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2021 Workers' Compensation Part B Fee Schedule

30630-31635

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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
30630   3 90 2 X 1,226.47 X
30630   1 90 2 X 1,322.04 X
30630   4 90 2 X 1,382.12 X
30630   2 90 2 X 1,426.17 X
30801   3 10 2 X 122.24 X
30801   1 10 2 X 129.15 X
30801   2 10 2 X 131.96 X
30801   4 10 2 X 134.67 X
30802   4 10 2 X 259.23 X
30802   3 10 2 X 261.12 X
30802   2 10 2 X 267.28 X
30802   1 10 2 X 270.89 X
30901   4 0 2 X 140.77 120.96
30901   1 0 2 X 146.13 124.86
30901   2 0 2 X 148.13 126.93
30901   3 0 2 X 159.61 136.82
30903   3 0 2 X 220.95 X
30903   4 0 2 X 225.78 X
30903   2 0 2 X 232.02 X
30903   1 0 2 X 234.68 X
30905   4 0 2 X 344.98 X
30905   1 0 2 X 374.80 X
30905   2 0 2 X 385.46 X
30905   3 0 2 X 390.51 X
30906   1 0 2 X 345.11 X
30906   3 0 2 X 361.65 X
30906   2 0 2 X 412.07 X
30906   4 0 2 X 415.05 X
30915   3 90 2 X 1,085.96 X
30915   4 90 2 X 1,114.18 X
30915   2 90 2 X 1,148.16 X
30915   1 90 2 X 1,184.66 X
30920   3 90 2 X 1,756.60 X
30920   4 90 2 X 1,870.65 X
30920   2 90 2 X 1,884.95 X
30920   1 90 2 X 1,915.91 X
30930   3 10 2 X 183.26 X
30930   2 10 2 X 188.08 X
30930   4 10 2 X 190.09 X
30930   1 10 2 X 190.38 X
30999     YYY 2 X # X
31000   4 10 2 X 135.01 117.33
31000   3 10 2 X 135.35 117.29
31000   1 10 2 X 137.79 119.29
31000   2 10 2 X 139.38 120.60
31002   2 10 2 X 184.05 X
31002   4 10 2 X 211.14 X
31002   3 10 2 X 213.32 X
31002   1 10 2 X 224.00 X
31020   4 90 2 X 526.57 X
31020   2 90 2 X 543.72 X
31020   3 90 2 X 546.25 X
31020   1 90 2 X 580.03 X
31030   3 90 2 X 1,333.75 X
31030   4 90 2 X 1,336.28 X
31030   2 90 2 X 1,415.24 X
31030   1 90 2 X 1,453.10 X
31032   4 90 2 X 1,510.34 X
31032   3 90 2 X 1,521.25 X
31032   2 90 2 X 1,569.38 X
31032   1 90 2 X 1,662.48 X
31040   4 90 2 X 1,553.19 X
31040   3 90 2 X 1,572.31 X
31040   2 90 2 X 1,906.39 X
31040   1 90 2 X 1,988.53 X
31050   4 90 2 X 1,408.44 X
31050   3 90 2 X 1,413.92 X
31050   2 90 2 X 1,442.80 X
31050   1 90 2 X 1,449.69 X
31051   4 90 2 X 1,386.64 X
31051   3 90 2 X 1,404.26 X
31051   2 90 2 X 1,606.96 X
31051   1 90 2 X 1,616.30 X
31070   3 90 2 X 761.96 X
31070   2 90 2 X 792.45 X
31070   4 90 2 X 808.75 X
31070   1 90 2 X 852.17 X
31075   4 90 2 X 1,768.12 X
31075   3 90 2 X 1,790.74 X
31075   2 90 2 X 1,909.77 X
31075   1 90 2 X 1,938.39 X
31080   4 90 2 X 1,851.79 X
31080   3 90 2 X 1,874.23 X
31080   2 90 2 X 1,992.09 X
31080   1 90 2 X 2,020.58 X
31081   4 90 2 X 2,070.07 X
31081   3 90 2 X 2,095.18 X
31081   2 90 2 X 2,228.80 X
31081   1 90 2 X 2,261.08 X
31084   4 90 2 X 2,550.36 X
31084   3 90 2 X 2,622.74 X
31084   2 90 2 X 2,754.62 X
31084   1 90 2 X 2,796.00 X
31085   4 90 2 X 2,698.62 X
31085   3 90 2 X 3,440.11 X
31085   2 90 2 X 3,440.72 X
31085   1 90 2 X 3,502.49 X
31086   4 90 2 X 2,108.44 X
31086   3 90 2 X 2,134.37 X
31086   2 90 2 X 2,264.83 X
31086   1 90 2 X 2,542.26 X
31087   4 90 2 X 2,098.12 X
31087   3 90 2 X 2,123.56 X
31087   2 90 2 X 2,259.33 X
31087   1 90 2 X 2,292.13 X
31090   2 90 2 X 2,617.06 X
31090   3 90 2 X 2,656.49 X
31090   1 90 2 X 2,663.62 X
31090   4 90 2 X 2,682.83 X
31200   4 90 2 X 964.86 X
31200   3 90 2 X 971.21 X
31200   1 90 2 X 1,010.62 X
31200   2 90 2 X 1,011.93 X
31201   4 90 2 X 1,394.54 X
31201   3 90 2 X 1,404.26 X
31201   2 90 2 X 1,479.84 X
31201   1 90 2 X 1,500.32 X
31205   4 90 2 X 1,843.23 X
31205   3 90 2 X 1,851.65 X
31205   2 90 2 X 1,892.14 X
31205   1 90 2 X 1,901.90 X
31225   3 90 2 X 3,636.79 X
31225   4 90 2 X 3,681.96 X
31225   2 90 2 X 3,755.10 X
31225   1 90 2 X 3,908.56 X
31230   4 90 2 X 3,973.83 X
31230   3 90 2 X 4,023.32 X
31230   2 90 2 X 4,285.58 X
31230   1 90 2 X 4,348.80 X
31231   4 0 2 X 158.39 X
31231   3 0 2 X 160.44 X
31231   2 0 2 X 171.23 X
31231   1 0 2 X 173.85 X
31233   4 0 2 X 474.46 X
31233   3 0 2 X 479.18 X
31233   2 0 2 X 501.13 X
31233   1 0 2 X 506.37 X
31235   4 0 2 X 580.20 X
31235   3 0 2 X 587.64 X
31235   2 0 2 X 627.51 X
31235   1 0 2 X 637.12 X
31237   4 0 2 X 392.71 X
31237   3 0 2 X 437.34 X
31237   1 0 2 X 441.44 X
31237   2 0 2 X 458.85 X
31238   4 0 2 X 442.06 X
31238   3 0 2 X 470.55 X
31238   2 0 2 X 482.85 X
31238   1 0 2 X 759.16 X
31239   4 10 2 X 1,906.02 X
31239   3 10 2 X 2,031.02 X
31239   2 10 2 X 2,206.11 X
31239   1 10 2 X 2,390.14 X
31240   4 0 2 X 687.49 X
31240   3 0 2 X 699.33 X
31240   2 0 2 X 707.66 X
31240   1 0 2 X 713.15 X
31241   2 0 2 X 567.25 X
31241   3 0 2 X 567.25 X
31241   4 0 2 X 567.25 X
31241   1 0 2 X 616.43 X
31253   2 0 2 X 635.57 X
31253   3 0 2 X 635.57 X
31253   4 0 2 X 635.57 X
31253   1 0 2 X 689.90 X
31254   4 0 2 X 989.94 X
31254   3 0 2 X 1,002.61 X
31254   2 0 2 X 1,084.61 X
31254   1 0 2 X 1,085.43 X
31255   3 0 2 X 2,184.65 X
31255   4 0 2 X 2,197.72 X
31255   2 0 2 X 2,250.44 X
31255   1 0 2 X 2,265.54 X
31256   4 0 2 X 654.56 X
31256   3 0 2 X 662.84 X
31256   2 0 2 X 706.53 X
31256   1 0 2 X 717.02 X
31257   2 0 2 X 565.62 X
31257   3 0 2 X 565.62 X
31257   4 0 2 X 565.62 X
31257   1 0 2 X 613.90 X
31259   2 0 2 X 599.70 X
31259   3 0 2 X 599.70 X
31259   4 0 2 X 599.70 X
31259   1 0 2 X 650.98 X
31267   4 0 2 X 889.22 X
31267   3 0 2 X 900.99 X
31267   2 0 2 X 974.25 X
31267   1 0 2 X 991.87 X
31276   4 0 2 X 1,384.75 X
31276   3 0 2 X 1,404.07 X
31276   2 0 2 X 1,491.78 X
31276   1 0 2 X 1,532.00 X
31287   4 0 2 X 926.82 X
31287   3 0 2 X 1,162.00 X
31287   2 0 2 X 1,192.84 X
31287   1 0 2 X 1,198.82 X
31288   3 0 2 X 1,066.15 X
31288   4 0 2 X 1,067.87 X
31288   2 0 2 X 1,121.97 X
31288   1 0 2 X 1,138.81 X
31290   4 10 2 X 2,726.19 X
31290   3 10 2 X 4,056.47 X
31290   2 10 2 X 4,152.09 X
31290   1 10 2 X 4,328.32 X
31291   4 10 2 X 2,863.85 X
31291   3 10 2 X 4,102.54 X
31291   2 10 2 X 4,201.06 X
31291   1 10 2 X 4,378.06 X
31292   4 10 2 X 2,214.35 X
31292   3 10 2 X 3,171.45 X
31292   2 10 2 X 3,247.68 X
31292   1 10 2 X 3,384.46 X
31293   4 10 2 X 2,422.20 X
31293   3 10 2 X 3,467.39 X
31293   2 10 2 X 3,550.74 X
31293   1 10 2 X 3,700.32 X
31294   4 10 2 X 2,768.67 X
31294   3 10 2 X 3,963.73 X
31294   2 10 2 X 4,059.13 X
31294   1 10 2 X 4,230.18 X
31295   2 0 2 X 2,907.70 258.34
31295   3 0 2 X 2,907.70 258.34
31295   4 0 2 X 2,907.70 258.34
31295   1 0 2 X 3,280.85 283.01
31296   2 0 2 X 5,438.66 308.56
31296   3 0 2 X 5,438.66 308.56
31296   4 0 2 X 5,438.66 308.56
31296   1 0 2 X 6,142.52 337.66
31297   2 0 2 X 5,385.84 252.79
31297   3 0 2 X 5,385.84 252.79
31297   4 0 2 X 5,385.84 252.79
31297   1 0 2 X 6,085.04 276.91
31298   2 0 2 X 4,629.71 323.62
31298   3 0 2 X 4,629.71 323.62
31298   4 0 2 X 4,629.71 323.62
31298   1 0 2 X 5,292.54 351.57
31299     YYY 2 X # X
31300   3 90 2 X 2,490.54 X
31300   4 90 2 X 2,528.39 X
31300   2 90 2 X 2,595.63 X
31300   1 90 2 X 2,667.81 X
31360   4 90 2 X 3,491.56 X
31360   3 90 2 X 3,527.81 X
31360   2 90 2 X 3,709.17 X
31360   1 90 2 X 3,753.93 X
31365   3 90 2 X 4,932.44 X
31365   4 90 2 X 5,005.24 X
31365   2 90 2 X 5,239.51 X
31365   1 90 2 X 5,289.31 X
31367   4 90 2 X 3,346.16 X
31367   3 90 2 X 3,387.27 X
31367   2 90 2 X 3,596.46 X
31367   1 90 2 X 3,646.93 X
31368   4 90 2 X 4,694.30 X
31368   3 90 2 X 4,753.36 X
31368   2 90 2 X 5,153.54 X
31368   1 90 2 X 5,317.45 X
31370   4 90 2 X 3,300.21 X
31370   3 90 2 X 3,340.82 X
31370   1 90 2 X 3,598.94 X
31370   2 90 2 X 3,962.11 X
31375   4 90 2 X 3,071.10 X
31375   3 90 2 X 3,108.26 X
31375   2 90 2 X 3,290.85 X
31375   1 90 2 X 3,334.97 X
31380   4 90 2 X 3,319.70 X
31380   3 90 2 X 3,348.58 X
31380   2 90 2 X 3,557.01 X
31380   1 90 2 X 3,607.25 X
31382   4 90 2 X 3,195.67 X
31382   3 90 2 X 3,234.63 X
31382   2 90 2 X 3,432.74 X
31382   1 90 2 X 3,480.50 X
31390   4 90 2 X 4,954.23 X
31390   3 90 2 X 5,018.08 X
31390   1 90 2 X 5,627.94 X
31390   2 90 2 X 5,660.19 X
31395   4 90 2 X 5,717.44 X
31395   3 90 2 X 5,790.19 X
31395   1 90 2 X 6,313.15 X
31395   2 90 2 X 6,345.27 X
31400   4 90 2 X 2,418.00 X
31400   3 90 2 X 2,425.96 X
31400   2 90 2 X 2,467.24 X
31400   1 90 2 X 2,477.15 X
31420   4 90 2 X 1,580.28 X
31420   3 90 2 X 1,599.65 X
31420   2 90 2 X 1,696.47 X
31420   1 90 2 X 1,935.60 X
31500   4 0 0 X 298.82 X
31500   3 0 0 X 302.21 X
31500   2 0 0 X 317.93 X
31500   1 0 0 X 321.76 X
31502   4 0 2 X 114.76 X
31502   3 0 2 X 116.19 X
31502   2 0 2 X 123.49 X
31502   1 0 2 X 125.26 X
31505   4 0 2 X 88.04 71.18
31505   3 0 2 X 91.49 73.98
31505   2 0 2 X 96.13 77.77
31505   1 0 2 X 97.52 78.81
31510   4 0 3 X 225.83 X
31510   3 0 3 X 228.27 X
31510   2 0 3 X 238.25 X
31510   1 0 3 X 240.66 X
31511   4 0 3 X 284.45 X
31511   1 0 3 X 337.72 X
31511   2 0 3 X 356.39 X
31511   3 0 3 X 382.22 X
31512   4 0 3 X 356.48 X
31512   2 0 3 X 519.36 X
31512   3 0 3 X 522.09 X
31512   1 0 3 X 543.13 X
31513   3 0 3 X 494.97 X
31513   1 0 3 X 540.13 X
31513   2 0 3 X 584.43 X
31513   4 0 3 X 607.07 X
31515   4 0 2 X 270.52 X
31515   3 0 2 X 273.62 X
31515   2 0 2 X 289.29 X
31515   1 0 2 X 292.95 X
31520   4 0 2 X 386.40 X
31520   3 0 2 X 390.99 X
31520   2 0 2 X 412.52 X
31520   1 0 2 X 417.75 X
31525   4 0 2 X 444.51 X
31525   3 0 2 X 449.91 X
31525   2 0 2 X 476.57 X
31525   1 0 2 X 497.37 X
31526   4 0 2 X 518.16 X
31526   3 0 2 X 553.49 X
31526   2 0 2 X 591.83 X
31526   1 0 2 X 601.06 X
31527   4 0 3 X 576.13 X
31527   3 0 3 X 583.25 X
31527   2 0 3 X 618.25 X
31527   1 0 3 X 626.74 X
31528   4 0 3 X 467.48 X
31528   2 0 3 X 504.67 X
31528   3 0 3 X 555.55 X
31528   1 0 3 X 583.87 X
31529   4 0 3 X 473.56 X
31529   2 0 3 X 508.31 X
31529   1 0 3 X 515.29 X
31529   3 0 3 X 515.44 X
31530   4 0 3 X 649.86 X
31530   3 0 3 X 657.99 X
31530   2 0 3 X 700.30 X
31530   1 0 3 X 710.49 X
31531   4 0 3 X 829.19 X
31531   3 0 3 X 839.80 X
31531   2 0 3 X 842.38 X
31531   1 0 3 X 850.87 X
31535   3 0 3 X 675.46 X
31535   4 0 3 X 706.41 X
31535   2 0 3 X 744.55 X
31535   1 0 3 X 744.95 X
31536   4 0 3 X 764.17 X
31536   3 0 3 X 774.10 X
31536   2 0 3 X 831.57 X
31536   1 0 3 X 845.44 X
31540   4 0 3 X 879.11 X
31540   3 0 3 X 890.31 X
31540   2 0 3 X 952.39 X
31540   1 0 3 X 967.34 X
31541   4 0 3 X 908.65 X
31541   3 0 3 X 920.64 X
31541   2 0 3 X 1,040.44 X
31541   1 0 3 X 1,050.93 X
31545   2 0 3 X 661.27 X
31545   3 0 3 X 661.27 X
31545   4 0 3 X 661.27 X
31545   1 0 3 X 727.01 X
31546   2 0 3 X 1,008.52 X
31546   3 0 3 X 1,008.52 X
31546   4 0 3 X 1,008.52 X
31546   1 0 3 X 1,113.47 X
31551   2 90 2 X 1,828.27 X
31551   3 90 2 X 1,828.27 X
31551   4 90 2 X 1,828.27 X
31551   1 90 2 X 2,003.12 X
31552   2 90 2 X 1,844.01 X
31552   3 90 2 X 1,844.01 X
31552   4 90 2 X 1,844.01 X
31552   1 90 2 X 2,026.71 X
31553   2 90 2 X 2,009.35 X
31553   3 90 2 X 2,009.35 X
31553   4 90 2 X 2,009.35 X
31553   1 90 2 X 2,210.27 X
31554   2 90 2 X 2,111.68 X
31554   3 90 2 X 2,111.68 X
31554   4 90 2 X 2,111.68 X
31554   1 90 2 X 2,328.84 X
31560   3 0 3 X 1,605.61 X
31560   4 0 3 X 1,788.72 X
31560   2 0 3 X 1,818.63 X
31560   1 0 3 X 1,824.56 X
31561   3 0 3 X 1,304.30 X
31561   1 0 3 X 1,429.74 X
31561   4 0 3 X 1,934.49 X
31561   2 0 3 X 1,984.81 X
31570   4 0 3 X 852.58 X
31570   3 0 3 X 888.19 X
31570   1 0 3 X 963.76 X
31570   2 0 3 X 1,043.07 X
31571   3 0 3 X 877.22 X
31571   4 0 3 X 916.19 X
31571   1 0 3 X 975.77 X
31571   2 0 3 X 1,072.73 X
31572   2 0 3 X 619.21 234.83
31572   3 0 3 X 619.21 234.83
31572   4 0 3 X 619.21 234.83
31572   1 0 3 X 701.47 256.12
31573   2 0 3 X 332.50 193.63
31573   3 0 3 X 332.50 193.63
31573   4 0 3 X 332.50 193.63
31573   1 0 3 X 372.38 211.48
31574   2 0 3 X 1,262.49 193.63
31574   3 0 3 X 1,262.49 193.63
31574   4 0 3 X 1,262.49 193.63
31574   1 0 3 X 1,449.90 211.48
31575   4 0 2 X 247.39 180.61
31575   3 0 2 X 250.60 182.62
31575   2 0 2 X 313.98 229.83
31575   1 0 2 X 328.94 240.81
31576   3 0 3 X 516.38 X
31576   2 0 3 X 636.85 X
31576   4 0 3 X 639.73 X
31576   1 0 3 X 659.01 X
31577   1 0 3 X 597.81 X
31577   4 0 3 X 772.04 X
31577   2 0 3 X 789.87 X
31577   3 0 3 X 818.63 X
31578   4 0 3 X 655.62 X
31578   3 0 3 X 664.12 X
31578   2 0 3 X 712.13 X
31578   1 0 3 X 790.51 X
31579   3 0 3 X 384.26 X
31579   4 0 3 X 426.19 X
31579   2 0 3 X 443.79 X
31579   1 0 3 X 465.96 X
31580   4 90 2 X 2,186.81 X
31580   3 90 2 X 2,394.27 X
31580   2 90 2 X 2,560.75 X
31580   1 90 2 X 2,600.83 X
31584   4 90 2 X 2,869.40 X
31584   3 90 2 X 2,903.51 X
31584   2 90 2 X 3,065.71 X
31584   1 90 2 X 3,104.96 X
31587   4 90 2 X 1,404.61 X
31587   3 90 2 X 1,421.85 X
31587   2 90 2 X 1,509.66 X
31587   1 90 2 X 1,530.93 X
31590   4 90 2 X 1,404.61 X
31590   3 90 2 X 1,421.85 X
31590   2 90 2 X 1,509.66 X
31590   1 90 2 X 1,530.93 X
31591   2 90 2 X 1,331.84 X
31591   3 90 2 X 1,331.84 X
31591   4 90 2 X 1,331.84 X
31591   1 90 2 X 1,470.68 X
31592   2 90 2 X 2,165.78 X
31592   3 90 2 X 2,165.78 X
31592   4 90 2 X 2,165.78 X
31592   1 90 2 X 2,375.42 X
31599     YYY 2 X # X
31600   3 0 2 X 738.11 X
31600   4 0 2 X 779.62 X
31600   2 0 2 X 794.20 X
31600   1 0 2 X 807.72 X
31601   4 0 2 X 890.03 X
31601   3 0 2 X 901.12 X
31601   1 0 2 X 979.89 X
31601   2 0 2 X 988.27 X
31603   4 0 2 X 794.90 X
31603   3 0 2 X 804.56 X
31603   2 0 2 X 863.27 X
31603   1 0 2 X 877.44 X
31605   4 0 2 X 725.67 X
31605   3 0 2 X 734.79 X
31605   1 0 2 X 797.62 X
31605   2 0 2 X 807.09 X
31610   4 90 2 X 1,360.00 X
31610   3 90 2 X 1,376.33 X
31610   2 90 2 X 1,466.52 X
31610   1 90 2 X 1,488.27 X
31611   4 90 2 X 1,258.98 X
31611   3 90 2 X 1,275.41 X
31611   1 90 2 X 1,396.38 X
31611   2 90 2 X 2,586.81 X
31612   4 0 2 X 187.42 X
31612   3 0 2 X 189.46 X
31612   2 0 2 X 196.84 X
31612   1 0 2 X 198.61 X
31613   4 90 2 X 657.68 X
31613   3 90 2 X 660.54 X
31613   2 90 2 X 667.00 X
31613   1 90 2 X 677.37 X
31614   4 90 2 X 1,315.97 X
31614   3 90 2 X 1,322.22 X
31614   2 90 2 X 1,355.34 X
31614   1 90 2 X 1,363.26 X
31615   4 0 2 X 413.21 X
31615   3 0 2 X 417.88 X
31615   1 0 2 X 438.42 X
31615   2 0 2 X 454.91 X
31622   4 0 2 X 549.36 X
31622   3 0 2 X 556.46 X
31622   2 0 2 X 592.65 X
31622   1 0 2 X 601.39 X
31623   2 0 3 X 476.30 330.11
31623   3 0 3 X 476.30 330.11
31623   4 0 3 X 476.30 330.11
31623   1 0 3 X 535.80 364.72
31624   2 0 3 X 480.72 333.80
31624   3 0 3 X 480.72 333.80
31624   4 0 3 X 480.72 333.80
31624   1 0 3 X 540.54 368.69
31625   4 0 3 X 619.02 X
31625   3 0 3 X 626.85 X
31625   2 0 3 X 665.84 X
31625   1 0 3 X 675.19 X
31626   2 0 2 X 607.96 311.86
31626   3 0 2 X 607.96 311.86
31626   4 0 2 X 607.96 311.86
31626   1 0 2 X 688.37 337.20
31627   2 ZZZ 0 X 1,637.07 151.61
31627   3 ZZZ 0 X 1,637.07 151.61
31627   4 ZZZ 0 X 1,637.07 151.61
31627   1 ZZZ 0 X 1,925.86 164.17
31628   4 0 3 X 741.96 X
31628   3 0 3 X 751.67 X
31628   2 0 3 X 797.70 X
31628   1 0 3 X 808.85 X
31629   4 0 3 X 700.55 X
31629   3 0 3 X 701.12 X
31629   2 0 3 X 706.48 X
31629   1 0 3 X 716.25 X
31630   4 0 3 X 706.37 X
31630   3 0 3 X 790.85 X
31630   1 0 3 X 838.76 X
31630   2 0 3 X 851.98 X
31631   3 0 3 X 732.17 X
31631   4 0 3 X 765.94 X
31631   2 0 3 X 791.00 X
31631   1 0 3 X 804.77 X
31632   2 ZZZ 0 X 129.35 101.07
31632   3 ZZZ 0 X 129.35 101.07
31632   4 ZZZ 0 X 129.35 101.07
31632   1 ZZZ 0 X 146.75 113.52
31633   2 ZZZ 0 X 159.07 126.29
31633   3 ZZZ 0 X 159.07 126.29
31633   4 ZZZ 0 X 159.07 126.29
31633   1 ZZZ 0 X 178.56 140.07
31634   2 0 3 X 2,583.70 305.54
31634   3 0 3 X 2,583.70 305.54
31634   4 0 3 X 2,583.70 305.54
31634   1 0 3 X 2,906.18 328.36
31635   4 0 3 X 821.25 X
31635   3 0 3 X 856.89 X
31635   2 0 3 X 863.50 X
31635   1 0 3 X 884.93 X