ 0 X 2,813.97 X
22845   2 ZZZ 0 X 3,056.92 X
22845   1 ZZZ 0 X 3,115.71 X
22846   4 ZZZ 0 X 1,520.98 X
22846   3 ZZZ 0 X 1,544.30 X
22846   2 ZZZ 0 X 1,650.20 X
22846   1 ZZZ 0 X 1,728.84 X
22847   4 ZZZ 0 X 1,689.78 X
22847   3 ZZZ 0 X 1,715.69 X
22847   2 ZZZ 0 X 1,833.40 X
22847   1 ZZZ 0 X 1,920.92 X
22848   4 ZZZ 0 X 1,102.11 X
22848   3 ZZZ 0 X 1,119.05 X
22848   2 ZZZ 0 X 1,195.88 X
22848   1 ZZZ 0 X 1,252.93 X
22849   4 90 2 X 2,235.16 X
22849   3 90 2 X 2,261.95 X
22849   2 90 2 X 2,425.67 X
22849   1 90 2 X 2,465.32 X